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Table 1 Characteristics of evaluations of suicide prevention interventions

From: A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

1st author, year, publication type Country, location Intervention type Intervention component/s (number of sessions) Target group (n), age, % male Design Data collection methods Outcomes Effects Follow-up months Cost
La Fromboise, 1995, journal article [41] US, rural New Mexico Education Culturally tailored school-based life skills curriculum, including manual and teacher raining. (3/week × 30 weeks) Native Americans (n=128): age range= 14–19 years, mean age=15.9 years and 36% male. Pre-post, with two control groups Self-report survey Observational methods Suicide vulnerability: hopelessness, depression and self-efficacy Intervention group less hopelessness (P<0.05); less suicidal (P<0.07); not less depressed. 8 months NR
Berman, 1999, journal article [42] US, rural Alaska Community prevention Alcohol restrictions Experimental: 29,000 Control: 21,000 Interrupted time series with control group Routinely collected population level data Death rates from accidents, suicides and homicides Significant reductions (P<0.05) in homicide for high level restrictions, and in suicide for low level restrictions. 21% reduction in overall injury deaths. 1-13yrs NR
Tsey, 2000, journal article [43] Australia, remote Qld Community prevention Four stage empowerment program (1 × 4hr session per week for 10 weeks per each stage) Aboriginal community members (n=31): age range= 20–50 years, median age=early 40 years, and 10% male Pre-post, no control Self-report survey Participant observation Narrative interviews Individual & community levels of empowerment NR 10, 20, 30, and 40 weeks  
May, 2005, journal article [39] US, rural New Mexico Community prevention Train youth as natural helpers Native Americans (n=800): age range = 10–19 and 20–24 years. Interrupted time series, no control Self-report by health professionals and police and medical records Suicide attempts, gestures & completions Significant reductions (P<0.05) in rates of suicidal gestures and attempts. No change in suicidal completions. 13yrs NR
Drug and suicide education
Family outreach post-suicide
Suicide-risk screening
Community cultural events
Reorientation of mental health services
Deane, 2006, journal article [35, 36] Australia, regional NSW Gatekeeper training Suicide awareness and skills Gatekeeper training (8 × 1 day workshops) Aboriginal Australian community members (n=48): age range= 19–55 years, mean age=36 years and 9% male. Pre-post, no control Self-report survey Interviews Knowledge Significant increases (P<0.05) pre-post training in knowledge, intentions, confidence. Non-significant changes post training to 2 years follow-up. 2yrs NR
Confidence
Intentions
Haggarty, 2006, journal article [34] Canada, rural Education Multi-media education (1 × 30 minute session) Healthcare providers, teachers, students and elders (n=24) Pre-post, no control Self-report survey Knowledge Significant increases (P<0.05) in knowledge NR NR
Westerman, 2007, grey report [38] Australia, rural and remote Western Australia Gatekeeper training Training and information workshops Aboriginal youth and community members (n=769): age range =15-25 years. Pre-post, no control Self-report survey Interviews Knowledge Confidence Intentions Significant improvements (P<.05) in knowledge and confidence in how to identify individuals at risk of suicide. NR NR
Muehlenkamp, 2009, journal article [37] US, Native American Gatekeeper training Gatekeeper training, education workshops, social activities, individual counselling and education seminars, student support team, social networking, spiritual ceremonies Native American college students (n=90) Pre-post, no control Self-report survey Knowledge Attitudes Reported improvements in problem solving ability, and marginal improvements in communication skills and knowledge NR NR
Skills
Allen, 2009, journal article [40] US, remote Alaska Community prevention Community module: 26 prevention activities (7 targeting community) in 32 sessions. Additional activities: increased alcohol control, suicide crisis response team & prayer walks (32 sessions over 12 months) Alaskan Indigenous youth (n=61): age range=12-17 years, mean age= 14 years, and 30% male. Pre-post, no control Self-report survey Community readiness Significant (P<0.05) increase in number of protective behaviours in youth. NR NR
Youth & adult protective behaviours
Adults of youth (n=47): mean age=48 years and 42% male.
     Community informants (n=5)       
  1. Note. NR=Not reported.