Source: KANSAS STATE UNIV submitted to
BUILDING COMMUNITY RESILIENCE TO PREVENT SUICIDE IN VULNERABLE RURAL COMMUNITIES IN KANSAS THROUGH EVIDENCE-BASED MENTAL HEALTH EDUCATION
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1029255
Grant No.
2022-46100-38173
Cumulative Award Amt.
$349,946.00
Proposal No.
2022-04846
Multistate No.
(N/A)
Project Start Date
Sep 1, 2022
Project End Date
Dec 31, 2024
Grant Year
2022
Program Code
[LX]- Rural Health & Safety Education
Project Director
Lane, J.
Recipient Organization
KANSAS STATE UNIV
(N/A)
MANHATTAN,KS 66506
Performing Department
(N/A)
Non Technical Summary
Suicide is an increasing issueamong rural communities in SE Kansas. One of the national strategies for decreasing suicidality is to provide suicide gatekeeper training to well-positioned key stakeholders in all communities. Suicide gatekeeper training isdesigned to educate individuals about suicide and provide them with the skills necessary to communicate with suicidal individuals. Question, Persuade, Refer, or QPR, is the most widely uitlized evidence-based suicide gatekeeper training. QPR offers emergency mental health for individuals experiencing suicidal ideation and distress. A person can be trained as a QPR gatekeeper in as little as an hour. Further, there is evidence that QPR can be enhanced through behavioral rehearsals, or role play activities, for participants.Our plan is to deliver QPR Instructor training along with behavioral rehearsal training to approximately 12 key stakeholders in rural communities across nine counties in SE Kansas. These key stakeholders will then be equipped to provide QPR training in their rural communities. In addition, we will gather and compile a list of community-based mental health resources for each county so that gatekeepers can refer suicidal individuals to the appropriate provider. Key stakeholders in these communities will be identified through collaboration with KSU Cooperative Extension. For short-term outcomes, this projectseeks to increase the suicide knowledge, suicide communication skills, and suicide gatekeeper of rural community members.For long-term outcomes, this project seeks to reduce the stigma of discussing suicide and ulimately the suicide rate in rural SE Kansas.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
80260993020100%
Goals / Objectives
·Aim 1will increase coordination of efforts to address suicide in rural communities in SE Kansas. Through Aim 1, the co-PIs and KSU Extension will make strategic connections with key stakeholders who are well-positioned to identify individuals at-risk for suicide in rural communities throughout nine counties in SE Kansas. Awareness and relationship-building meetings among key stakeholders, KSU Extension agents, and the co-PIs will provide the opportunity to create a comprehensive community-based suicide prevention strategy that will increase capacity of local communities to support suicide gatekeeper training and to refer suicidal individuals to appropriate mental health resources. Approximately 5-10 meetings will be held with these key stakeholders. These meetings will initialize collaborative plans to implement QPR suicide gatekeeper training in rural communities across SE Kansas.· Aim 2 will increase capacities of local communities to support suicide gatekeeper training programming for rural residents. The co-PIs and identified key stakeholders will be provided with suicide gatekeeper instructor training to equip them to implement evidence-based Question, Persuade, Refer (QPR) programming, which teaches individuals to recognize the warning signs of suicide and to effectively communicate with potentially suicidal individuals. In addition to the 2 co-PIs, there will be an estimated 20 key stakeholders trained as QPR instructors. The 8-hour training will be provided by the QPR Institute and can be completed online. Additionally, the co-PIs will increase capacity by providing role-play formation and behavioral rehearsal training to key stakeholders to enhance QPR programming. Key stakeholders who attend the training will be asked to sign a letter of commitment to co-facilitate at least two training courses for rural residents within 24 months of completing the instructor training.· Aim 3 will increase capacities of local communities to refer suicidal individuals to appropriate local mental health resources. The co-PIs and KSU Extension will collaborate with key stakeholders to identify mental health providers in each of the nine counties serving SE Kansas. The co-PIs will build strategic connections with each provider to inform them of the collaborative plan to increase suicide gatekeeping in each community and to seek permission to include the provider on a list of referral sources. The co-PIs will also identify appropriate tele-mental health resources and providers for rural communities, as well as provide emergency resources and crisis hotline contact information.· Aim 4 will empower rural community members in SE Kansas to identify and engage with potentially suicidal individuals in their communities. The co-PIs, KSU Extension, and key stakeholders will plan and implement in-person training to 360 rural community stakeholders, over two years through the evidence-based suicide gatekeeper program QPR. All participants in Aim 4 will sign up for the training through K-State Qualtrics Survey. They will complete an online pre-survey prior to starting the evidence-based gatekeeper training and an online post-survey upon completion. In addition, participants will be asked to complete a 6-month follow-up survey to assess longitudinal changes. Expected outcomes for rural residents includes increased suicide gatekeeper self-efficacy, increased suicide knowledge, increased suicide communication skills, and increased number of referrals of suicidal individuals to mental health care providers.
Project Methods
In Aim 1, meeting minutes and letters of commitment will be used to assess the coordination of suicide gatekeeper training work in rural communities. In Aim 2, training registration confirmations, training certificates of completion, attendance records, and assessments of participant changes (pre-/post-surveys) will be used to assess the implementation of the QPR instructor course with behavioral rehearsal augmentation. In Aim 3, meeting minutes, letters of support, and completed mental health provider referral lists will be used to assess the development of community-based mental health referral lists for each rural county. In Aim 4, registration lists and assessments of participant changes (pre-/post-surveys) will be used to assess the implementation of the suicide gatekeeper training program for rural communities across SE Kanas.In Aims 2 and 4, two instruments will be utilized as pre- and post-surveys to assess changes in suicide knowledge, suicide communication skills, and suicide gatekeeper self-efficacy: The Suicide Knowledge and Skills Questionnaire and the Suicide Prevention Gatekeeper Self-Efficacy Scale (GKSES). The Suicide Knowledge and Skills Questionnaire is a 13-item scale two scales. The suicide knowledge subscale measures suicide knowledge through nine true/false statements about suicide, and the suicide skills subscale measures suicide communication skills through four self-report items about participants' comfort in addressing suicidal individuals (Smith et al., 2014). The GKSES measures gatekeeper self-efficacy through nine self-report items about participants' confidence in their ability to help suicidal individuals (Takahashi et al., 2021).

Progress 09/01/22 to 08/31/23

Outputs
Target Audience: Changes/Problems:Some timeline adjustments have been made in Aim 2 since our initial submission, and have been adjusted from Quarter 3 to Quarter 4. The items, to ensure all key stakeholders have completed QPR instructor training and implement and evaluate behavioral rehearsal training were adjusted to best meet participant needs and summer schedules. We do not foresee either of these adjustments impacting our overall project timeline. What opportunities for training and professional development has the project provided?Identified community key stakeholders are currently undergoing training to later provide training to community participantsin the future. How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?Stakeholders will provide the training to implement Aim 4. Aim 4will empower rural community members in SE Kansas to identify and engage with potentially suicidal individuals in their communities. The co-PIs, KSU Extension, and key stakeholders will plan and implement in-person training to 360 rural community stakeholders, over two years through the evidence-based suicide gatekeeper program QPR.All participants in Aim 4 will sign up for the training through K-State Qualtrics Survey. They will complete an online pre-survey prior to starting the evidence-based gatekeeper training and an online post-survey upon completion. In addition, participants will be asked to complete a 6-month follow-up survey to assess longitudinal changes. Expected outcomes for rural residents includes increased suicide gatekeeper self-efficacy, increased suicide knowledge, increased suicide communication skills, and increased number of referrals of suicidal individuals to mental health care providers.

Impacts
What was accomplished under these goals? Aim 1:The co-PIs and KSU Extension made strategic connections with key stakeholders who are well-positioned to identify individuals at-risk for suicide in rural communities throughout nine counties in SE Kansas. Approximately 3collaborative meetings and several individual follow-up meetings were held with key stakeholders to develop collaborative plans to implement QPR suicide gatekeeper training in rural communities across SE Kansas. Aim 2:The co-PIs and identified key stakeholders to provide suicide gatekeeper instructor training, to implement evidence-based Question, Persuade, Refer (QPR) programming, which teaches individuals to recognize the warning signs of suicide and to effectively communicate with potentially suicidal individuals. In addition to the 2 co-PIs, 8 key stakeholders are currently being trained as QPR instructors. The 8-hour training will be provided by the QPR Institute andcompleted online by all participants by September 1. The co-PIs will increase capacity by providing role-play formation and behavioral rehearsal training to key stakeholders to enhance QPR programming on Wednesday, September 27th. The identified 8key stakeholders signed a letter of commitment to co-facilitate at least two training courses for rural residents within 24 months of completing the instructor training. Aim 3:The co-PIs, KSU Extension, and the graduate studentcollaborated and identifiedmental health providers in thenine counties serving SE Kansas. The co-PIs and graduate student builtstrategic connections with each provider to inform them of the collaborative plan to increase suicide gatekeeping in each community and to seek permission to include the provider on a list of referral sources, as well as provide emergency resources and crisis hotline contact information.

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