Krishnamoorthy Sadhvi, Ross Victoria, Mathieu Sharna, Armstrong Gregory, Kõlves Kairi
Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University.
Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne.
Psychol Serv. 2024 Jul 29. doi: 10.1037/ser0000887.
Complex interventions combining multiple evidence-based strategies have gained substantial traction in suicide prevention across the world. However, implementing these interventions in real-life settings is fraught with several challenges, significant resource demands, and evidence on the merits of implementing complex interventions remains a topic of debate. This study explores the real-world experiences of implementing complex interventions, including challenges, lessons learned, and the way forward. Sixteen participants (nine leaders, five implementors, and two lived experience advocates) from varied professional backgrounds and experiences were purposively recruited from six high-income countries and one low- and middle-income country. Participants were encouraged to reflect on their experiences of implementing complex suicide prevention interventions in their specific country contexts. Thematic analysis was conducted to identify, organize, and offer real-world insights into challenges, lessons learned, and what is needed as the way forward. Important themes related to challenges and lessons learned emerged: (a) stakeholder characteristics, engagement, and dynamics; (b) resources such as funding priorities and capacity; (c) contextual factors including larger sociocultural beliefs, policies, and legislation surrounding suicide and its prevention; (d) nature of lived experience engagement; (e) design and approach to interventions; (f) delivery of interventions; and (g) the scope of evaluation. The study yielded important insights into practice recommendations related to the implementation of complex suicide prevention interventions on the ground. Important pathways for designing interventions, collaboration, and stakeholder engagement for future implementation efforts were discussed. These real-life experiences and lessons learned from international experts are critical in understanding and bridging the know-do gap. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
结合多种循证策略的复杂干预措施在全球自杀预防领域已获得广泛关注。然而，在现实环境中实施这些干预措施充满了诸多挑战、需要大量资源，而且关于实施复杂干预措施的益处的证据仍是一个有争议的话题。本研究探讨了实施复杂干预措施的现实经验，包括挑战、经验教训以及未来的发展方向。从六个高收入国家和一个低收入和中等收入国家有目的地招募了16名来自不同专业背景和经历的参与者（9名领导者、5名实施者和2名有实际生活经历的倡导者）。鼓励参与者反思他们在各自国家背景下实施复杂自杀预防干预措施的经验。进行了主题分析，以识别、组织并提供关于挑战、经验教训以及未来发展方向所需内容的现实见解。出现了与挑战和经验教训相关的重要主题：（a）利益相关者的特征、参与度和动态关系；（b）资金优先级和能力等资源；（c）背景因素，包括围绕自杀及其预防的更大的社会文化观念、政策和立法；（d）实际生活经历参与的性质；（e）干预措施的设计和方法；（f）干预措施的实施；以及（g）评估范围。该研究为实地实施复杂自杀预防干预措施的实践建议提供了重要见解。讨论了未来实施工作中设计干预措施、合作以及利益相关者参与的重要途径。这些来自国际专家的现实经验和教训对于理解和弥合知行差距至关重要。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
