@article{HegerlWittenburgArensmanetal.2009,
  author    = {Hegerl, Ulrich and Wittenburg, Lisa and Arensman, Ella and Van Audenhove, Chantal and Coyne, James C. and McDaid, David and van der Feltz-Cornelis, Christina M. and Gusm{\~a}o, Ricardo and Kopp, M{\´a}ria and Maxwell, Margaret and Meise, Ullrich and Roskar, Saska and Sarchiapone, Marco and Schmidtke, Armin and V{\"a}rnik, Airi and Bramesfeld, Anke},
  title     = {Optimizing Suicide Prevention Programs and Their Implementation in Europe (OSPI Europe): an evidence-based multi-level approach},
  series = {BMC Public Health},
  volume    = {9},
  journal   = {BMC Public Health},
  number    = {428},
  doi       = {10.1186/1471-2458-9-428},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-154695},
  year      = {2009},
  abstract  = {Background Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. Method The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. Discussion This multi-centre research seeks to overcome major challenges of field research in suicide prevention. It pools data from four European regions, considerably increasing the study sample, which will be close to one million. In addition, the study will gather important information concerning the potential to transfer this multilevel program to other health care systems. The results of this research will provide a basis for developing an evidence-based, efficient concept for suicide prevention for EU-member states.},
  language  = {en}
}
@article{HarrisMaxwellO'Connoretal.2013,
  author    = {Harris, Fiona M. and Maxwell, Margaret and O'Connor, Rory C. and Coyne, James and Arensman, Ella and Andr{\´a}s, Sz{\´e}kely and Gusm{\~a}o, Ricardo and Coffey, Claire and Costa, Susana and Zoltan, Cserh{\´a}ti and Koburger, Nicole and van Audenhove, Chantal and McDaid, David and Maloney, Julia and V{\"a}rnik, Peeter and Hegerl, Ulrich},
  title     = {Developing social capital in implementing a complex intervention: a process evaluation of the early implementation of a suicide prevention intervention in four European countries},
  series = {BMC Public Health},
  volume    = {13},
  journal   = {BMC Public Health},
  number    = {158},
  doi       = {10.1186/1471-2458-13-158},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-122117},
  year      = {2013},
  abstract  = {Background: Variation in the implementation of complex multilevel interventions can impact on their delivery and outcomes. Few suicide prevention interventions, especially multilevel interventions, have included evaluation of both the process of implementation as well as outcomes. Such evaluation is essential for the replication of interventions, for interpreting and understanding outcomes, and for improving implementation science. This paper reports on a process evaluation of the early implementation stage of an optimised suicide prevention programme (OSPI-Europe) implemented in four European countries. Methods: The process analysis was conducted within the framework of a realist evaluation methodology, and involved case studies of the process of implementation in four European countries. Datasets include: repeated questionnaires to track progress of implementation including delivery of individual activities and their intensity; serial interviews and focus groups with stakeholder groups; and detailed observations at OSPI implementation team meetings. Results: Analysis of local contexts in each of the four countries revealed that the advisory group was a key mechanism that had a substantial impact on the ease of implementation of OSPI interventions, particularly on their ability to recruit to training interventions. However, simply recruiting representatives of key organisations into an advisory group is not sufficient to achieve impact on the delivery of interventions. In order to maximise the potential of high level 'gatekeepers', it is necessary to first transform them into OSPI stakeholders. Motivations for OSPI participation as a stakeholder included: personal affinity with the shared goals and target groups within OSPI; the complementary and participatory nature of OSPI that adds value to pre-existing suicide prevention initiatives; and reciprocal reward for participants through access to the extended network capacity that organisations could accrue for themselves and their organisations from participation in OSPI. Conclusions: Exploring the role of advisory groups and the meaning of participation for these participants revealed some key areas for best practice in implementation: careful planning of the composition of the advisory group to access target groups; the importance of establishing common goals; the importance of acknowledging and complementing existing experience and activity; and facilitating an equivalence of benefit from network participation.},
  language  = {en}
}