Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1
Aseltine, R. H., & DeMartino, R. (2004). An outcome evaluation of the SOS suicide prevention program. American Journal of Public Health, 94, 446-451. 
Study 2
Aseltine, R. H., Schilling, E. A., James, A., & Glanovsky, J. (n.d.). Evaluating the SOS suicide prevention program: A replication and extension. Unpublished manuscript.
Supplementary Materials
Adolescent Suicide Prevention Program. (2005). Center for Social Policy and Community Development.
Aseltine, R. H. (2001). An outcome evaluation of the 2000-2001 SOS Suicide Prevention Program. Report prepared for Screening for Mental Health, Inc.
Aseltine, R. H. (2002). An evaluation of the SOS Suicide Prevention Program: Final report for findings from the 2001-2002 school year. Report prepared for Screening for Mental Health, Inc.
McDade, M. (n.d.). Process evaluation of the referral and follow-up services used by schools participating in the SOS/CMHS program. Unpublished manuscript.
Newspaper articles about local school's SOS implementation (nine articles)
Pigeon, S. (n.d.). Signs of Suicide: An evidence-based suicide prevention program for secondary school students [PowerPoint presentation].
Proposal for Suicide Prevention Pilot Project
SOS Signs of Suicide High School Program trainer's manual
SOS Signs of Suicide High School Program training video
SOS Signs of Suicide Program quarterly report (January-March 2006) prepared for Screening for Mental Health, Inc.
SOS Signs of Suicide Secondary School Program procedure manual
Outcomes
| Outcome 1: Suicide attempts |
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Description of Measures
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Suicide attempts were indicated by a single self-report item from the Centers for Disease Control and Prevention Youth Risk Behavior Survey: "During the past 3 months, did you actually attempt suicide (yes or no)?"
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Key Findings
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In randomized controlled trials involving more than 6,000 students in five high schools, SOS Signs of Suicide participants were 40% less likely than comparable students who did not participate in the intervention to report attempting suicide in the past 3 months. In one evaluation, 3.6% of intervention participants reported suicide attempts, compared with 5.4% of control students.
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Studies Measuring Outcome
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Study 1, Study 2
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Study Designs
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Experimental
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Quality of Research Rating
|
2.3
(0.0-4.0 scale)
|
| Outcome 2: Knowledge of depression and suicide |
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Description of Measures
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Knowledge about depression and suicide was measured by 10 true/false questionnaire items. The measure was adapted from instruments previously used to evaluate school-based suicide prevention programs.
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Key Findings
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In randomized controlled trials, SOS Signs of Suicide participants demonstrated greater knowledge about depression and suicide after participating in the intervention than comparable high school students. In one evaluation, the intervention achieved a small effect size on knowledge (Cohen's d = 0.35).
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Studies Measuring Outcome
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Study 1, Study 2
|
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Study Designs
|
Experimental
|
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Quality of Research Rating
|
2.2
(0.0-4.0 scale)
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| Outcome 3: Attitudes toward depression and suicide |
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Description of Measures
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Attitudes toward depression and suicide were measured with an 8-item Likert scale. The measure was adapted from instruments previously used to evaluate school-based suicide prevention programs.
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Key Findings
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SOS Signs of Suicide participants had more desirable attitudes regarding depression and suicide after participating in the intervention than comparable high school students. The intervention achieved a small effect size on attitudes (Cohen's d = 0.25, 0.37) in each of the two evaluations that looked at this outcome.
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Studies Measuring Outcome
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Study 1
|
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Study Designs
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Experimental
|
|
Quality of Research Rating
|
2.8
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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13-17 (Adolescent)
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51.4% Female
48.6% Male
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42.8% Hispanic or Latino
25.3% Black or African American
16.4% White
15.5% Race/ethnicity unspecified
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Study 2
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13-17 (Adolescent)
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50% Female
50% Male
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35% Hispanic or Latino
25% White
24% Black or African American
16% Race/ethnicity unspecified
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
|
|
1: Suicide attempts
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0.8
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2.0
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2.0
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3.0
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3.0
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3.0
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2.3
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2: Knowledge of depression and suicide
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0.0
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2.0
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2.0
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3.0
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3.0
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3.0
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2.2
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3: Attitudes toward depression and suicide
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2.0
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2.0
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2.0
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3.0
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3.5
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4.0
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2.8
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Study Strengths
The majority of suicide prevention interventions for adolescents only assess the impact of programs on proximal variables such as knowledge, not on actual suicide attempts, as is the case in this study. The large sample and presence of a comparison group suggest adequate power for analyses and the ability to look at differences between students exposed to the program and those who were not. The high overall response rate and intent-to-treat approach to analyses also are strengths.
Study Weaknesses
Additional documentation of the reliability and validity of outcome measures would have strengthened the study. Pretest differences between schools in outcome measures were not assessed prior to combining data, which would have aided in the interpretation and clarification of results. The effects of demographic variables, but not schools, were examined in statistical models of outcome measures. Pretest measures of outcomes also would have added confidence that assignment of classes to experimental and control conditions resulted in equivalent groups being compared.
