Dissemination and implementation of suicide prevention training in one Scottish regionReport as inadecuate

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BMC Health Services Research

, 8:246

First Online: 03 December 2008Received: 22 July 2008Accepted: 03 December 2008DOI: 10.1186-1472-6963-8-246

Cite this article as: Gask, L., Lever-Green, G. & Hays, R. BMC Health Serv Res 2008 8: 246. doi:10.1186-1472-6963-8-246


BackgroundAs part of a national co-ordinated and multifaceted response to the excess suicide rate, the Choose Life initiative, the Highland Choose Life Group launched an ambitious programme of training for National Health Service NHS, Council and voluntary organisation staff. In this study of the dissemination and implementation of STORM Skills-based Training On Risk Management, we set out to explore not only the outcomes of training, but key factors involved in the processes of diffusion, dissemination and implementation of the educational intervention.

MethodsParticipants attending STORM training in Highland Region provided by 12 trained facilitators during the period March 2004 to February 2005 were recruited. Quantitative data collection from participants took place at three time points; immediately before training, immediately post-training and six months after training. Semi-structured telephone interviews were carried out with the training facilitators and with a sample of course participants 6 months after they had been trained. We have utilized the conceptual model described by Greenhalgh and colleagues in a Framework analysis of the data, for considering the determinants of diffusion, dissemination and implementation of interventions in health service delivery and organization.

ResultsSome 203 individuals completed a series of questionnaire measures immediately pre time 1 and immediately post time 2 training and there were significant improvements in attitudes and confidence of participants. Key factors in the diffusion, dissemination and implementation process were the presence of a champion or local opinion leader who supported and directed the intervention, local adaptation of the materials, commissioning of a group of facilitators who were provided with financial and administrative support, dedicated time to provide the training and regular peer-support.

ConclusionFeatures that contributed to the success of STORM were related to both the context the multi-dimensional support provided from the host organisation and the favourable policy environment and the intervention openness to local adaptation, clinical relevance and utility, and the dynamic interaction between context and the intervention.

Linda Gask, Gillian Lever-Green and Rebecca Hays contributed equally to this work.

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Author: Linda Gask - Gillian Lever-Green - Rebecca Hays

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