MCHbest. NPM 7: Injury Hospitilization
Strategy. Implementation of Established, Evidence-based or Informed Suicide Prevention Programs
Approach. Apply implementation science and quality improvement for testing, adapting, sustainably implementing, and widely spreading established suicide prevention programs.
Overview. Specific suicide and self-harm prevention programming in school-based settings has been identified as moderately preventative. For example, programs such as Signs of Suicide; Question, Persuade and Refer; Sources of Strength, and The Good Behavior Game can be implemented at the school-level.1
Evidence. Moderate Evidence. This strategy has been tested more than once and results trend positive overall. See references below for peer-reviewed sources to support this strategy. It should be noted that the approach to use specific evidence-based/informed programs that have been shown to be effective can be used across child safety topics.2
Target Audience. School-Based/Student
Outcome. School-based interventions: A systematic review found evidence that school-based interventions "can be effective in improving a number of health outcomes. Four studies specifically reviewed school-based suicide prevention programs. One review of 16 programs identified two programs, Signs of Suicide and The Good Behavior Game, reduced suicide attempts, while other programs reduced suicide ideation and improvement in general life skills. [[citation]]
Examples from the Field. Access descriptions of ESMs dealing with suicide and self-harm prevention. Access descriptions of all current ESMs that generally use implementation science and quality improvement fto advance programs across child safety topics. You can use these ESMs to see how other Title V agencies are addressing the NPM.
The Tennessee Department of Health (TN-DOH) formed a state team of partners to reduce suicide and self harm among 10 - 19 year olds through sustainable implementation and spread of the gatekeeper program Question, Persuade and Refer (QPR). Conducting weekly survelliance, the TN-DOH monitored suicide-related behaviors and provided this information to the Tennessee Suicide Prevention Network. This partnership contributed to 111 QPR trainings to more than 3,700 adolescents in one year.
The Role of Title V. Title V agencies can use implementation science and quality improvement metods to identify pilot sites, support funding, train, and provide technical assistance (TA) for sustainable implementation and spread of evidence-based/informed strategies and programs.
- Establish an improvement team.
- Provide TA on building partnerships and accessing funding.
- Provide TA on implementation and spread using evidence-based/informed practices.
- Build and maintain a data collection system to drive decision making.
For additional suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies.
Sample ESMs. Using the approach “Apply implementation science and quality improvement for testing, adapting, sustainably implementing, and widely spreading established suicide prevention programs,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
1 Langley et al. (2009). The Improvement Guide (2nd ed.). Jossey-Bass: San Francisco, CA.
2 Abbott & Elliott, 2017; Burrus et al., 2012; Filene, Kaminski, Valle, & Cachat, 2013; Langford et al., 2014; MacArthur et al., 2018.