实施综合社区自杀预防计划,印度古吉拉特邦:集群随机对照试验
Lakshmi Vijayakumar1,2, Soumitra Pathare3, Nikhil Jain3
1SNEHA and Head of the Psychiatry Department, https://ror.org/058xqwv02Voluntary Health Services, Chennai, India.
印度的一项大规模的自杀预防干预措施将自杀死亡率降低了43%,但并没有显著降低自杀企图. 该研究强调了低收入和中等收入国家 (LMICs) 多元组件战略的潜力.
科学领域:
- 全球公共卫生 全球公共卫生
- 心理健康研究 心理健康研究
- 干预科学 干预科学
背景情况:
- 自杀是低收入和中等收入国家 (LMICs) 的重大公共卫生问题.
- 这些地区大规模预防自杀干预的证据有限.
- 现有的研究往往缺乏全面的,多元件的方法.
研究的目的:
- 评估印度农村地区的综合性自杀预防干预措施.
- 评估干预对自杀死亡和自杀企图的影响.
- 检查学校计划的实施和有效性,限制手段和加强风险识别.
主要方法:
- 一个实用集群随机对照试验,涉及印度梅萨纳的124个村庄.
- 干预包括基于学校的意识,社区农药储存和社区卫生工作者 (CHW) 的培训.
- 治疗意图分析使用混合效应的Poisson回归;新型自杀监测系统捕获了主要结果.
主要成果:
- 自杀企图和死亡的综合结果没有显著减少.
- 在干预组中观察到自杀死亡率减少了43% (IRR为0.57,95%CI为0.32-1.02).
- 高学生参与率 (≥90%) 与抑郁症/想法减少;高农药储物柜吸收率 (88.83%);医疗保健工作人员表现出更好的知识,并确定了108名处于风险的个人.
结论:
- 多组件干预显著减少了自杀死亡,但没有自杀企图.
- 该研究表明,扩大规模,复杂的干预措施在LMICs的可行性和影响.
- 这些发现推动了预防自杀的研究,并强调了综合方法的重要性.
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