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Motivating Behavior Change in Parents for Suicide Prevention in the Midwest, USA

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Abstract

Safe storage of lethal means is an evidence-based approach to suicide prevention that is underutilized. This naturalistic study investigated whether a presentation on parenting teenagers that includes education about safe storage of firearms and medications, paired with tools to enact change, can impact storage practices. Ten community presentations for parents were given between November 2018 and September 2019 in the Midwest region of the United States. Multiple topics pertinent to parenting adolescents were included with an emphasis on safe storage of firearms and medications to reduce suicide risk. Toolkits including medication storage boxes and cable gun locks were offered to help parents enact recommended changes. Surveys were completed prior to the presentation (T1), immediately following the presentation (T2), and 2 weeks after the presentation (T3). Five-hundred eighty-one parents comprised the initial study sample, of whom 410 (70.6%) completed the primary study endpoint. Generalized linear mixed models with and without worst-case imputation were used to evaluate changes in safe storage practices. Results suggested the odds of storing firearms in the safest manner possible increased 5.9 times (95% CI 2.6–13.5, p < 0.001) without imputation and increased 2.0 times (95% CI 1.1–3.4, p = 0.02) with the worst-case imputation. Among participants with unlocked medications at baseline, 56.5% reported they had disposed of old medications and 53.0% reported locking up bottles of medication by the primary study endpoint. This study provides preliminary evidence that safe storage education paired with tools for behavior change motivates parents to enact safe storage measures.

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Acknowledgements

The authors thank Teresa Maag, Tina Mckown, the Medical Writing Center at Children’s Mercy, the Lock it for Love program and our countless community partners for support in this work.

Funding

Grant from Dr. Kevin and Dr. Adriane Latz #70305, Grant from Nick’s Voice #164890, and FY19 internal Community Benefit Support from Children’s Mercy Hospital.

Author information

Authors and Affiliations

  1. Division of Developmental and Behavioral Health, Children’s Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO, 64108, USA

    Shayla Sullivant

  2. UMKC School of Medicine, Kansas City, MO, USA

    Shayla Sullivant, Hung-Wen Yeh & Mark Connelly

  3. Biostatistics and Epidemiology Core, Health Sciences and Outcomes Research, Children’s Mercy Kansas City, Kansas City, MO, USA

    Hung-Wen Yeh

  4. Division of Precision Therapeutics, Children’s Mercy Kansas City, Kansas City, MO, USA

    Alexandra Hartwig

Authors
  1. Shayla Sullivant
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  2. Hung-Wen Yeh
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  3. Alexandra Hartwig
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  4. Mark Connelly
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Contributions

SS conceived of and designed the study, collected data and wrote the manuscript. MC helped design the study, performed analysis and wrote the manuscript. HY performed the analysis and contributed to writing the manuscript. AH collected data and assisted with writing the manuscript.

Corresponding author

Correspondence to Shayla Sullivant.

Ethics declarations

Conflict of interest

None.

Ethical Approval

The IRB at Children's Research Institute, Children's Mercy Kansas City, approved this study, STUDY00000340: Approved under regulatory exempt cat 2 with a 3-year renewal, effective 8/27/2018, expiration date 3/39/2022.

Informed Consent

What this project is about: This project is a partnership between community organizations and Developmental and Behavioral Sciences staff at Children’s Mercy Hospital. We are providing education about steps parents can take to improve the health and safety of their children as they become teens. To learn if this education is helpful, we hope to learn about your experience of attending the talk, and what you learn. We also want to understand what steps parents may take after the talk and what barriers they encounter. What you will be asked to do: If you agree to participate, you will complete a brief online survey before the presentation, immediately after the presentation and two weeks after the presentation. This will take approximately 5 minutes each time to complete. Are there any risks or benefits of participating in the project? You may not directly benefit from the project, but you may learn concepts that improve safety for youth in your home. There is some risk of discomfort to you given some of the topics (eating disorders, suicide, addiction) can be difficult. There is slight risk of loss of confidentiality when using the internet. Your confidentiality will be protected to the greatest extent possible. What will we receive for participating in the study: One adult from each household that participates will receive a toolkit (approximately $50 value) that contains the following: a lockable medication storage box, four weekly medication organizers, a bag with instructions on how to dispose of unwanted medications, and a pamphlet describing the importance of these steps. A cable gun lock will be available to those who want one, along with education on how to use it. Participation is voluntary: Your participation in this research project is completely voluntary and you can withdraw at any time. You can stop completing the surveys at any time. There are no consequences for not completing the online surveys. All answers will be kept confidential: If you agree to participate, you will be asked to provide your e-mail address to receive a message with a link to complete the final assessment. All e-mail addresses will be stored on a secure web server and kept separate from individual responses to survey questions. An ID code will be assigned to your responses so that the survey responses remain anonymous. The project team at Children’s Mercy will review the responses from the project in a summary format. Who I can contact for information: If you have any questions about this project, you can contact the Research Project Coordinator, Teresa Maag, at 816-302-3038 or tamaag@cmh.edu. If you have any questions about your rights as a research participant, you can contact the Children’s Mercy Institutional Review Board at (816) 701-4358.

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Sullivant, S., Yeh, HW., Hartwig, A. et al. Motivating Behavior Change in Parents for Suicide Prevention in the Midwest, USA. J Community Health 47, 495–503 (2022). https://doi.org/10.1007/s10900-022-01077-5

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