The Efficacy of an Online Gatekeeper Training Program for Suicide Prevention in College Students
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Abstract: Suicidal behaviors (e.g., suicidal ideation, suicide attempt) are a significant problem on college campuses. Suicide is one of the leading causes of death among college-aged individuals. Also, suicidal behaviors in college students are associated with many negative outcomes (e.g., death, hopelessness), and students who report suicidal ideation are more likely to engage in risky behaviors (e.g., driving under the influence) than students who do not. Colleges typically have a variety of available resources (e.g., counseling centers) that are at low or no cost and are effective in reducing suicidal behaviors. However, students at risk for suicide either do not seek help whatsoever, or disclose their intentions to their peers versus mental health professionals.
Question, Persuade, and Refer (QPR) is the most frequently used gatekeeper training, suicide prevention program on college campuses. Gatekeeper training programs, such as QPR, aim to teach individuals to identify those at risk for suicide and to refer the at-risk individuals to professional help. While face-to-face QPR programs have been shown to be effective, there is limited research examining the efficacy of an online QPR training program. This is important because online programs can be beneficial due to a college student’s frequency of use of online and how they can be used to quickly gain information.
It was hypothesized that students who receive the online QPR training will demonstrate larger increases in knowledge of suicidal behaviors, knowledge of how to perform in the gatekeeper role, amount of preparedness to perform in the role, and in self-efficacy from pre- to post-training than students who receive a control training. 92 undergraduate students from Loyola University Maryland were randomly assigned to receive one of two conditions, the online QPR training program or the control group, an online micro-expression training (METT) unrelated to suicide prevention. The study hypotheses were examined using mixed analyses of variance (ANOVAs) to examine the main and interactive effects of training condition (QPR vs. METT) and assessment time (pre-training vs. post-training) on individual knowledge, perceived knowledge, perceived preparedness, and perceived efficacy. There was a significant interaction (time x condition) effect for all four variables, all F(1, 90) > 6.73, p < .011, ηp2 > .07. Examination of the interactions revealed that for all variables, there was no significant difference between conditions at pre-training, however, there were significant differences at post-training such that those in the QPR condition scored higher on all variables than those in the METT condition. While both groups increased significantly from pre-training to post-training, those in the QPR condition displayed significantly larger increases on all four variables.
Considering the vast majority of college students use the Internet on a regular basis, and feel comfortable using it, online QPR training could be useful in training students to identify suicidal behaviors in their peers. In addition, it can be used to train students more conveniently, cheaply, and easily than face-to-face training. It also has the potential to reduce the amount of instructor variability, and can eliminate hassles involved in attending face-to-face trainings (e.g., traffic).