Evaluating the Effectiveness of a Post-Training Enhancement to the LifeKeepers Suicide Prevention Gatekeeper Training

Background: Gatekeeper training (GKT) programs improve knowledge and self-efficacy in suicide prevention, but the sustainability of these improvements is uncertain. While booster sessions are suggested to enhance retention, existing research is inconclusive. Aim: This study aimed to evaluate the effectiveness of booster sessions in the LifeKeepers GKT program for maintaining long-term knowledge and self-efficacy at 6 months post-training. Method: A total of 1,732 participants who had completed LifeKeepers GKT were randomly assigned to one of three trial groups, an intervention (booster), control (training as usual), or attention control group. Participants completed measures of knowledge and self-efficacy at 3, 6, and 12 months and reported their frequency of interventions and referrals at 3 and 6 months. Results: No significant differences were found between the groups in terms of knowledge retention, self-efficacy, or behavior change at any follow-up point. However, sustained improvements were observed across all groups. Limitations: Ceiling effects and attrition may have influenced the findings. Conclusion: Booster sessions did not significantly enhance knowledge, self-efficacy, or behavior outcomes. All groups demonstrated sustained improvements, but ceiling effects and attrition caution against overinterpreting the findings. Further research is needed to explore effective strategies for long-term retention.