Article type
Year
Abstract
Introduction: The best available evidence for many community health interventions, such as adolescent suicide prevention programs, is seldom based on randomized trials. Alternative overview methods are required to summarize the literature and make recommendations for practice.
Objective: To develop a method to systematically appraise and summarize evidence on the effectiveness of adolescent suicide prevention programs and to summarize strategies used to disseminate results to practice settings.
Methods: Search strategies included on-line searches, hand searches of selected journals, and searches of reference lists. In total, 187 articles published between 1980 and 1995 were retrieved. Articles were assessed for relevance and validity by two independent reviewers. Articles were relevant if they evaluated a program within the scope of Public Health Nursing practice and gave information on student outcomes. The five validity criteria included method of allocation to study group, level of agreement to participate, control for confounders, method of data collection, and percent of subjects available for follow up. Articles were given an overall rating of strong, moderate or weak.
Results: Only eleven articles met the relevance criteria. All of these articles were rated weak, meaning that at least one criterion was rated fail. The most common weaknesses of the articles included lack of description of randomization, inadequate control for potential confounders and lack of pretesting of instruments. The evidence suggests that there may be both beneficial and harmful effects of the programs on some students, and that the potential negative effects, especially among males, could have serious consequences. Results have been disseminated in short reports, presentations and through the Internet.
Discussion: The methods of this systematic overview have facilitated optimal use of the available evidence related to adolescent suicide prevention programs and can be used to appraise and summarize the effectiveness of other community health interventions.
Objective: To develop a method to systematically appraise and summarize evidence on the effectiveness of adolescent suicide prevention programs and to summarize strategies used to disseminate results to practice settings.
Methods: Search strategies included on-line searches, hand searches of selected journals, and searches of reference lists. In total, 187 articles published between 1980 and 1995 were retrieved. Articles were assessed for relevance and validity by two independent reviewers. Articles were relevant if they evaluated a program within the scope of Public Health Nursing practice and gave information on student outcomes. The five validity criteria included method of allocation to study group, level of agreement to participate, control for confounders, method of data collection, and percent of subjects available for follow up. Articles were given an overall rating of strong, moderate or weak.
Results: Only eleven articles met the relevance criteria. All of these articles were rated weak, meaning that at least one criterion was rated fail. The most common weaknesses of the articles included lack of description of randomization, inadequate control for potential confounders and lack of pretesting of instruments. The evidence suggests that there may be both beneficial and harmful effects of the programs on some students, and that the potential negative effects, especially among males, could have serious consequences. Results have been disseminated in short reports, presentations and through the Internet.
Discussion: The methods of this systematic overview have facilitated optimal use of the available evidence related to adolescent suicide prevention programs and can be used to appraise and summarize the effectiveness of other community health interventions.