Sources of Strength
The aim of the current trial is to test how effectively the Sources of Strength program can promote help-seeking for suicide in adolescents in Australian high schools.
The school system has been identified as an ideal setting for the implementation of prevention and early intervention programs for suicide. However, in Australia, there is a lack of suicide prevention programs routinely delivered in schools. Internationally, there is evidence for the effectiveness of peer-led interventions that take a social connectedness approach to improve help-seeking for suicide.
Youth suicide is a significant public health problem. In 2011, suicide was the leading cause of death in young Australians aged 15-24 years. The prevalence of youth suicide, and the significant burden associated with it, has given rise to the development of a range of interventions aimed at the prevention of suicidal behaviour and the promotion of help-seeking and early identification for suicide in young people.
The need to promote and assist help-seeking behaviour among youth is critical, as young people often do not seek or receive help for suicidal thoughts and behaviour.
The universal Sources of Strength program takes a social connectedness approach to improving help-seeking for suicide and general psychological distress. This program is designed to build socioecological protective influences across an entire school student population and focuses on enhancing help-seeking norms, youth-adult communication, and coping skills to promote help-seeking.
History of the project
The Sources of Strength program has been evaluated in a randomised controlled trial of 18 high schools, 453 peer leaders and 2,675 students located in the US, with consistent evidence of a positive intervention effect on the norms, attitudes and behaviour of both peer leaders and the wider student population.
The present project is a large trial designed to evaluate the effectiveness of the evidence-based Sources of Strength program in Australian schools. The need to implement and evaluate suicide prevention programs in Australian schools is high, given a recent review of 43 school-based suicide prevention studies only identified one gatekeeper trial in Australia, with a second indicated trial underway.
Sixteen schools from the ACT and NSW will be recruited to participate in this trial.Back to top
This study is a two-arm cluster randomised controlled trial that will compare the evidence-based Sources of Strength program to a wait-list control condition. Sixteen Australian high schools will be recruited to the trial, with all adolescents in Years 7 to 10 (12- 16 years) invited to participate.
Peer leaders from intervention condition schools will receive training in the Sources of Strength program and will integrate positive messages, across three months, with the support of adult advisors. Activities may take the form of class presentations, posters, videos and messages on social media sites, and will aim to change help-seeking norms, strengthen youth-adult connections and promote positive coping.
The primary outcome measure for the study is help-seeking intentions, while secondary outcomes include help-seeking behaviour, help-seeking attitudes and norms, referral of distressed peers, availability of adult help, positive coping and suicidal behaviour.
Data will be collected pre-intervention, post-intervention (after the initial 3 months of messaging), and at the end of the first (6-month follow-up) and the second year after implementation (18-month follow-up). Primary analyses will compare changes in help-seeking intentions for the intervention condition relative to the wait-list control condition using mixed-effects repeated-measures analyses to account for clustering within schools.Back to top
NHMRC Project GrantBack to top