School-based multidisciplinary student-led clinics in health and Australian accreditation standards: A scoping review.

INTRODUCTION: Student-led clinics can provide health services to marginalised groups where service offerings are sparse or difficult to access, such as rural areas. Offering these services to children and young people can promote health and well-being by addressing the individual challenges and the social determinants of health. There is uncertainty, however, as to whether student-led clinics can meet Australian accreditation standards for health professionals completing degree programs. OBJECTIVE: This study aims to determine the capacity for health student placements in school-based student-led clinics to meet accreditation standards. DESIGN: A systematic scoping review was conducted based on Arksey and O'Malley's framework and the PRISMA-ScR statement. SETTING: Several databases were examined, including Ebsco (Academic Source and CINAHL), ProQuest (PsycINFO, ERIC) and grey literature sources along with a desktop review of accreditation standards across seven health disciplines. Two independent reviewers screened eligible studies. FINDINGS: The search retrieved 1037 records with 65 full-text papers assessed for eligibility. Eleven papers met the inclusion criteria. Based on the evidence, both nursing and exercise and sports science accreditation standards were best suited to student-led clinics. DISCUSSION: Although broad categories of work-integrated learning activities were applied, it appears feasible to expect accreditation standards for health disciplines at an Australian university to be a good fit for health student-led school-based clinics. CONCLUSION: Increasing health student placement opportunities within student-led clinics can improve the health and well-being of children and young people in regional, rural and remote (RRR) areas of Australia who may otherwise have limited access to allied health services.

Co-creation of new knowledge: Good fortune or good management?

BACKGROUND: Potential solutions to bridging the research practice gap include collaborative frameworks and models. Yet there is little evidence demonstrating their application in practice. In addressing this knowledge gap, this in-depth case study explored how the co-creation of new knowledge framework and its four collaborative processes (co-ideation, co-design, co-implementation, and co-evaluation) are utilised to support people who had attempted suicide through an Australian psychoeducational program known as Eclipse. METHODS: Using a case study design and a thematic analysis methodology, multiple sources of qualitative data (collaborative group discussion, personal communications) were analysed inductively and deductively to examine the implementation of co-creation and explore the perspectives of researchers and stakeholders about co-creation and collaborative relationships. RESULTS: Three broad themes were identified: (1) understanding the language and practice of co-creation, (2) perception of trust formation, and (3) the value of co-creation opportunities. Ultimately, implementing co-creation with or between researchers, industry and people with lived experience requires trust, reciprocity, good fortune, and good management. While implementing co-creation, the co-creation framework was revised to include additional elements identified as missing from the initially proposed framework. CONCLUSION: Co-creation of new knowledge poses many challenges to researchers and stakeholders, particularly regarding its "messiness" and non-linear approach to implementation and evaluation. However, as this case study demonstrates, it has the potential to become an alternative framework of best practice for public health interventions in third sector organisations, most notably as it eliminates the often-lengthy gap reported between research evidence and translation into practice. The research highlights the need for co-creation to further study its effectiveness in integrating research and service delivery to generate new knowledge. This may lead to a cultural and behavioural change in the service provider's approach to research, offering better outcomes for providers, clients, policymakers, universities, and funders.

Organisations and researchers need to collaborate to produce new knowledge of health interventions. The literature identifies that there is a substantial evidence gap between producing knowledge and improving health outcomes. Here we reflect, via a case study methodology, on ways to co-create new knowledge by following a four-step collaborative process. The case study reviews the evaluation of an Australian-based psychoeducational program for people who attempt suicide by analysing multiple qualitative data sources to explore the perspectives of researchers and stakeholders. We discovered the need for a shared language of co-creation that focuses on experiences of collaboration while seeking out new value-creation opportunities and dismantling barriers. We learnt that implementing co-creation requires trust and good fortune within collaborative relationships alongside good management. Using the alternative collaboration framework of best practice for public health interventions in third sector organisations may eliminate gaps between research evidence and translation into practice, assisting health providers, clients, policymakers, universities, and funders.

Evidence of co-creation practices in suicide prevention in government policy: a directed and summative content analysis.

BACKGROUND: In Australia, the collaborative involvement of stakeholders, especially those with lived experience in mental health and suicide prevention, has become important to government policy and practice at Federal and State levels. However, little is known about how governments translate this intention into frameworks of co-creation for policy, funding programs, service improvement, and research and evaluation. We investigated the extent to which publicly available government policies refer to collaborative practice using an established translation model. METHODS: An exploratory directed and summative content analysis approach was used to analyse the contents of Federal (also known as Commonwealth), State and Territories policy documents on mental health and suicide prevention published in Australia between 2010 and 2021. The data was extracted, compared to an existing translation model, and summated to demonstrate the evidence of co-creation-related concepts between government and stakeholders. RESULTS: 40 policy documents (nine at the Federal and 31 at the State and Territory level) were identified and included in the analysis. Only 63% of policy documents contained references to the concept of co-design. Six of the State policies contained references to the concept of co-production. Across all policy documents, there were no references to other concepts in the model adopted for this study, such as co-creation, co-ideation, co-implementation, and co-evaluation. CONCLUSION: Although the government at Federal, State and Territory levels appear to support collaborative practice through partnership and co-design, this study suggests a narrow approach to the theoretical model for co-creation at a policy level. Implications for both research and practice are discussed.

Effectiveness of Brief Contact Interventions for Bereavement: A Systematic Review.

Brief contact interventions are an efficient and cost-effective way of providing support to individuals. Whether they are an effective bereavement intervention is not clear. This systematic review included articles from 2014 to 2021.711 studies were identified, with 15 meeting inclusion criteria. The brief contact interventions included informational and emotional supports. Narrative synthesis identified that participants valued brief contact interventions, however some did not find them helpful. Exposure to a brief contact intervention was typically associated with improvements in wellbeing. Studies with comparison groups typically found significant but modest improvements in grief, depression symptoms and wellbeing associated with the intervention. However, one intervention was associated with significant deterioration of depression symptoms. Existing brief contact interventions for bereavement appear feasible, generally acceptable to the target population and are associated with improvements in wellbeing. Further development and evaluation to account for why improvements occur, and to identify any unintended impacts, is required.

A Psychoeducational Support Group Intervention for People Who Have Attempted Suicide: An Open Trial with Promising Preliminary Findings.

Psychoeducational groups have been used to address many health needs. Yet, there are few such options available for people who have attempted suicide. This study presents preliminary findings from an open trial of Eclipse, an 8-week closed, psychoeducational group for people who have attempted suicide. It examined the effectiveness of the Eclipse program in reducing suicidal ideation, depressive symptoms, perceived burdensomeness and thwarted belongingness, and increasing resilience and help-seeking. Results showed statistically significant improvements in depressive symptoms, perceived burdensomeness, resilience and help-seeking from baseline (T1) to immediate post-test (T2), and in perceived burdensomeness from T1 to 1-month follow-up (T3). A pervasiveness analysis showed that over half of the participants reported improvements in key study outcomes, respectively, as a result of participating in the Eclipse group. Psychoeducational support groups could provide broad application for those who have previously attempted suicide in decreasing severity of suicidal thinking by reductions in depressive symptoms, burdensomeness, and thwarted belongingness.

A mixed-methods systematic review of suicide prevention interventions involving multisectoral collaborations.

BACKGROUND: Governments and third-sector organizations (TSOs) require support to reduce suicide mortality through funding of suicide prevention services and innovative research. One way is for researchers to engage individuals and services in multisectoral collaborations, to collaboratively design, develop and test suicide prevention services and programmes. However, despite widespread support, to date, it remains unclear as to the extent to which stakeholders are being included in the research process, or if they are, how these partnerships occur in practice. To address this gap, the authors conducted a systematic review with the aim of identifying evidence of multisectoral collaborations within the field of suicide prevention, the types of stakeholders involved and their level of involvement. METHODS: The authors conducted a strategic PRISMA-compliant search of five electronic databases to retrieve literature published between January 2008 and July 2021. Hand-searching of reference lists of key systematic reviews was also completed. Of the 7937 papers retrieved, 16 papers finally met the inclusion criteria. Because of data heterogeneity, no meta-analysis was performed; however, the methodological quality of the included studies was assessed. RESULTS: Only one paper included engagement of stakeholders across the research cycle (co-ideation, co-design, co-implementation and co-evaluation). Most stakeholders were represented by citizens or communities, with only a small number of TSOs involved in multisectoral collaborations. Stakeholder level of involvement focused on the co-design or co-evaluation stage. CONCLUSION: This review revealed a lack of evidence of multisectoral collaborations being established between researchers and stakeholders in the field of suicide prevention research, even while such practice is being espoused in government policies and funding guidelines. Of the evidence that is available, there is a lack of quality studies documenting the collaborative research process. Also, results showed that the inclusion of co-researchers from communities or organizations is defined as co-creation, but further analysis revealed that collaboration was not consistent across the duration of projects. Researchers and practitioners should consider issues of power and equity in multisectoral collaborations and encourage increased engagement with TSOs, to rigorously research and evaluate suicide prevention services.

Effective Elements for Workplace Responses to Critical Incidents and Suicide: A Rapid Review.

Despite high rates of critical incidents (CIs) in working class occupations, there is a significant gap in our understanding of responses to these events. In this study, we aimed to inform a response training module by synthesising the key elements of pre-, during- and post-incident responses to CIs and suicide in the workplace. A rapid review identified studies on responses to CIs or suicide deaths in the workplace published between January 2015 and June 2020. A systematic search of six databases (Medline, CINAHL, PsycINFO, Sociology Collection, Academic Search and Business Search Complete) and grey literature was performed. Studies were excluded if the focus was on non-colleagues. Two reviewers independently conducted record screening, a review of the full text and assessed study quality. The existing evidence was synthesised and interventions were categorised using Haddon's Matrix. Five studies were included, reporting on CIs across a range of workplace settings, including railways, factories, police and military, along with external critical response units. Overall, study quality was assessed as being poor. Most of the evidence focused on the pre-incident and post-incident stage. There is little evidence on responses to CIs in the workplace. Evidence-based education and training is necessary to establish organisational responses to assist with supporting workers exposed to workplace CIs.

What Is the Co-Creation of New Knowledge? A Content Analysis and Proposed Definition for Health Interventions.

Co-creation of new knowledge has the potential to speed up the discovery and application of new knowledge into practice. However, the progress of co-creation is hindered by a lack of definitional clarity and inconsistent use of terminology. The aim of this paper is to propose a new standardised definition of co-creation of new knowledge for health interventions based on the existing co-creation literature. The authors completed a systematic search of electronic databases and Google Scholar using 10 of the most frequently used co-creation-related keywords to identify relevant studies. Qualitative content analysis was performed, and two reviewers independently tested the categorisation of papers. Of the 6571 papers retrieved, 42 papers met the inclusion criteria. Examination of the current literature on co-creation demonstrated how the variability of co-creation-related terms can be reduced to four collaborative processes: co-ideation, co-design, co-implementation and co-evaluation. Based on these four processes, a new definition of co-creation of new knowledge for health interventions is proposed. The analysis revealed the need to address the conceptual ambiguity of the definition of "co-creation of new knowledge". The proposed new definition may help to resolve the current definitional issues relating to co-creation, allowing researchers and policymakers to progress the development of co-creation of new knowledge in research and practice.

Providing support following exposure to suicide: A mixed method study.

Exposure to suicide and the associated impacts for those left behind can be long lasting and traumatic. Literature has predominantly examined the experience of suicide and impact from the perspective of those closest to the deceased-with studies primarily focused on kin relationships. Appropriate and timely support delivered by skilled professionals, through the provision of postvention support, has been suggested as a way to reduce morbidity and mortality associated with exposure to suicide. The evidence regarding what support, for whom, and the timing of support is scarce. As an extension of this scarcity, there is minimal research examining the ways in which provision of this postvention (that is, support following exposure to suicide) support impacts workers. This paper explores service use data gathered to evaluate a nation-wide Australian suicide postvention service, in conjunction with qualitative data from those providing postvention support to those exposed to suicide to understand who accesses support and the impact of providing such support on service providers. Postvention workers provide insight into the demands of responding to suicide, the pressure of being on call, and the ways in which they are able to maintain their well-being through external supervision.

Improving the evidence base for services working with youth at-risk of involvement in the criminal justice system: developing a standardised program approach.

BACKGROUND: Young people who engage in multiple risk behaviour (high-risk young people) such as substance abuse, antisocial behaviour, low engagement in education and employment, self-harm or suicide ideation are more likely to experience serious harms later in life including homelessness, incarceration, violence and premature death. In addition to personal disadvantage, these harms represent an avoidable social and economic cost to society. Despite these harms, there is insufficient evidence about how to improve outcomes for high-risk young people. A key reason for this is a lack of standardisation in the way in which programs provided by services are defined and evaluated. METHODS: This paper describes the development of a standardised intervention model for high-risk young people. The model can be used by service providers to achieve greater standardisation across their programs, outcomes and outcome measures. To demonstrate its feasibility, the model is applied to an existing program for high-risk young people. CONCLUSIONS: The development and uptake of a standardised intervention model for these programs will help to more rapidly develop a larger and more rigorous evidence-base to improve outcomes for high-risk young people.

A Systematic Mapping of Suicide Bereavement and Postvention Research and a Proposed Strategic Research Agenda.

BACKGROUND: Suicide may have disruptive and/or devastating effects on family, friends, and the broader community. Of late, increased interest from suicide researchers has given rise to an upsurge in research productivity addressing suicide bereavement and postvention. At this critical juncture, the establishment of an agenda will help guide the direction of future scholarly research in this field. AIMS: To conduct an exhaustive systematic mapping review and bibliometric analysis of peer-reviewed suicide bereavement and postvention research published over the past 50 years. METHOD: A comprehensive and strategic search of electronic databases and web-based search engines for original research studies was conducted resulting in the identification of 443 articles. RESULTS: Since 1965, the global research activities in the field of suicide bereavement and postvention is approximately 8.86 papers per year. There remains a lack of evaluation studies on the effects of interventions/programs with the majority of papers being explanatory in nature. Several areas of study within this field remain neglected. LIMITATIONS: While the search strategy was rigorous, potential limitations exist due to nonstandardized nomenclature and English language only inclusion, which inherently favors research from high-income countries. CONCLUSION: Suggested topics for a research agenda are proposed from the current limitations in the field.

Is Exposure to Suicide Beyond Kin Associated with Risk for Suicidal Behavior? A Systematic Review of the Evidence.

Suicide bereavement and postvention literature often espouses risk for subsequent suicidal behavior among those previously exposed to a suicide death. Most often risk is discussed in relation to kin; however, many more individuals are exposed to suicide, and the impact of this exposure is important to understand in relation to targeting postvention. This review examined the research literature (1990-2014) to determine the evidence base for risk among those exposed to suicide. The findings demonstrate that risk of suicidal behaviors among those exposed to the suicide is significantly higher than those unexposed. These results are discussed within the context of current research in the field of postvention, and suggestions for future research are suggested.