@article{ref1,
title="Impact of Sources of Strength on adolescent suicide deaths across three randomized trials",
journal="Injury prevention",
year="2023",
author="Wyman, Peter and Cero, Ian and Brown, Charles Hendricks and Espelage, Dorothy and Pisani, Anthony and Kuehl, Tomei and Schmeelk-Cone, Karen",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Universal interventions are key to reducing youth suicide rates, yet no universal intervention has demonstrated reduction in suicide mortality through an RCT. This study pooled three cluster-RCTs of Sources of Strength (n=78 high schools), a universal social network-informed intervention. In each trial, matched pairs of schools were assigned to immediate intervention or wait-list. Six schools were assigned without a pair due to logistical constraints. During the study period, no suicides occurred in intervention schools vs four in control schools, that is, suicide rates of 0 vs. 20.86/100,000, respectively. <br><br>RESULTS varied across statistical tests of impact. A state-level exact test pooling all available schools showed fewer suicides in intervention vs. control schools (p=0.047); whereas a stricter test involving only schools with a randomised pair found no difference (p=0.150). <br><br>RESULTS suggest that identifying mortality-reducing interventions will require commitment to new public-health designs optimised for population-level interventions, including adaptive roll-out trials.<p /> <p>Language: en</p>",
language="en",
issn="1353-8047",
doi="10.1136/ip-2023-044944",
url="http://dx.doi.org/10.1136/ip-2023-044944"
}