Table 1 Two-hour Training Program for vendors of pesticides to identify and respond to high-risk customers in Sri Lanka

Session 1: Discussion (30 min)

An informal discussion with vendors to allow them to share their experiences of high-risk customers Expected outcome: Convince vendors that they are in a “strong” position to prevent suicide

Session 2: Lecture using PowerPoint presentation (60 min)

(2A). Lecture on suicide/pesticide poisoning as a major public health problem (10 min)

Objective: To improve knowledge on suicide, pesticide poisoning and prevention

Contents:

- Suicide, especially pesticide poisoning, is one of the major public health problems

- Every one in five individuals who use pesticides for self-poisoning purchase them from shops

- Impulsiveness plays a critical role

- Majority of suicides are preventable

(2B). Lecture on high-risk customers (30 min)

Objective: To improve knowledge on how to identify high-risk customers

Contents:

1. Observation of unusual customer behavior (Examples: sadness, nervousness, disheveled appearance, aggressiveness, garbled speech, trembling).

2. Characteristics and unusual behavior of high-risk customers

3. Common ways of asking for pesticides for self-poisoning

4. Common strategies used by high-risk customers to mislead the vendors

5. Most important two risk factors of high-risk customers:

(i). Not being a farmer

(ii). Intoxication from alcohol during the purchase

6. Common questions that could be asked from the customer to confirm farming status

Examples: “Can you describe the nature of the pest attack?” “What was pesticide you applied the last time?” “What is the age of the crop?”

(2C). Lecture on how vendors can respond to high-risk customers (20 min)

Objective: To train vendors on some of the appropriate response to high-risk customers

Examples: come back later, return with another family member, contact family member

Session 3: Role play (30 min)

Objective: To practice how to identify and respond to high-risk customers

(3A). Demonstration (10 min)

A short demonstration was performed by the research staff playing roles as a high-risk client with two types of pesticide vendors, including one vendor carefully observing the customer’s behavior, questioning the customer about the purchase and responding to the at risk customer, while the other vendor paid less attention to his customer and sold pesticides without asking further questions.

(3B). Practical session (10 min.)

A practical session was conducted for participants to practice some of the tips they had learned during the training. Research staff had asked pesticides from vendors in different ways to practice how normally high-risk clients would ask for pesticides and then for the vendors to practice some of the appropriate ways to respond, e.g. come back the following day, bring a family member etc.

(3C). Summary and evaluation (10 min.)

A feedback for the practical session was provided while summarizing the important points.