Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed...

Area of Science:

• Implementation science
• Public health
• Mental health services research

Background:

• Suicide is a significant public health issue in Canada, with many decedents having recent primary care contact.
• Smokers face elevated suicide risks due to co-occurring conditions and social determinants, highlighting primary care's potential role in prevention.

Purpose of the Study:

• To identify barriers and facilitators for integrating suicide prevention into smoking cessation programs in primary care.
• To develop and test strategies for implementing suicide screening and assessment in Ontario primary care settings.

Main Methods:

• A three-phase sequential mixed-method design was used, including interviews, consensus discussions, and Plan-Do-Study-Act cycles.
• The Consolidated Framework for Implementation Research and Expert Recommendations for Implementing Change tools guided the process.

Main Results:

• Lack of training and educational materials were identified as key barriers by healthcare providers.
• A webinar, preamble to depression questions, and an infographic were endorsed and tested as acceptable and feasible implementation strategies.

Conclusions:

• Despite implementation barriers, suicide prevention protocols can be successfully integrated into primary care smoking cessation programs.
• Tested strategies offer practical solutions for enhancing suicide screening and assessment in primary care settings.