Effectiveness of a Multimodal Community Intervention Program to Prevent Suicide and Suicide Attempts: A Quasi-Experimental Study
Year: 2013
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: Multilevel and multimodal interventions have been suggested for suicide prevention. However, few studies have reported the outcomes of such interventions for suicidal behaviours. METHODS: We examined the effectiveness of a community-based multimodal intervention for suicide prevention in rural areas with high suicide rates, compared with a parallel prevention-as-usual control group, covering a total of 631,133 persons. The effectiveness was also examined in highly populated areas near metropolitan cities (1,319,972 persons). The intervention started in July 2006, and continued for 3.5 years. The primary outcome was the incidence of composite outcome, consisting of completed suicides and suicide attempts requiring admission to an emergency ward for critical care. We compared the rate ratios (RRs) of the outcomes adjusted by sex, age group, region, period and interaction terms. Analyses were performed on an intention-to-treat basis and stratified by sex and age groups. FINDINGS: In the rural areas, the overall median adherence of the intervention was significantly higher. The RR of the composite outcome in the intervention group decreased 7% compared with that of the control group. Subgroup analyses demonstrated heterogeneous effects among subpopulations: the RR of the composite outcome in the intervention group was significantly lower in males (RR = 0.77, 95% CI 0.59-0.998, p = 0.0485) and the RR of suicide attempts was significantly lower in males (RR = 0.39, 95% CI 0.22-0.68, p = 0.001) and the elderly (RR = 0.35, 95% CI 0.17-0.71, p = 0.004). The intervention had no effect on the RR of the composite outcome in the highly populated areas. INTERPRETATION: Our findings suggest that this community-based multimodal intervention for suicide prevention could be implemented in rural areas, but not in highly populated areas. The effectiveness of the intervention was shown for males and for the elderly in rural areas. TRIAL REGISTRATION: ClinicalTrials.gov NCT00737165 UMIN Clinical Trials Registry UMIN000000460.
Source: PLoS ONE
Authors: Yutaka Ono, Akio Sakai, Kotaro Otsuka, Hidenori Uda, Hirofumi Oyama, Naoki Ishizuka, Shuichi Awata, Yasushi Ishida, Hiroto Iwasa, Yuichi Kamei, Yutaka Motohashi, Jun Nakamura, Nobuyuki Nishi, Naoki Watanabe, Toshihiko Yotsumoto, Atsuo Nakagawa, Yuriko Suzuki, Miyuki Tajima, Eriko Tanaka, Hironori Sakai, Naohiro Yonemoto
Institutions: National Center of Neurology and Psychiatry, National Center for Cognitive Behavior Therapy and Research, Iwate Medical University, Aomori University of Health and Welfare, National Center for Global Health and Medicine, Tokyo Metropolitan Institute of Gerontology, University of Miyazaki, Hirosaki University, National Center Hospital of Neurology and Psychiatry, Akita University, University of Occupational and Environmental Health Japan, Kagoshima Prefectural Government, Keio University, National Institute of Mental Health, Nihon University, The Institute of Humanities and Social Sciences, College of Humanities and Sciences, Nihon University, Gunma University, Translational Medical Center, National Center of Neurology and Psychiatry
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,382
OpenAlex ID: W2065902842