Lisa Wexler1, Suzanne Rataj2, Jerreed Ivanich3, Jya Plavin4, Anna Mullany5, Roberta Moto6, Tanya Kirk6, Eva Goldwater7, Rhonda Johnson8, Kirk Dombrowski9. 1. School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States. Electronic address: lwexler@umich.edu. 2. School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States. Electronic address: srataj@umass.edu. 3. Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, United States. Electronic address: jerreedivanich@gmail.com. 4. School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States. Electronic address: jplavin@umass.edu. 5. Health Promotion and Policy, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States. Electronic address: amullany@umass.edu. 6. Maniilaq Association, POB 256, Kotzebue, AK, 99752, United States. 7. Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, United States. Electronic address: eva.goldwater@umass.edu. 8. Department of Health Sciences, University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 99508, United States. Electronic address: rmjohnson2@alaska.edu. 9. Department of Sociology, University of Nebraska-Lincoln, 708 Oldfather Hall, Lincoln, NE, 68588, United States. Electronic address: kdombrowski2@unl.edu.
Abstract
RATIONALE: This study evaluates the process and preliminary outcomes of Promoting Community Conversations About Research to End Suicide (PC CARES), an intervention that brings key stakeholders together so they can discuss suicide prevention research and find ways to put it into practice. Originally piloted in remote and rural Alaskan communities, the approach shows promise. METHOD: Using a multi-method design, the study describes a series of locally-facilitated "learning circles" over 15 months and their preliminary results. Sign-in sheets documented participation. Transcriptions of audio-recorded sessions captured facilitator fidelity, accuracy, and the dominant themes of community discussions. Linked participant surveys (n=83) compared attendees' perceived knowledge, skills, attitudes, and their 'community of practice' at baseline and follow-up. A cross-sectional design compared 112 participants' with 335 non-participants' scores on knowledge and prevention behaviors, and considered the social impact with social network analyses. RESULTS: Demonstrating feasibility in small rural communities, local PC CARES facilitators hosted 59 two to three hour learning circles with 535 participants (376 unique). Local facilitators achieved acceptable fidelity to the model (80%), and interpreted the research accurately 81% of the time. Discussions reflected participants' understanding of the research content and its use in their lives. Participants showed positive changes in perceived knowledge, skills, and attitudes and strengthened their 'community of practice' from baseline to follow-up. Social network analyses indicate PC CARES had social impact, sustaining and enhancing prevention activities of non-participants who were 'close to' participants. These close associates were more likely take preventive actions than other non-participants after the intervention. CONCLUSION: PC CARES offers a practical, scalable method for community-based translation of research evidence into selfdetermined, culturally-responsive suicide prevention practice.
RATIONALE: This study evaluates the process and preliminary outcomes of Promoting Community Conversations About Research to End Suicide (PC CARES), an intervention that brings key stakeholders together so they can discuss suicide prevention research and find ways to put it into practice. Originally piloted in remote and rural Alaskan communities, the approach shows promise. METHOD: Using a multi-method design, the study describes a series of locally-facilitated "learning circles" over 15 months and their preliminary results. Sign-in sheets documented participation. Transcriptions of audio-recorded sessions captured facilitator fidelity, accuracy, and the dominant themes of community discussions. Linked participant surveys (n=83) compared attendees' perceived knowledge, skills, attitudes, and their 'community of practice' at baseline and follow-up. A cross-sectional design compared 112 participants' with 335 non-participants' scores on knowledge and prevention behaviors, and considered the social impact with social network analyses. RESULTS: Demonstrating feasibility in small rural communities, local PC CARES facilitators hosted 59 two to three hour learning circles with 535 participants (376 unique). Local facilitators achieved acceptable fidelity to the model (80%), and interpreted the research accurately 81% of the time. Discussions reflected participants' understanding of the research content and its use in their lives. Participants showed positive changes in perceived knowledge, skills, and attitudes and strengthened their 'community of practice' from baseline to follow-up. Social network analyses indicate PC CARES had social impact, sustaining and enhancing prevention activities of non-participants who were 'close to' participants. These close associates were more likely take preventive actions than other non-participants after the intervention. CONCLUSION: PC CARES offers a practical, scalable method for community-based translation of research evidence into selfdetermined, culturally-responsive suicide prevention practice.
Keywords:
Alaska Native; Community Education; Community Mobilization; Community of Practice; Suicide Prevention; Train-the-Trainer; Upstream Prevention
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