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To summarize a first stage of research on implementation of a peer leader suicide
prevention program by testing the utility of a method for tracking and reporting each
school's success in retaining and preparing Peer Leaders.
Peer leader programs that prepare opinion leaders to spread healthy practices through
their social networks reduce high-risk sex behaviors and show promise in preventing
adolescent substance use and suicidal behavior. However, knowledge of implementation
processes is very limited. To address this limitation, we drew on the Stages of Implementation
Completion (SIC) framework to measure a key phase of peer leader implementation.
40 high schools were randomly assigned to either immediate Sources of Strength (n
= 20) or waitlist (n = 20). The schools were underserved by mental health services
and over-represented by youth at high risk for suicide (e.g., American Indians). In
the 20 implementing schools, 656 students (18-71 per school) received Peer Leader
(PL) training. Adult mentors facilitated PL meetings to reinforce program concepts
and help PLs plan and execute activities to spread healthy coping practices. Using
a framework derived from the Stages of Implementation Completion (SIC), school reports
of PL meeting dates/attendance were codified as indices of school success in retaining
and preparing PLs. Surveys with 5,712 students showed wide school-level variation
in success of PLs in reaching their classmates with the prevention concepts. In analytic
models examining predictors of school-level exposure, a higher proportion of student
population trained as PLs and greater retention of PLs predicted higher population
exposure to the prevention program, congruent with diffusion of innovations theory,
whereas frequency of meetings did not.
Contribution to the field
Identified an efficient method (derived from the SIC) for assessing a school's success
in preparing/retaining peer leaders. This approach shows promise in providing schools
actionable data to increase impact of peer-led programs.
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7th Annual Conference on the Science of Dissemination and Implementation in Health