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Suicide is one of the main causes of death among teenagers. Because it is preventable, primary prevention of suicide has become a public health priority, with encouraging results in promoting suicide awareness and reducing suicidal thoughts among adolescents. However, the lack of studies conducted among vulnerable populations (i.e., marginalised, disengaged and disadvantaged) is a major gap, even though these populations present an increased risk of suicidal behaviour.
The aim of this project is to test the effectiveness of a brief primary suicide prevention intervention for vulnerable adolescents, using a randomised controlled trial. Vulnerable adolescents include those 1) detained in juvenile detention centres, 2) at risk of dropping out of school, 3) undergoing treatment for psychiatric disorders, 4) belonging to a sexual or gender diversity, 5) affected by chronic conditions, or 6) with relational/familial problems. The main aim is to test the effectiveness of the intervention on a composite measure of suicide awareness, psychological distress and suicidal thoughts. The project will also explore other issues that present challenges for vulnerable populations: access to primary suicide prevention and non-response bias. The study will provide relevant results to address the current lack of high-quality evidence for primary suicide prevention in adolescents.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primary suicide prevention intervention | Experimental | The framework of the primary suicide prevention intervention is psychoeducation. The intervention lasts for 90 minutes and is conducted in groups of 5 to 15 (on average 10) participants. It provides general information on suicidal behaviors, information about facts and myths about suicide, identification of risk factors and warning signs of suicidal behaviors, and information on ways to seek for help and get support for themselves and others in the canton. The intervention includes a lecture, group discussions based on case examples, and a quiz on facts and myths about suicide. It is conducted by a trained staff member with the support of a psychologist trained in suicide prevention for children and adolescents. It follows a standardized format. |
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| Art-based control intervention | Active Comparator | The control intervention will be an art-based activity, a workshop on slam poetry. At the end of the study, participants will get a flyer containing information on suicide prevention with the participants of the control group. Therefore, they will have a low-threshold intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Primary suicide prevention intervention | Behavioral | Psychoeducation workshop |
|
| Measure | Description | Time Frame |
|---|---|---|
| Composite measure of suicide awareness | Nine-item perceived suicide awareness scale (PSAS-9), assessed on a 5-point scale, score ranging from 0 to 36, with a higher score indicating a higher suicide awareness | One-week post-baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Composite measure of suicide awareness | Nine-item perceived suicide awareness scale (PSAS-9), assessed on a 5-point scale, score ranging from 0 to 36, with a higher score indicating a higher suicide awareness | Three-month post-baseline |
| Knowledge on suicide |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with serious adverse events (safety outcome) | Death, life-threatening event, and hospitalisation | One-month post baseline |
| Number of participants with adverse events (safety outcome) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Stéphanie Baggio, Prof. | Contact | +41316846774 | stephanie.baggio@unibe.ch |
| Name | Affiliation | Role |
|---|---|---|
| Stéphanie Baggio, Prof. | Institute of Primary Health Care (BIHAM), University of Bern | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dialogai et Totem | Recruiting | Geneva | Canton of Geneva | 1201 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41286939 | Derived | Baggio S, Bailey E, Edan A, Heller P, Kapp C, Lambert N, Michaud L, Mundt AP, Nsingi N, Perez S, Peregalli S, Piguet C, Piotrowski C, Prutyanova Y, Rumley M, Sapin M, Urben S, Iglesias K. Evaluating primary suicide prevention in adolescents with risk factors (ESPAIR): study protocol for a cluster-randomized controlled trial. Trials. 2025 Nov 24;26(1):537. doi: 10.1186/s13063-025-09266-y. |
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Data will be shared on https://www.swissubase.ch.
After the publication of the main results of the study
Upon approval from the principal investigator
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| Art-based control intervention | Behavioral | Slam poetry workshop |
|
Literacy of Suicide Scale (LOSS), 12 binary (true/false) questions, score ranging from 0 to 12, with a higher score indicating higher knowledge on suicide |
| One-week post-baseline; three-month post-baseline |
| Knowledge of local resources | Self-developed scale on local resources, 6 binary (true/false) questions, score ranging from 0 to 6, with a higher score indicating higher knowledge of local resources | One-week post-baseline; three-month post-baseline |
| Suicidal thoughts | Suicidal Ideation Attributes Scale (SIDAS), 10 questions assessed on a 5-point scale, with a score ranging from 0 to 50. A higher score indicates a higher level of suicidal thoughts. | One-week post-baseline; three-month post-baseline |
| Psychological distress | Kessler Psychological Distress scale (K-6), 6-item scale is assessed on a 5-point scale, with a score ranging from 0 to 24. A higher score indicates a higher level of psychological distress. | One-week post-baseline; three-month post-baseline |
| Access to primary suicide prevention | Self-developed scale on primary suicide prevention training, 3 questions combined in a binary indicator (yes/no) | Baseline |
| Attrition | Percentage of participants who drop out, continuous variable (0-100), with a higher percentage indicating a higher level of attrition | Three-month post-baseline |
Scarification, insomnia, appetite problems, substance use, and para-suicidal endangerment behaviors identified and reported by the local team
| One-month post baseline |
| Self-reported distress (safety outcome) | Composite outcome with two questions from Bailey et al. (2017, https://https://doi.org/10.1027/0227-5910/a000465) related to the distressing and pleasurable nature of the intervention, assessed on a 5-point scale, score ranging from 0 to 8, a higher score indicating higher self-reported distress | One-week post-baseline |
| Programme ForMe (anciennement SEMO) et dispositif ProPULSE | Recruiting | Plan-les-Ouates | Canton of Geneva | 1228 | Switzerland |
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| Centre de Détention et d'Observation La Clairière | Recruiting | Vernier | Canton of Geneva | 1214 | Switzerland |
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| Programme Intégration et Formation Professionnelle | Recruiting | Vernier | Canton of Geneva | 1214 | Switzerland |
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| Agnodice | Recruiting | Lausanne | Canton of Vaud | 1003 | Switzerland |
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| Vogay | Recruiting | Lausanne | Canton of Vaud | 1003 | Switzerland |
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| Centre Thérapeutique de Jour pour Adolescents | Recruiting | Lausanne | Canton of Vaud | 1005 | Switzerland |
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| Unité de Soins Psychiatriques Fermée pour Mineurs | Recruiting | Lausanne | Canton of Vaud | 1008 | Switzerland |
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| Établissement de Détention pour mineurs et jeunes adultes Les Léchaires | Recruiting | Palézieux | Canton of Vaud | 1607 | Switzerland |
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| Centre éducatif fermé de Pramont | Recruiting | Sierre | Valais | 3977 | Switzerland |
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| CAP Formations, Cité des Métiers | Recruiting | Geneva | 1205 | Switzerland |
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| Unité de Liaison Ambulatoire et Hospitalière, Service de psychiatrie de l'enfant et de l'adolescent, HUG | Recruiting | Geneva | 1205 | Switzerland |
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| Foyers de Gilly | Recruiting | Grand-Lancy | 1212 | Switzerland |
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| Foyer de Chailly | Recruiting | Lausanne | 1012 | Switzerland |
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| Ren'Fort | Recruiting | Lausanne | 1018 | Switzerland |
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| Foyer La Pommeraie | Recruiting | Lonay | 1027 | Switzerland |
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| Service des Parcours Individualisé | Recruiting | Onex | 1213 | Switzerland |
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| Le Repuis | Recruiting | Petit Lancy | 1213 | Switzerland |
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| Astural, Parcours A2mains | Recruiting | Thônex | 1226 | Switzerland |
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| ID | Term |
|---|---|
| D000092864 | Suicide Prevention |
| D013405 | Suicide |
| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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