title: Efficacy of Adolescent Suicide Prevention E-Learning Modules for Gatekeepers: A Randomized Controlled Trial.
abstract: BACKGROUND
  Face-to-face gatekeeper training can be an effective strategy in the enhancement of gatekeepers' knowledge and self-efficacy in adolescent suicide prevention. However, barriers related to access (eg, time, resources) may hamper participation in face-to-face training sessions. The transition to a Web-based setting could address obstacles associated with face-to-face gatekeeper training. Although Web-based suicide prevention training targeting adolescents exists, so far no randomized controlled trials (RCTs) have been conducted to investigate their efficacy.
  
  
  OBJECTIVE
  This RCT study investigated the efficacy of a Web-based adolescent suicide prevention program entitled Mental Health Online, which aimed to improve the knowledge and self-confidence of gatekeepers working with adolescents (12-20 years old). The program consisted of 8 short e-learning modules each capturing an important aspect of the process of early recognition, guidance, and referral of suicidal adolescents, alongside additional information on the topic of (adolescent) suicide prevention.
  
  
  METHODS
  A total of 190 gatekeepers (ages 21 to 62 years) participated in this study and were randomized to either the experimental group or waitlist control group. The intervention was not masked. Participants from both groups completed 3 Web-based assessments (pretest, posttest, and 3-month follow-up). The outcome measures of this study were actual knowledge, and participants' ratings of perceived knowledge and perceived self-confidence using questionnaires developed specifically for this study.
  
  
  RESULTS
  The actual knowledge, perceived knowledge, and perceived self-confidence of gatekeepers in the experimental group improved significantly compared to those in the waitlist control group at posttest, and the effects remained significant at 3-month follow-up. The overall effect sizes were 0.76, 1.20, and 1.02, respectively, across assessments.
  
  
  CONCLUSIONS
  The findings of this study indicate that Web-based suicide prevention e-learning modules can be an effective educational method to enhance knowledge and self-confidence of gatekeepers with regard to adolescent suicide prevention. Gatekeepers with limited time and resources can benefit from the accessibility, simplicity, and flexibility of Web-based training.
  
  
  BACKGROUND
  Netherlands Trial Register NTR3625; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3625 (Archived by WebCite at http://www.webcitation.org/6eHvyRh6M).
authors.affiliation: Department of Clinical Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands. ghonchehr@gmail.com.
authors.forename: Rezvan
authors.identifier: http://orcid.org/0000-0002-5968-0405
authors.initials: R
authors.lastname: Ghoncheh
authors.forename: Madelyn S
authors.identifier: http://orcid.org/0000-0002-2881-9152
authors.initials: MS
authors.lastname: Gould
authors.forename: Jos Wr
authors.identifier: http://orcid.org/0000-0001-9617-1020
authors.initials: JW
authors.lastname: Twisk
authors.forename: Ad Jfm
authors.identifier: http://orcid.org/0000-0003-1701-5332
authors.initials: AJ
authors.lastname: Kerkhof
authors.forename: Hans M
authors.identifier: http://orcid.org/0000-0002-9643-2363
authors.initials: HM
authors.lastname: Koot
keywords: Adolescent; E-learning; Gatekeepers; Learning; Modules; Online Systems; Prevention; Referral and Consultation; Suicide; Training; Web-based
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