Towards development of guidelines for harnessing implementation science for suicide prevention: an international Delphi expert consensus study.

Krishnamoorthy, Armstrong, Ross, Reifels, Purdon, Francis, Hawgood, Mathieu, Kasal, Crawford, Gustavson, Székely, Baran, Erlangsen, Nemiro, Curnow, Reidenberg, Biechowska, Arensman, Quarshie, Shand, Ramirez, Zbukvic, Gullestrup, McGill, King, Vijayakumar, White, Barnaby, Sinyor, Sokól-Szawlowska, Van Zyl, Sisask, Phillips, Rezaeian, Yonemoto, Pollock, Jain, Yip, Qin, Toczyski, Dandona, Gusmão, Jabr, Spafford, Hwang, Niederkrotenthaler, Hegerl, Poštuvan, Motohashi, Kõlves. Towards development of guidelines for harnessing implementation science for suicide prevention: an international Delphi expert consensus study. BMJ public health. 2025 Jan 1; 3(1):e001206, DOI: 10.1136/bmjph-2024-001206.

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Abstract:

OBJECTIVES: Suicide research and prevention are complex. Many practical, methodological and ethical challenges must be overcome to implement effective suicide prevention interventions. Implementation science can offer insights into what works, why and in what context. Yet, there are limited real-world examples of the application of implementation science in suicide prevention. This study aimed to identify approaches to employ principles of implementation science to tackle important challenges in suicide prevention. METHODS: A questionnaire about promoting implementation science for suicide prevention was developed through thematic analysis of stakeholder narratives. Statements were categorised into six domains: research priorities, practical considerations, approach to intervention design and delivery, lived experience engagement, dissemination and the way forward. The questionnaire (n = 52 statements-round 1; n = 44 statements-round 2; n = 9 statements-round 3) was administered electronically to a panel (n = 62-round 1, n = 48-round 2; n = 45-round 3) of international experts (suicide researchers, leaders, project team members, lived experience advocates). Statements were rated on a Likert scale based on an understanding of importance and priority of each item. Statements endorsed by at least 85% of the panel would be included in the final guidelines. RESULTS: Eighty-two of the 90 statements were endorsed. Recommendations included broadening research inquiries to understand overall programme impact; accounting for resources in the translation of evidence into practice; embedding implementation science in intervention delivery and design; meaningfully engaging lived experience; considering channels for dissemination of implementation-related findings and focusing on next steps needed to routinely harness the strengths of implementation science in suicide prevention research, practice and training. CONCLUSION: An interdisciplinary panel of suicide prevention experts reached a consensus on optimal strategies for using implementation science to enhance the effectiveness of policies and programmes aimed at reducing suicide.