The Willingness to Intervene Against Suicide Enhanced Questionnaire.

The purpose of this study was to test the reliability and validity of the Willingness to Intervene against Suicide Enhanced (WISE) questionnaire. The WISE is a revised version of the Willingness to Intervene against Suicide (WIS) questionnaire, which was based on the theory of planned behavior, and it has consistently predicted the intention to intervene with a suicidal individual. Evaluation of the WIS showed that it was internally consistent with adequate goodness-of-fit indices for three of the four scales. The subjective norms scale did not meet the goodness-of-fit indices standard cutoff criteria. Due to this, the WIS questionnaire has been revised into the WISE. However, the dimensionality of these factors needed to be tested. College students (n = 824) completed an online survey to test the WISE. The data were analyzed using confirmatory factor analysis, reliability analysis, and multiple regression. The WISE was internally consistent, and the scales met acceptable criteria for goodness-of-fit indices. The WISE explained a range of variance in participants' intention to intervene from 12 to 40%.

Occupational Suicide Exposure and Impact on Mental Health: Examining Differences Across Helping Professions.

The purpose of the current study was to examine the relationship of suicide exposure with depression, anxiety, and post-traumatic stress disorder across three occupational groups likely to be exposed to suicide (i.e., first responders, crisis workers, mental health professionals). An online survey was completed by 1,048 participants. Results indicated that first responders, mental health professionals, and crisis workers were all exposed to suicide in the routine course of their occupation. Exposure to suicide significantly impacted mental health, specifically on depression, anxiety, and PTSD symptoms. The level of exposure to suicide was associated with higher levels of depression, anxiety, and PTSD.

PAs' attitudes about adolescent suicide screening: The Theory of Planned Behavior.

OBJECTIVE: Suicide is an increasing public health problem for adolescents and young adults. The purpose of this study was to identify the frequency of physician assistants' (PAs') self-reported adolescent suicide risk assessments and to elicit salient beliefs regarding behavioral attitudes, norm referents, control factors, and intention to conduct suicide risk assessment with adolescents. METHODS: A convenience sample of PAs completed an anonymous cross-sectional questionnaire. Relationships were assessed using bivariate analyses and qualitative theme analysis. RESULTS: Forty-three PAs completed the questionnaire. Many PAs supported suicide risk assessment screening as a strategy to identify adolescents who are suicidal at an earlier stage of their illness; lack of time during the visit and problematic parental involvement were identified as barriers. CONCLUSIONS: PAs recognized that screening adolescents for suicide ideation may help prevent suicides. Their practice behaviors, however, did not correspond to this belief.

Suicide knowledge and intention to intervene: college students.

Objective: The revised Willingness to Intervene against Suicide questionnaire and the Expanded Revised Facts on Suicide Quiz were employed to examine the relationship between college students' knowledge about suicide and intention to intervene. Participants: College students (n = 515) participated, a majority being women and Caucasian. Methods: Participants completed an online survey. Data were analyzed in SPSS. Results: College students have poor knowledge of suicide facts; however, this low level of accurate knowledge was not associated with intention to intervene with a suicidal person. Attitudes, subjective norms, perceived behavioral control, sex, and no previous suicide attempt were all significant predictors of intention to intervene. Conclusions: These results challenge the notion that one must be well-informed in order to intend to take action.

Suicide Exposure in Crisis Workers.

Background: Crisis workers provide services to individuals who are in acute distress. There is no research examining personal and occupational exposure to suicide in these workers. Aims: We aimed to examine the prevalence of personal, occupational, and colleague suicide exposure among crisis workers, the mental health outcomes associated with suicide exposures, and perceived professional preparedness for client suicide. Method: Crisis workers (n = 115) completed an online survey assessing suicide exposure, depression, anxiety, and posttraumatic stress disorder. Results: Over a third of participants (33.9%, n = 37) reported that they had lost at least one client to suicide, with an average of 2.30 clients (SD = 4.47) lost to suicide. Over three quarters (77.1%, n = 81) of study participants reported they had experienced at least one personal loss to suicide. Those who perceived their relationship to the personal suicide as close or very close had significantly greater PTSD symptoms (M = 3.29, SD = 2.23) than those who perceived their relationship as not at all close, not close, or somewhat close (M = 1.38, SD = 1.69), t(20) = -2.10, p = .049. Limitations: Snowball sampling is the study's main limitation. Conclusion: The current study demonstrates that a substantial percentage of crisis workers are exposed to suicide and additional research is needed to determine how exposures impact practice and personal symptoms in this population.

Attitudes and Beliefs of Pediatric Residents and Physician Assistant Students Toward Screening Adolescents for Suicide in Primary Care.

INTRODUCTION: The objectives of this study were to: (1) describe attitudes of health professional trainees for conducting routine screening for suicidal ideation with adolescents; (2) identify the relationship between intention to conduct suicide risk assessments and behavioral attitudes, norm referents, and behavioral control; and (3) investigate the relationship between intention to conduct these assessments and self-reported clinic behavior. METHODS: Second-year physician assistant (PA) students and pediatric residents (MD) at 3 universities voluntarily completed an anonymous cross-sectional questionnaire. The questionnaire was guided by the Theory of Planned Behavior and included items about previous experience with suicide. Pearson correlation and multivariable linear regression were used to analyze the data. RESULTS: There were usable and complete data for 105 respondents (n = 105). The sample included PA students (89.52%, n = 94) and pediatric residents (10.48%, n = 11). Trainees were significantly more likely to have higher intention to conduct suicide risk assessments when they reported greater behavioral control (Std. ß = 0.34, p <0.001) and reported suicide being discussed during previous clinic visits as a student/resident (Std. ß = 0.21, p = 0.03), controlling for profession, race, behavioral attitudes, and norm referents. Trainees were significantly more likely to report conducting suicide risk assessments when they had greater behavioral control (Std. ß = 0.27, p = 0.01) and greater intention to conduct these assessments (Std. ß = 0.21, p = 0.03), controlling for profession, race, behavioral attitudes, and norm referents. DISCUSSION: Second-year PA students and pediatric residents support screening adolescents for suicide risk. Training on methods to increase behavioral control may increase rates of screenings.

Strategies to increase health literacy in the infant feeding series (TIFS): a six-lesson curriculum for low-income mothers.

Low literacy can be a serious barrier to educating audiences about important health issues. This article explicates strategies used to increase health literacy in The Infant Feeding Series, a six-lesson curriculum on infant feeding practices. The curriculum was developed by a multidisciplinary team of researchers, health educators, and community stakeholders with the primary goal of increasing low-income mothers' knowledge and self-efficacy to delay the introduction of solid foods into infants' diets. Strategies used to develop the low literate accessible materials include (a) incorporation of formative research and theory, (b) media components, (c) reading level assessment of materials, (d) review of materials by multiple stakeholders, (e) one-on-one home delivery, (f) pilot evaluation of lessons, and (g) a workbook incentive designed to integrate knowledge and motivate participants to complete the curriculum through scrapbook activities. These strategies are discussed as they relate to lesson content and curriculum effectiveness.

Suicide Prevention: College Students' Intention to Intervene.

The objective of this article was to examine college students' intention to intervene with a suicidal individual and examine the Willingness to Intervene against Suicide questionnaire (WIS). College students (n = 1065) completed an online questionnaire about their attitudes, subjective norms, and perceived behavioral control regarding suicide and suicide intervention as well as their intention to intervene with a suicidal individual. The data were analyzed using confirmatory factor analysis, reliability analysis, and multiple regression. It was found that the WIS significantly predicted intention to intervene with a suicidal individual. The WIS was internally consistent with adequate goodness-of-fit indices for three of the four sub-scales. The WIS is an effective tool for predicting intention to intervene; however, the subjective norms sub-scale should be revised to improve the model.

Using the Theory of Planned Behavior to Predict College Students' Intention to Intervene With a Suicidal Individual.

BACKGROUND: Suicide among college students is an issue of serious concern. College peers may effectively intervene with at-risk persons due to their regular contact and close personal relationships with others in this population of significantly enhanced risk. AIMS: The current study was designed to investigate whether the theory of planned behavior constructs predicted intention to intervene when a college peer is suicidal. METHOD: Undergraduate students (n = 367) completed an on-line questionnaire; they answered questions about their attitudes, subjective norms, perceived behavioral control regarding suicide and suicide intervention, as well as their intention to intervene when someone is suicidal. The data were analyzed using multiple regression. RESULTS: The statistical significance of this cross-sectional study indicates that the theory of planned behavior constructs predicts self-reported intention to intervene with a suicidal individual. CONCLUSION: Theory of planned behavior is an effective framework for understanding peers' intention to intervene with a suicidal individual.

The Willingness to Intervene Against Suicide Questionnaire.

Three studies resulted in the Willingness to Intervene Against Suicide Questionnaire. College students (ns = 172, 253, and 367) completed an online questionnaire based on theory of planned behavior constructs regarding suicide intervention. Exploratory factor analysis produced 10 factors: intervening will affect the suicidal person and the participant; important others recommend seeking help, suggesting the suicidal person see a counselor, and talking to the suicidal person; interpersonal and intervention self-efficacy; and intention to seek outside help, encourage to seek outside help, and recognize a need for action. The Willingness to Intervene Against Suicide Questionnaire assesses college students' willingness to intervene when someone is suicidal.

Exposure to suicide and identification as survivor. Results from a random-digit dial survey.

BACKGROUND: There is little empirical evidence regarding lifetime exposure to suicide or identification of those impacted by suicide deaths. Studies previously conducted used only convenience samples. AIMS: To determine the prevalence of suicide exposure in the community and those affected by suicide deaths. METHODS: A random digit dial sample of 302 adults. RESULTS: 64% of the sample knew someone who had attempted or died by suicide, and 40% knew someone who died by suicide. No demographic variables differentiated exposed versus unexposed, indicating that exposure to suicide cuts across demographics. Almost 20% said they were a "survivor" and had been significantly affected by a suicide death. Demographic variables did not differentiate groups. The relationship to the decedent was not related to self-identified survivor status; what did differentiate those individuals impacted by the death from those who did not was their perception of their relationship with the decedent. CONCLUSIONS: Kinship proximity and relationship category to the deceased appeared to be unrelated to survivor status, but perceived psychological closeness to the deceased showed a robust association with self-identified survivor status. We need an expanded definition of "suicide survivor" to account for the profound impact of suicide in the community.

The development of effective message content for suicide intervention: theory of planned behavior.

BACKGROUND: Each year there are over 31,000 suicides in the United States, constituting a significant problem in every respect. It is important for research efforts to focus on the communication elements involved in suicide prevention because the messages produced by individuals close to those who have suicidal thoughts have the potential to save a life. AIMS: The current manuscript presents the theory of planned behavior (TPB) as a foundation to increase understanding of what message content would be most effective to convince an individual to intervene when someone is suicidal. METHODS: Suicide and suicidal behaviors are briefly reviewed, as is the TPB. Then it is argued how and why TPB can help construct persuasive messages. RESULTS: The authors suggest that TPB guide the content of persuasive messages. Messages created in combination of persuasive theories with TPB are likely to encourage an individual to intervene when someone is suicidal. CONCLUSIONS: A key element to suicide prevention is intervention by close others. Use of TPB provides an increased understanding of how to persuade close individuals to intervene when an individual is suicidal.