title: An outcome evaluation of the Sources of Strength suicide prevention program delivered by adolescent peer leaders in high schools.
abstract: OBJECTIVE
  We examined the effectiveness of the Sources of Strength suicide prevention program in enhancing protective factors among peer leaders trained to conduct schoolwide messaging and among the full population of high school students.
  
  
  METHODS
  Eighteen high schools--6 metropolitan and 12 rural--were randomly assigned to immediate intervention or the wait-list control. Surveys were administered at baseline and 4 months after program implementation to 453 peer leaders in all schools and to 2675 students selected as representative of the 12 rural schools.
  
  
  RESULTS
  Training improved the peer leaders' adaptive norms regarding suicide, their connectedness to adults, and their school engagement, with the largest gains for those entering with the least adaptive norms. Trained peer leaders in larger schools were 4 times as likely as were untrained peer leaders to refer a suicidal friend to an adult. Among students, the intervention increased perceptions of adult support for suicidal youths and the acceptability of seeking help. Perception of adult support increased most in students with a history of suicidal ideation.
  
  
  CONCLUSIONS
  Sources of Strength is the first suicide prevention program involving peer leaders to enhance protective factors associated with reducing suicide at the school population level.
authors.affiliation: Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 300 Crittenden Boulevard, Rochester, NY 14642, USA. peter_wyman@urmc.rochester.edu
authors.forename: Peter A
authors.initials: PA
authors.lastname: Wyman
authors.forename: C Hendricks
authors.initials: CH
authors.lastname: Brown
authors.forename: Mark
authors.initials: M
authors.lastname: LoMurray
authors.forename: Karen
authors.initials: K
authors.lastname: Schmeelk-Cone
authors.forename: Mariya
authors.initials: M
authors.lastname: Petrova
authors.forename: Qin
authors.initials: Q
authors.lastname: Yu
authors.forename: Erin
authors.initials: E
authors.lastname: Walsh
authors.forename: Xin
authors.initials: X
authors.lastname: Tu
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003479:Curriculum; D005260:Female; D005845:Georgia; D006801:Humans; D016014:Linear Models; D008297:Male; D009518:New York; D009658:North Dakota; D017063:Outcome Assessment, Health Care; D010379:Peer Group; D000297:Psychology, Adolescent; D013405:Suicide / Q000523:psychology; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention