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Don’t Invite Everyone! Training Variables Impacting the Effectiveness of QPR Trainings

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Abstract

Gatekeeper trainings have been increasingly utilized in response to rising suicide rates in youths. However, the extent to which common factors inherent to gatekeeper trainings impact training outcomes is largely understudied. As such, the present study explored how factors such as training size and trainer engagement abilities influenced trainee participation and outcomes (i.e. changes in attitudes, perceived behavioral control (PBC), and knowledge regarding suicide prevention). All trainees participated in a gatekeeper training; trainers were not randomly assigned. Mediation and moderation analyses were completed using the PROCESS macro for SPSS (Hayes in Introduction to mediation, moderation, and conditional process analysis: a regression-based approach, Guilford Press, New York, 2013). Trainee participation in a training was examined as a mediator of the relationship between the training size and training outcomes, while trainer engagement was examined as a moderator of the relationship between size of training and trainee participation. Size of training was significantly related to lower changes in participant knowledge, along with lower trainee participation in gatekeeper trainings. Trainee participation significantly mediated the relationship between size of training, attitudes, and PBC. Additionally, trainer engagement significantly moderated the association between size of training and trainee participation. The results of this study suggest that general gatekeeper training-related variables may influence participant outcomes, specifically through trainee participation.

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References

  • Abildso, C. G., Dyer, A., Kristjansson, A. L., Mann, M. J., Bias, T., Coffman, J., et al. (2018). Evaluation of an intimate partner violence training for home visitors using the theory of planned behavior. Health Promotion Practice, 19(2), 194–202.

    PubMed  Google Scholar 

  • Aguinis, H., Beaty, J. C., Boik, R. J., & Pierce, C. A. (2005). Effect size and power in assessing moderating effects of categorical variables using multiple regression: A 30-year review. Journal of Applied Psychology, 90, 94–107.

    Google Scholar 

  • Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.

    Google Scholar 

  • Aldrich, R. S., Wilde, J., & Miller, E. (2018). The effectiveness of QPR suicide prevention training. Health Education Journal, 77(8), 964–977.

    Google Scholar 

  • Arnold, H. J., & Feldman, D. C. (1981). Social desirability response bias in self-report choice situations. Academy of Management Journal, 24(2), 377–385.

    Google Scholar 

  • Arrizabalaga-López, M., de Jáuregui, D. R. F., Portillo, M. P., Martínez, O., Etaio, I., Mauleón, J. R., et al. (2018). A randomised controlled trial of a program based on the theory of planned behavior to promote fruit and vegetable intake among schoolchildren: PROFRUVE study protocol. BMC Public Health, 18(1), 827.

    PubMed  PubMed Central  Google Scholar 

  • Berkel, C., Mauricio, A. M., Schoenfelder, E., & Sandler, I. N. (2011). Putting the pieces together: An integrated model of program implementation. Prevention Science, 12, 23–33.

    PubMed  PubMed Central  Google Scholar 

  • Blatchford, P., Bassett, P., & Brown, P. (2011). Examining the effect of class size on classroom engagement and teacher–pupil interaction: Differences in relation to pupil prior attainment and primary vs. secondary schools. Learning and Instruction, 21(6), 715–730.

    Google Scholar 

  • Bollinger, B. J. (2019). Stand, Speak, Act: Using the Theory of Planned Behavior to evaluate a sexual assault bystander intervention campaign on a tri-campus university. Doctoral dissertation.

  • Bressoux, P., Kramarz, F., & Prost, C. (2009). Teachers’ training, class size and students’ outcomes: Learning from administrative forecasting mistakes. The Economic Journal, 119(536), 540–561.

    Google Scholar 

  • Suicide Prevention Resource Center. (2013). Comparison table of suicide prevention gatekeeper training programs. https://www.sprc.org/sites/default/files/migrate/library/SPRC_Gatekeeper_matrix_Jul2013update.pdf.

  • Cerel, J., Padgett, J. H., Robbins, V., & Kaminer, B. (2012). A state's approach to suicide prevention awareness: Gatekeeper training in Kentucky. Journal of Evidence-Based Social Work, 9(3), 283–292.

    PubMed  Google Scholar 

  • Christens, B. D., Speer, P. W., & Peterson, N. A. (2016). Assessing community participation: Comparing self-reported participation data with organizational attendance records. American Journal of Community Psychology, 57(3–4), 415–425.

    PubMed  Google Scholar 

  • Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53.

    Google Scholar 

  • Cross, W. F., Chen, T., Schmeelk-Cone, K., Tu, X., Kleinman, M., & Gould, M. S. (2017). Trainer fidelity as a predictor of crisis counselors’ behaviors with callers who express suicidal thoughts. Psychiatric Services, 68(10), 1083–1087.

    PubMed  Google Scholar 

  • 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. The Journal of Primary Prevention, 32(3–4), 195.

    PubMed  PubMed Central  Google Scholar 

  • Curtin, S. C., Heron, M., Miniño, A. M., & Warner, M. (2018). Recent increases in injury mortality among children and adolescents aged 10–19 years in the United States: 1999–2016. National Vital Statistics Reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 67(4), 1–16.

    Google Scholar 

  • Del Boca, F. K., & Darkes, J. (2003). The validity of self-reports of alcohol consumption: State of the science and challenges for research. Addiction, 98, 1–12.

    PubMed  Google Scholar 

  • Des Jarlais, D. C., Lyles, C., Crepaz, N., & the Trend Group. (2004). Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement. American Journal of Public Health, 94, 361–366.

    Google Scholar 

  • Dumesnil, H., & Verger, P. (2009). Public awareness campaigns about depression and suicide: A review. Psychiatric Services, 60(9), 1203–1213.

    PubMed  Google Scholar 

  • Finnerty, M. T., Rapp, C. A., Bond, G. R., Lynde, D. W., Ganju, V., & Goldman, H. H. (2009). The state health authority yardstick (SHAY). Community Mental Health Journal, 45(3), 228–236.

    PubMed  Google Scholar 

  • Forys, K., McKellar, J., & Moos, R. (2007). Participation in specific treatment components predicts alcohol-specific and general coping skills. Addictive Behaviors, 32(8), 1669–1680.

    PubMed  Google Scholar 

  • Gauld, D., & Miller, P. (2004). The qualifications and competencies held by effective workplace trainers. Journal of European Industrial Training, 28(1), 8–22.

    Google Scholar 

  • Hagger, M. S., Chan, D. K., Protogerou, C., & Chatzisarantis, N. L. (2016). Using meta-analytic path analysis to test theoretical predictions in health behavior: An illustration based on meta-analyses of the theory of planned behavior. Preventive Medicine, 89, 154–161.

    PubMed  Google Scholar 

  • Hangartner, R. B., Totura, C. M. W., Labouliere, C. D., Gryglewicz, K., & Karver, M. S. (2019). Benchmarking the “Question, Persuade, Refer” program against evaluations of established suicide prevention gatekeeper trainings. Suicide and Life-Threatening Behavior, 49(2), 353–370.

    PubMed  Google Scholar 

  • Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.

    Google Scholar 

  • Isaac, M., Elias, B., Katz, L. Y., Belik, S. L., Deane, F. P., Enns, M. W., et al. (2009). Gatekeeper training as a preventative intervention for suicide: A systematic review. The Canadian Journal of Psychiatry, 54(4), 260–268.

    PubMed  Google Scholar 

  • Kaplan, M. L., Asnis, G. M., Sanderson, W. C., Keswani, L., de Lecuona, J. M., & Joseph, S. (1994). Suicide assessment: Clinical interview vs. self-report. Journal of Clinical Psychology, 50(2), 294–298.

    CAS  PubMed  Google Scholar 

  • Litteken, C., & Sale, E. (2018). Long-term effectiveness of the question, persuade, refer (QPR) suicide prevention gatekeeper training program: Lessons from Missouri. Community Mental Health Journal, 54(3), 282–292.

    PubMed  Google Scholar 

  • Low, S., Van Ryzin, M. J., Brown, E. C., Smith, B. H., & Haggerty, K. P. (2014). Engagement matters: lessons from assessing classroom implementation of steps to respect: A bullying prevention program over a one-year period. Prevention Science, 15, 165–176.

    PubMed  Google Scholar 

  • Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., et al. (2005). Suicide prevention strategies: A systematic review. JAMA, 294(16), 2064–2074.

    CAS  PubMed  Google Scholar 

  • Massatti, R. R., Sweeney, H. A., Panzano, P. C., & Roth, D. (2008). The de-adoption of innovative mental health practices (IMHP): Why organizations choose not to sustain an IMHP. Administration and Policy in Mental Health and Mental Health Services Research, 35(1–2), 50–65.

    PubMed  Google Scholar 

  • Matsuo, M. (2014). Instructional skills for on-the-job training and experiential learning: An empirical study of Japanese firms. International Journal of Training and Development, 18(4), 225–240.

    Google Scholar 

  • McHugh, R. K., & Barlow, D. H. (2010). The dissemination and implementation of evidence-based psychological treatments: A review of current efforts. American Psychologist, 65(2), 73–84.

    Google Scholar 

  • Nix, R. L., Bierman, K. L., & McMahon, R. J. (2009). How attendance and quality of participation affect treatment response to parent management training. Journal of Consulting and Clinical Psychology, 77(3), 429.

    PubMed  PubMed Central  Google Scholar 

  • Oliver, P., Spee, K., Akroyd, S., & Wolfgramm, T. (2015). Gatekeeper evaluation report. Auckland: Ministry of Health.

    Google Scholar 

  • Pescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G. (2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry, 167(11), 1321–1330.

    Google Scholar 

  • Prihodova, L., Guerin, S., Tunney, C., & Kernohan, W. G. (2019). Key components of knowledge transfer and exchange in health services research: Findings from a systematic scoping review. Journal of advanced nursing, 75(2), 313–326.

    PubMed  Google Scholar 

  • Repenning, N. P. (2002). A simulation-based approach to understanding the dynamics of innovation implementation. Organization Science, 13(2), 109–127.

    Google Scholar 

  • Schumacher, J. A., Coffey, S. F., Walitzer, K. S., Burke, R. S., Williams, D. C., Norquist, G., et al. (2012). Guidance for new motivational interviewing trainers when training addiction professionals: Findings from a survey of experienced trainers. Motivational Interviewing: Training, Research, Implementation, Practice, 1(1), 7.

    Google Scholar 

  • Steinmetz, H., Knappstein, M., Ajzen, I., Schmidt, P., & Kabst, R. (2016). How effective are behavior change interventions based on the theory of planned behavior? Zeitschrift für Psychologie, 224(3), 216–233.

    Google Scholar 

  • Szeto, A. C., & Dobson, K. S. (2010). Reducing the stigma of mental disorders at work: a review of current workplace anti-stigma intervention programs. Applied and Preventive Psychology, 14(1–4), 41–56.

    Google Scholar 

  • Tait, L., & Michail, M. (2014). Educational interventions for general practitioners to identify and manage depression as a suicide risk factor in young people: A systematic review and meta- analysis protocol. Systematic Reviews, 3(1), 1–7.

    Google Scholar 

  • Taylor, S., Xia, Y., Do, A., Qin, S., & de Guzman, M. R. (2017). Health Rocks! program: The association of youth engagement with program outcomes. Presented at the National Youth at Risk Conference, 2017.

  • Tompkins, T. L., Witt, J., & Abraibesh, N. (2010). Does a gatekeeper suicide prevention program work in a school setting? Evaluating training outcome and moderators of effectiveness. Suicide and Life-Threatening Behavior, 40(5), 506–515.

    PubMed  Google Scholar 

  • Totura, C. M. W., Labouliere, C. D., Gryglewicz, K., & Karver, M. S. (2019). The role of youth trainee–trainer alliance and involvement in school-based prevention: A moderated-mediation model of student gatekeeper suicide prevention training. Administration and Policy in Mental Health and Mental Health Services Research, 46(2), 209–219.

    PubMed  Google Scholar 

  • Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., et al. (2008). Bridging the gap between prevention research and practice: The Interactive Systems Framework for dissemination and implementation. American Journal of Community Psychology, 41(3–4), 171–181.

    PubMed  Google Scholar 

  • Watson, K., Handal, B., & Maher, M. (2016). The influence of class size upon numeracy and literacy performance. Quality Assurance in Education, 24(4), 507–527.

    Google Scholar 

  • Witt, K., Milner, A., Allisey, A., Davenport, L., & LaMontagne, A. D. (2017). Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis. American Journal of Industrial Medicine, 60(4), 394–407.

    PubMed  Google Scholar 

  • Wright, K. B. (2005). Researching Internet-based populations: Advantages and disadvantages of online survey research, online questionnaire authoring software packages, and web survey services. Journal of Computer-Mediated Communication, 10(3), 1034.

    Google Scholar 

  • Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., et al. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104.

    PubMed  PubMed Central  Google Scholar 

  • Wyman, P. A., Henry, D., Knoblauch, S., & Brown, C. H. (2015). Designs for testing group-based interventions with limited numbers of social units: The dynamic wait-listed and regression point displacement designs. Prevention Science, 16(7), 956–966.

    PubMed  PubMed Central  Google Scholar 

  • Zisblatt, L., Hayes, S. M., Lazure, P., Hardesty, I., White, J. L., & Alford, D. P. (2017). Safe and competent opioid prescribing education: Increasing dissemination with a train-the-trainer program. Substance Abuse, 38(2), 168–176.

    PubMed  Google Scholar 

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Funding

This study was funded by the Substance Abuse and Mental Health Services Administration (Grant Number 1U79SM061748-01).

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Correspondence to Amanda L. Peterson.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of South Florida (Pro00019538) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Peterson, A.L., Monahan, M.F., Bender, A.M. et al. Don’t Invite Everyone! Training Variables Impacting the Effectiveness of QPR Trainings. Adm Policy Ment Health 48, 343–353 (2021). https://doi.org/10.1007/s10488-020-01078-3

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