TY  - JOUR
PY  - 2024//
TI  - Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study
JO  - Frontiers in psychiatry
A1  - Minian, Nadia
A1  - Gayapersad, Allison
A1  - Coroiu, Adina
A1  - Dragonetti, Rosa
A1  - Zawertailo, Laurie
A1  - Zaheer, Juveria
A1  - O'Neill, Braden
A1  - Lange, Shannon
A1  - Thomson, Nicole
A1  - Crawford, Allison
A1  - Kennedy, Sidney H.
A1  - Selby, Peter
SP  - e1286078
EP  - e1286078
VL  - 15
IS  - 
N2  - INTRODUCTION: In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. STUDY OBJECTIVES: The objectives of the study are to understand barriers/facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. <br><br>METHODS: The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. <br><br>RESULTS: Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. <br><br>CONCLUSION: Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes.<p />  <p>Language: en</p>
LA  - en
SN  - 1664-0640
UR  - http://dx.doi.org/10.3389/fpsyt.2024.1286078
ID  - ref1
ER  -