Acosta Joie, Ramchand Rajeev, Jaycox Lisa H, Becker Amariah, Eberhart Nicole K
Rand Health Q. 2013 Feb 28;2(4):2. eCollection 2013 Winter.
To help inform the evaluation design for CalMHSA's suicide prevention (SP) and early intervention initiatives, a review of program evaluation literature was done to assess program effectiveness and identify previously used evaluation methodologies. Using evidence from the literature review, the authors provide an overview of the epidemiology of suicides and of non-fatal self-inflicted injuries in California and present a framework for evaluating SP programs, including candidate evaluation measures. The review identified three methodological considerations that can inform the evaluation of SP programs: (1) identifying whether a SP program was effective at reducing suicide deaths is challenging because suicide is such a rare event; (2) SP programs may have differential effects on population subgroups, because suicide rates differ by age, race, and sex; and (3) SP programs may show immediate reductions in suicide attempts but their long-term effects are uncertain. The review also identified two critical gaps in the literature. First, SP evaluation research explores the effects of programs on such outcomes as reduced access to lethal means, provision of care, and crisis response; however, we need to learn more about how these programs influence suicide rates. Second, more research must address the differential effectiveness of SP programs for population subgroups vulnerable to suicide.
为了给加州精神卫生服务管理局（CalMHSA）的自杀预防（SP）和早期干预计划的评估设计提供参考信息，我们对项目评估文献进行了综述，以评估项目效果并确定先前使用的评估方法。作者利用文献综述中的证据，概述了加利福尼亚州自杀及非致命性自我伤害的流行病学情况，并提出了一个评估自杀预防项目的框架，包括候选评估指标。该综述确定了三个可用于指导自杀预防项目评估的方法学考量因素：（1）确定自杀预防项目是否能有效降低自杀死亡人数具有挑战性，因为自杀是一种罕见事件；（2）自杀预防项目可能对不同人群亚组产生不同影响，因为自杀率因年龄、种族和性别而异；（3）自杀预防项目可能会使自杀未遂情况立即减少，但其长期效果尚不确定。该综述还指出了文献中的两个关键空白。第一，自杀预防评估研究探讨了项目在减少获取致命手段、提供护理和危机应对等方面的效果；然而，我们需要更多地了解这些项目如何影响自杀率。第二，更多研究必须关注自杀预防项目对易自杀人群亚组的不同效果。
