title: Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills.
abstract: Suicide is the third leading cause of death among 10-24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual with training plus brief behavioral rehearsal (i.e., role play practice) on a variety of learning outcomes after training and at follow-up for 91 school staff and 56 parents in a school community. We found few differences between school staff and parent participants. Both training conditions resulted in enhanced knowledge and attitudes, and almost all participants spread gatekeeper training information to others in their network. Rigorous standardized patient and observational methods showed behavioral rehearsal with role play practice resulted in higher total gatekeeper skill scores immediately after training and at follow-up. Both conditions, however, showed decrements at follow-up. Strategies to strengthen and maintain gatekeeper skills over time are discussed.
authors.affiliation: Department of Psychiatry, Box Psych, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, USA. wendi_cross@urmc.rochester.edu
authors.forename: Wendi F
authors.initials: WF
authors.lastname: Cross
authors.forename: David
authors.initials: D
authors.lastname: Seaburn
authors.forename: Danette
authors.initials: D
authors.lastname: Gibbs
authors.forename: Karen
authors.initials: K
authors.lastname: Schmeelk-Cone
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: White
authors.forename: Eric D
authors.initials: ED
authors.lastname: Caine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D003256:Community Participation / Q000379:methods* / Q000523:psychology; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training / Q000379:methods; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D018794:Problem-Based Learning; D011361:Professional Competence / Q000706:statistics & numerical data; D016730:Program Development; D015397:Program Evaluation; D011594:Psychometrics; D012017:Referral and Consultation / Q000458:organization & administration*; D012381:Role Playing; D012572:School Health Services; D012649:Self Concept; D020377:Self Efficacy; D013405:Suicide / Q000523:psychology; D055815:Young Adult; D000092864:Suicide Prevention