Program evaluation of a suicide prevention training for primary care

Abstract

Background: More than a third of people who die by suicide visited their primary care provider in the month before their death. Primary care staff thus have a valuable opportunity to treat this preventable public health problem. However, in order to do so successfully they require appropriate and effective training. If a person presenting with suicide risk has a negative experience when opening up to a health care professional, it may lead to further despair and silence.

Despite the clear need for education in this area, existing trainings often do not meet the content needs and time constraints of primary care staff. Often, the content is insufficient in addressing the challenges faced by providers when dealing with suicide concerns in their practice. Also, available trainings often fail to consider the time constraints primary care staff face which is a barrier for training in the first place. A recently developed video-based training, called SafeSide Primary CARE aims to address these requirements and to equip providers with the necessary tools to tackle suicide risk in the primary care context. Initial studies of early versions of this training have yielded promising results, leading to a further iteration that now requires evaluation. Objective: This dissertation describes a program evaluation of SafeSide Primary CARE encompassing 4 primary care practices plus nursing students from an Ivy League School in the northeast of the US. A total of 130 primary care staff and nursing students participated in this evaluation. These staff included physicians, nurse practitioners, physician assistants, staff nurses, and administrative personnel. Methods: Participants were invited to complete a pre-test that included knowledge and self-efficacy items, as well as questions about their role and experience. They participated in three 50-minute sessions of SafeSide Primary CARE training. After the training, participants completed a post-training evaluation of knowledge, self-efficacy, and their perception of their ability to transfer training to a clinical setting, as well as an assessment of overall satisfaction. Results: Knowledge and self-efficacy items were analyzed using a paired t- test and revealed statistically significant gains. Data on perceptions of ability to transfer training

and overall satisfaction collected in the post-test assessment were examined in relation to different learner groups with very positive results. Open-ended questions revealed themes that pointed towards changes in attitudes, knowledge skills and practice in suicide prevention. Conclusion: These findings are in line with prior program evaluations of the preceding iterations of the SafeSide Primary CARE training. This program evaluations demonstrates that the SafeSide Primary CARE program provides a training model and content that is relevant to the Primary CARE. The results of this program evaluation will aid the development of future iterations of this training, which will have a direct impact on providers and staff.