Evaluating the SOS suicide prevention program: a replication and extension

Robert H Aseltine Jr, Amy James, Elizabeth A Schilling, Jaime Glanovsky, Robert H Aseltine Jr, Amy James, Elizabeth A Schilling, Jaime Glanovsky

Abstract

Background: Suicide is a leading cause of death for children and youth in the United States. Although school based programs have been the principal vehicle for youth suicide prevention efforts for over two decades, few have been systematically evaluated. This study examined the effectiveness of the Signs of Suicide (SOS) prevention program in reducing suicidal behavior.

Methods: 4133 students in 9 high schools in Columbus, Georgia, western Massachusetts, and Hartford, Connecticut were randomly assigned to intervention and control groups during the 2001-02 and 2002-03 school years. Self-administered questionnaires were completed by students in both groups approximately 3 months after program implementation.

Results: Significantly lower rates of suicide attempts and greater knowledge and more adaptive attitudes about depression and suicide were observed among students in the intervention group. Students' race/ethnicity, grade, and gender did not alter the impact of the intervention on any of the outcomes assessed in this analysis.

Conclusion: This study has confirmed preliminary analysis of Year 1 data with a larger and more racially and socio-economically diverse sample. SOS continues to be the only universal school-based suicide prevention program to demonstrate significant effects of self-reported suicide attempts in a study utilizing a randomized experimental design. Moreover, the beneficial effects of SOS were observed among high school-aged youth from diverse racial/ethnic backgrounds, highlighting the program's utility as a universal prevention program.

Trial registration: clinicaltrials.gov NCT000387855.

Trial registration: ClinicalTrials.gov NCT00387855.

References

    1. CDC Youth suicide and attempted suicide. Morbidity and Mortality Weekly Report (MMWR) 2004;53:471.
    1. CDC . Health, United States. U.S. Department of Health and Human Services Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD; 2005. Death rates for suicide, according to sex, race Hispanic origin and age: United States, selected years 1950–2003.
    1. Joffe RT, Offord DR, Boyle MH. Ontario child health study: suicidal behavior in youth age 12–16 years. American Journal of Psychiatry. 1998;145:1420–1423.
    1. Kann L, Kinchen SA, Williams BI, Ross JG, Lowry R, Grunbaum JA, Kolbe LJ. Center for Disease Control and Prevention. Youth risk behavioral surveillance–United States. CDC Surveillance Summaries. 2000;49:22–25.
    1. Wagman Borowsky I, Ireland M, Resnick MD. Adolescent suicide attempts: risks and protectors. Pediatrics. 2001;107:485–493. doi: 10.1542/peds.107.3.485.
    1. Spirito A, Overholser J, Ashworth S, Morgan J, Benedict-Drew C. Evaluation of a suicide awareness curriculum for high school students. Journal of the American Academy of Child and Adolescent Psychiatry. 1988;27:700–711. doi: 10.1097/00004583-198811000-00007.
    1. Shaffer D, Garland A, Vieland V, Underwood M, Busner C. The impact of curriculum-based suicide prevention programs for teenagers. Journal for the American Academy of Adolescent Psychiatry. 1991;30:588–596.
    1. Portzky G, van Heeringen K. Suicide prevention in adolescents: a controlled study of the effectiveness of a school-based psycho-educational program. Journal of Child Psychology and Psychiatry. 2006;47:910–918. doi: 10.1111/j.1469-7610.2006.01595.x.
    1. Kalafat J, Elias M. An evaluation of a school-based suicide awareness intervention. Suicide and Life-Threatening Behavior. 1994;24:224–233.
    1. Aseltine RH, DiMartino R. An outcome evaluation of the SOS suicide prevention program. American Journal of Public Health. 2004;94:446–451.
    1. Gould M, Marrocco F, Kleinman M, Thomas J, Mostkoff K, Cote J, Davies M. Evaluating iatrogenic risk of youth suicide screening programs. Journal of the American Medical Association. 2005;293:1635–1643. doi: 10.1001/jama.293.13.1635.
    1. Shaffer D, Vieland V, Garland A, Rojas M, Underwood M, Busner C. Adolescent suicide attempters: Response to suicide prevention programs. Journal of the American Medical Association. 1991;264:3151–55. doi: 10.1001/jama.264.24.3151.
    1. Jacobs DG, Brewer M, Klein-Benheim M. Suicide assessment: an overview and recommended protocol. In: Jacobs DG, editor. The Harvard Medical School Guide to Suicide Assessment and Intervention. San Francisco, CA: Jossey-Bass; 1999. pp. 3–39.
    1. Aseltine RH. Evaluation of a school based suicide prevention program. Adolescent and Family Health. 2003;3:81–88.
    1. Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME. NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychology. 2000;39:28–38. doi: 10.1097/00004583-200001000-00014.
    1. Lucas CP, Zhang H, Fisher PW, Shaffer D, Regier DA, Narrow WE, Bourdan K, Dulcan MK, Canino G, Rubio-Stipec M, Lahey BB, Frimen P. The DISC Predictive Scales (DPS): efficiently screening for diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry. 2001;40:443–449. doi: 10.1097/00004583-200104000-00013.
    1. Research Triangle Institute SUDAAN 9.0.1. NC: Research Triangle Park. 2004.
    1. Sankoh AJ, Huque MF, Dubey SD. Some comments on frequently used multiple endpoint adjustment methods in clinical trials. Statistical Methods. 1997;16:2529–2542.
    1. Aicken M, Gensler H. Adjusting for multiple testing when reporting research results: the Bonferroni vs Holm methods. American Journal of Public Health. 1996;86:726–728.
    1. Raudenbush SW, Spybrook J, Liu X, Congdon R. Optimal design for longitudinal and multilevel research. version 155, Software Documentation. 2005.

Source: PubMed

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