Intention to Enact and Enactment of Gatekeeper Behaviors for Suicide Prevention: an Application of the Theory of Planned Behavior
Tóm tắt
Gatekeeper training for suicide prevention was evaluated on a college campus to examine the impact of training on gatekeeper enactment of behaviors in support of suicide prevention and identify predictors of enactment of gatekeeper behaviors. Trained gatekeepers (N = 216) displayed greater perceived knowledge and self-efficacy for suicide prevention and reported higher rates of self-reported actual gatekeeper behaviors, including inquiring about suicidal ideation and referring for mental health treatment when they encountered someone in distress, compared to their untrained counterparts (N = 169). Consistent with the Theory of Planned Behavior, SEM results indicated that attitudes, self-efficacy, and perceived knowledge explained intentions to engage in gatekeeper behaviors, accounting for 59% of the variance in intentions to inquire about suicidal ideation and supporting the role of attitudes and perceived behavioral control in intentions to act. These intentions explained self-reported actual gatekeeper behaviors among participants who encountered someone in distress, with each one-point increase in intention associated with nearly twice the likelihood of both inquiring about suicidal ideation and referring someone for mental health care. On the other hand, self-reported situational barriers were associated with a decreased likelihood of referral behavior, indicating the role of actual behavioral control over volitional actions. Findings support the value of gatekeeper training for promoting factors that influence the likelihood of action on behalf of suicide prevention.
Tài liệu tham khảo
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.
Ajzen, I. (2011). The theory of planned behavior: Reactions and reflections. Psychology and Health, 26, 1113–1127.
Ajzen, I. (2014). Constructing a theory of planned behavior questionnaire. Retrieved from http://people.umass.edu/aizen/pdf/tpb.measurement.pdf.
Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127, 142–161.
Albright, G. (2013). Kognito interactive: At risk for college students. In Using virtual role-play with avatars to build gatekeeper skills among college students and student leaders Retrieved from http://resources.kognito.com/us/kognito_study_student_version.pdf.
Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H, Freeman and Company.
Barnett, S. M., & Ceci, S. J. (2002). When and where do we apply what we learn?: A taxonomy for far transfer. Psychological Bulletin, 128, 612–637.
Blume, B. D., Ford, J. K., Baldwin, T. T., & Huang, J. L. (2010). Transfer of training: A meta-analytic review. Journal of Management, 36, 1065–1105.
Brown, C. H., Wyman, P. A., Brinales, J. M., & Gibbons, R. D. (2007). The role of randomized trials in testing interventions for the prevention of youth suicide. International Review of Psychiatry, 19, 1–15.
Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: A systematic review. Psychological Medicine, 33, 395–405.
Centers for Disease Control and Prevention (2015). WISQARS leading causes of death reports: National and regional. Retrieved from: http://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html
Cooke, R., & French, D. P. (2008). How well do the theory of reasoned action and theory of planned behavior predict intentions and attendance at screening programs? A meta-analysis. Psychology & Health, 23, 745–765.
Cross, W., Matthieu, M. M., Lezine, D., & Knox, K. L. (2010). Does a brief suicide prevention gatekeeper training program enhance observed skills? Crisis: The Journal of Crisis Intervention and Suicide Prevention, 31, 149–159.
Cross, W. F., Seaburn, D., Gibbs, D., Schmeelk-Cone, K., White, A. M., & Caine, E. D. (2011). Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. Journal of Primary Prevention, 32, 195–211.
Goldston, D. B., Walrath, C. M., McKeon, R., Puddy, R. W., Lubell, K. M., Potter, L. B., & Rodi, M. S. (2010). The Garrett Lee Smith Memorial Suicide Prevention Program. Suicide and Life Threatening Behavior, 40, 245–256.
Hamdi, E., Price, S., Qassem, T., Amin, Y., & Jones, D. (2008). Suicides not in contact with mental health services: Risk indicators and determinants of referral. Journal of Mental Health, 17, 398–409.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55.
Indelicato, N. A., Mirsu-Paun, A., & Griffin, W. D. (2011). Outcomes of a suicide prevention gatekeeper training on a university campus. Journal of College Student Development, 52, 350–361.
Isaac, M., Elias, B., Katz, L. Y., Belik, S. L., Deane, F. P., Enns, M. W., & Sareen, J. (2009). Gatekeeper training as a preventative intervention for suicide: A systematic review. Canadian Journal of Psychiatry, 54, 260–268.
Jackson, D. L. (2003). Revisiting sample size and number of parameter estimates: Some support for the n:Q hypothesis. Structural Equation Modeling: A Multidisciplinary Journal, 10, 128–141.
Johnson, L. A., & Parsons, M. E. (2012). Adolescent suicide prevention in a school setting use of a gatekeeper program. NASN School Nurse, 27, 312–317.
Keller, D. P., Schut, L. J., Puddy, R. W., Williams, L., Stephens, R. L., & McKeon, R. (2009). Tennessee lives count: Statewide gatekeeper training for youth suicide prevention. Professional Psychology: Research and Practice, 40, 126–133.
Klimes-Dougan, B., Klingbeil, D. A., & Meller, S. J. (2013). The impact of universal suicide-prevention programs on the help-seeking attitudes and behaviors of youths. Journal of Crisis Intervention and Suicide Prevention, 34, 82–97.
Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York: The Guilford Press.
Kraiger, K. (2002). Decision-based evaluation. In K. Kraiger (Ed.), Creating, implementing, and managing effective training and development (pp. 331–375). San Francisco, CA: Jossey-Bass.
Lamis, D. A., Underwood, M., & D'Amore, N. (2016). Outcomes of a suicide prevention gatekeeper training program among school personnel. Crisis. Advance online publication. doi:10.1027/0227-5910/a000414.
Lipson, S. (2013). A comprehensive review of mental health gatekeeper-trainings for adolescents and young adults. International Journal of Adolescent Medicine and Health, 26, 305–455.
Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: Exploring the question, weighing the merits. Structural Equation Modeling: A Multidisciplinary Journal, 9, 151–173.
Matthieu, M. M., Chen, Y., Schohn, M., Lantinga, L. J., & Knox, K. L. (2009). Educational preferences and outcomes from suicide prevention training in the veteran’s health administration: One-year follow-up with healthcare employees in upstate New York. Military Medicine, 174, 1123–1131.
Moore, J. T., Cigularov, K. P., Chen, P. Y., Martinez, J. M., & Hindman, J. (2011). The effects of situational obstacles and social support on suicide-prevention gatekeeper behaviors. Crisis, 32, 264–271.
Quinnett, P. (1995). QPR: Ask a question, save a life. Spokane, Washington: The QPR Institute.
Quinnett, P. (2014). QPR: Ask a question, save a life. Spokane, Washington: The QPR Institute Retrieved from www.qprinstitute.com.
Stuart, C., Waalen, J. K., & Haelstromm, E. (2003). Many helping hearts: An evaluation of peer gatekeeper training in suicide risk assessment. Death Studies, 27, 321–333.
Substance Abuse and Mental Services Health Administration (2014). SAMHSA’s National Registry for Evidence-based Programs and Practices. Retrieved from http://www.nrepp.samhsa.gov/ViewAll.aspx
Teo, A. R., Andrea, S. B., Sakakibara, R., Motohara, S., Matthieu, M. M., & Fetters, M. D. (2016). Brief gatekeeper training for suicide prevention in an ethnic minority population: A controlled intervention. BMC Psychiatry, 16, 1–9.
Tompkins, T. L., & Witt, J. (2009). The short-term effectiveness of a suicide prevention gatekeeper training program in a college setting of residence life advisers. Journal of Primary Prevention, 30, 131–149.
Topa, G., & Moriano, J. A. (2010). Theory of planned behavior and smoking: Meta-analysis and SEM model. Substance Abuse & Rehabilitation, 1, 23–33.
Walrath, C., Garraza, L., Reid, H., Goldston, D. B., & McKeon, R. (2015). Impact of the Garrett Lee Smith Youth Suicide Prevention Program on suicide mortality. American Journal of Public Health, 105, 986–993.
Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., & Pena, J. B. (2008). Randomized trial of a gatekeeper program for suicide prevention: One-year impact on secondary school staff. Journal of Counseling and Clinical Psychology, 76, 104–115.
Wyman, P. A., Brown, C. H., LoMurray, M., Schmeelk-Cone, K., Petrova, M., Yu, Q., & Wang, W. (2010). An outcome evaluation of the Sources of Strength suicide prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health, 100, 1653–1661.
Yakunina, E. S., Rogers, J. R., Waehler, C. A., & Werth, J. L. (2010). College students' intentions to seek help for suicidal ideation: Accounting for the help-negation effect. Suicide and Life-threatening Behavior, 40, 438–450.