Effectiveness of suicide prevention gatekeeper training: 12-month follow-up of SafeTALK training to community members.

OBJECTIVE: Long-term assessments of gatekeeper training (GKT) with multiple follow-ups are rare. Therefore, the aim of the current analysis is to examine 12-month follow-up outcomes of SafeTALK training in addition to the earlier analysis of pre-, post-, and 6-month follow-up. METHOD: Two hundred and sixty two community volunteers participated in half-day (4-h) gatekeeper training sessions. Before, after, and 6- and 12-month follow-up surveys were used to assess participants' knowledge, efficacy, and reluctance to intervene. Linear mixed effects regression was used in statistical analysis. RESULTS: Fifty six participants (21.4%) completed the 12-month follow-up, representing an attrition rate of 78.6% from pre-test. Linear mixed model analysis revealed a significant, consistent effect for time for knowledge, efficacy, and reluctance. Post-hoc testing revealed significant differences between scores at pre-test and 12-month follow-up for GK knowledge and efficacy; however, no significant difference was seen between these time points for reluctance to intervene. No significant change was measured between the 6 and 12 months for any outcomes. GK knowledge and efficacy remained significantly above pre-test scores. CONCLUSION: The evaluation of the GKT demonstrated the long-term effectiveness of community-based suicide prevention training programs to improve and maintain GK knowledge and efficacy.

Preventing suicide; nurse education and the occluded issue of gender.

Suicide prevention training recommended as part of national suicidal strategies across the UK has contributed to a reduction in suicide. Previous studies have found suicide prevention training changes attitude and increases confidence in ability to utilise suicide prevention strategies. There is limited evidence relating to the different responses to suicide prevention training by females and males. As the majority of nurses are female it is important to know if they report the same increases in confidence after suicide prevention training. An exploratory study utilising a survey design and repeated measures was used to investigate the effect of SafeTALK training on the level of general perceived self-efficacy (GPSE) in student nurses and to observe for any gender-related differences. A sample (N = 128) of first year student nurses were asked to complete a GPSE assessment pre and post SafeTALK training. Males reported higher scores on both total pre and post-training scores of GPSE and on mean scores per question compared to females. An effect of time (F (1, 118) = 20.07, p = .001) but no effect of gender (F (1, 118) = 3.53, p = .06) was found. A post-hoc sample size calculation revealed that a replication of the current investigation with a sample size of N = 15 (males), N = 155 (females), would be likely to find a statistically significant difference between genders in GPSE scores. It may be prudent to consider joint facilitation, with both male and female facilitators of SafeTALK training sessions. Specific pedagogical strategies can also be used to promote an increase in self-efficacy in those people undertaking SafeTALK training.

Does the quality of safetalk motivational interviewing counseling predict sexual behavior outcomes among people living with HIV?

OBJECTIVE: Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention. METHODS: We used a structured instrument (the MISC 2.0 coding system) as well as a client-reported instrument to rate intervention sessions on aspects of MI quality. Then we correlated client-reported UAVI with specific counseling behaviors and the proportion of interactions that achieved MI quality benchmarks. RESULTS/CONCLUSION: Higher MISC-2.0 global ratings and a higher ratio of reflections to questions both significantly predicted fewer UAVI acts at 8-month follow-up. Analysis of client ratings, which was more exploratory, showed that clients who rated their sessions higher in counselor acceptance, client disclosure, and relevance reported higher numbers of UAVIs, whereas clients who selected higher ratings for perceived benefit were more likely to have fewer UAVI episodes. PRACTICE IMPLICATIONS: Further research is needed to determine the best methods of translating information about MI quality into dissemination of effective MI interventions with people living with HIV.