Non-inferiority randomised trial of the web-based Recognise and Respond gatekeeper training program (Preprint)

• DOI: 10.2196/preprints.63204
• Publication Date: 2024-07-02T12:48:26Z
• Authors: Cassandra Chakouch; Ann Martin; Philip Batterham; Demee Rheinberger; Fiona Shand

BACKGROUND Gatekeeper training teaches community members to identify individuals at-risk of suicide and assist them with help-seeking. A new online program (Recognise and Respond; R&R) was created to address the need for a program specific to the Australian context, in consultation with clinicians, researchers, and people with a lived experience of suicide.

OBJECTIVE The primary objective was to examine the short- and medium-term impacts of the R&R gatekeeper training program on gatekeeper confidence to identify and support an individual experiencing thoughts of suicide. Secondary objectives were to examine the short-and medium-term impacts of the R&R program on gatekeeper attitudes towards suicide prevention and knowledge of appropriate responses to signs of suicide.

METHODS A non-inferiority randomised controlled trial compared R&R with the ‘Question, Persuade, Refer’ (QPR) online program. 524 participants completed baseline and were randomised to receive access to either the R&R (n = 263) or QPR (n = 261) online programs. All outcomes were measured at baseline, post-intervention, and three-month follow-up via online surveys. The trial was conducted entirely online, with no face-to-face contact with participants. Data were analysed using mixed effects linear models.

RESULTS Participants in both groups reported significant improvements in confidence across time indicating non-inferiority of the R&R program. Both groups showed significant improvements on attitudes and knowledge scores at post-intervention and follow-up, relative to baseline. Improvement in attitude scores between baseline and post-test were greater for the QPR group compared to the R&R group but not at follow-up. Gains at post-intervention were maintained at follow-up for both groups on all outcomes. There were no other between-group differences.

CONCLUSIONS The findings demonstrate that R&R is as effective as QPR online in improving gatekeeper confidence to identify and support someone having thoughts of suicide.

CLINICALTRIAL This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000489998p).