使用RE-AIM框架对泰国北部社区自杀监测系统的评估
Mathuros Tipayamongkholgul1, Suratsawadee Klinchan2, Patcharee Veeraphan3
1Research Institute for Languages and Cultures of Asia, Mahidol University, 999 Phuttamonton Sai 4, Salaya, Phuttamonton, Nakhonpathom, 73170, Thailand. mathuros.tip@mahidol.ac.th.
BMC public health
|November 29, 2025
概括
泰国兰普的四大支柱战略成功地识别并干预了有自杀风险的个人. 虽然自杀率略有下降,但解决耻辱和提高识字能力是持续预防社区自杀的关键.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 社区心理学 社区心理学
背景情况:
- 自杀是一个重大的全球公共卫生挑战,在低收入和中等收入国家,自杀率不成比例地高.
- 泰国面临着不断上升的自杀率,特别是在像兰普这样的北部地区.
- 兰普洪省卫生局启动了"四大支柱"战略,这是一个以社区为基础的,多部门的自杀预防方法.
研究的目的:
- 评估"四大支柱"自杀预防战略在兰普洪省的可行性和有效性.
- 评估该战略在RE-AIM框架的五个维度中的表现:覆盖范围,有效性,采用,实施和维护.
主要方法:
- 一个融合的并行混合方法研究,利用自杀监测数据 (2020-2022) 和对600名成年人的社区调查.
- 通过36次深入访谈和3次焦点小组讨论 (n=21) 收集了定性数据.
- 该RE-AIM框架指导数据收集和分析,以评估自杀预防策略.
主要成果:
- 该策略达到了2,876名处于自杀风险的个人,没有随后报告的自杀行为.
- 在实施后的Lamphun中观察到自杀率的适度下降,尽管在统计学上并不显著 (p=0.331).
- 该策略的采用是可变的,受文化信仰,资源限制和耻辱的影响,在种族社区 (p<0.01) 发现自杀识字率较低.
结论:
- "四大支柱"战略证明了通过综合社区监测和响应系统来降低自杀风险的可行性和前景.
- 地方适应对于可行性至关重要,保持战略的核心原则.
- 提高自杀知识,减少耻辱感,加强多部门合作对于扩大和维持泰国和类似环境中的自杀预防工作至关重要.
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