Community mobilization for rural suicide prevention: Process, learning and behavioral outcomes from Promoting Community Conversations About Research to End Suicide (PC CARES) in Northwest Alaska. (July 2019)

• Record Type: Journal Article
• Authors: Wexler, Lisa; Rataj, Suzanne; Ivanich, Jerreed; Plavin, Jya; Mullany, Anna; Moto, Roberta; Kirk, Tanya; Goldwater, Eva; Johnson, Rhonda; Dombrowski, Kirk
• Is Part Of: Social science & medicine. Volume 232(2019)
• Page Start: 398
• Page End: 407
• Publication Date: 2019-07
• Subjects: Suicide Prevention -- Community Education -- Alaska Native -- Train-the-Trainer -- Community Mobilization -- Upstream Prevention -- Community of Practice; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2019.05.028
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Rationale: This study evaluates the process and preliminary outcomes of Promoting Community Conversations About Research to End Suicide (PC CARES), an intervention that brings key stakeholders together so they can discuss suicide prevention research and find ways to put it into practice. Originally piloted in remote and rural Alaskan communities, the approach shows promise. Method: Using a multi-method design, the study describes a series of locally-facilitated "learning circles" over 15 months and their preliminary results. Sign-in sheets documented participation. Transcriptions of audio-recorded sessions captured facilitator fidelity, accuracy, and the dominant themes of community discussions. Linked participant surveys (n=83) compared attendees' perceived knowledge, skills, attitudes, and their 'community of practice' at baseline and follow-up. A cross-sectional design compared 112 participants' with 335 non-participants' scores on knowledge and prevention behaviors, and considered the social impact with social network analyses. Results: Demonstrating feasibility in small rural communities, local PC CARES facilitators hosted 59 two to three hour learning circles with 535 participants (376 unique). Local facilitators achieved acceptable fidelity to the model (80%), and interpreted the research accurately 81% of the time. Discussions reflected participants' understanding of the research content and its use in their lives. Participants showed positive changes in perceived knowledge, skills, and attitudes and strengthened their 'community of practice' from baseline to follow-up. Social network analyses indicate PC CARES had social impact, sustaining and enhancing prevention activities of non-participants who were 'close to' participants. These close associates were more likely take preventive actions than other non-participants after the intervention. Conclusion: PC CARES offers a practical, scalable method for community-based translation of research evidence into selfdetermined, culturally-responsive suicide prevention practice. Highlights: PC CARES aims to translate research to local suicide prevention practice. The pilot shows feasibility, community, and cultural acceptability in rural Alaska. Linked pre-follow-up surveys show participant learning and behavioral outcomes. At follow-up, participants did more prevention behaviors than non-participants. Social network analysis suggests positive social impact of PC CARES.