title: Student Evaluation of the Yellow Ribbon Suicide Prevention Program in Midwest Schools.
abstract: OBJECTIVE
  Yellow Ribbon is a gatekeeper-type suicide prevention program that is widely used in public schools. However, data on its effectiveness are limited. The purpose of our study was to evaluate self-reported changes in knowledge and comfort level communicating about suicide following Yellow Ribbon training for a large, representative sample of students from a public school system in the midwestern United States.
  
  
  METHODS
  The program was administered to students within the same school district during 2006 through 2009. A pre-post survey using a 4-point Likert scale was administered to rate students' knowledge of risk factors and available resources, comfort level communicating about suicide, estimate of friends at risk for suicide, and behavioral intent toward help-seeking.
  
  
  RESULTS
  Aggregate responses from 3,257 students, aged 11 to 18 years, were collected by the schools; 51% were female, 33% were Hispanic, and 30% were white. Suicide-related knowledge of risk factors, where to go for help, and resources, along with comfort level in asking for help, all significantly improved following program participation (Cramer's V = 0.243 to 0.376,P< .001). Responses were associated with age and gender, indicating that younger males may benefit more than older males.
  
  
  CONCLUSIONS
  Implementation of the Yellow Ribbon school-based suicide prevention program appears to be beneficial for students in the midwestern United States. We observed significant improvement in knowledge, comfort level, and behavioral intent for help-seeking if suicidal thoughts occur. Findings also suggested that Yellow Ribbon training administered during middle school may be especially helpful for males.
authors.affiliation: Department of Psychiatry and Behavioral Sciences and.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Flynn
authors.affiliation: Department of Psychiatry and Behavioral Sciences and.
authors.forename: Rosalee
authors.initials: R
authors.lastname: Zackula
authors.affiliation: Department of Psychiatry and Behavioral Sciences and.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Klaus
authors.affiliation: Sedgwick County Suicide Prevention Coalition, Kansas Youth Suicide Prevention Program, McGinness Family Foundation, Wichita, Kansas.
authors.forename: Liz
authors.initials: L
authors.lastname: McGinness
authors.affiliation: Department of Psychiatry and Behavioral Sciences and.
authors.forename: Susan
authors.initials: S
authors.lastname: Carr
authors.affiliation: Department of Psychiatry and Behavioral Sciences and.
authors.forename: Matthew
authors.initials: M
authors.lastname: Macaluso
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D033062:Friends / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015146:Midwestern United States; D015397:Program Evaluation; D012306:Risk; D012572:School Health Services; D012574:Schools; D012737:Sex Factors; D013334:Students / Q000523:psychology*; D000092864:Suicide Prevention