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Measuring trainer fidelity in the transfer of suicide prevention training.

ABSTRACT: BACKGROUND:Finding effective and efficient models to train large numbers of suicide prevention interventionists, including 'hotline' crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. AIMS:To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. METHOD:We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. RESULTS:On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. In all, 18% of trainers' observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. CONCLUSIONS:We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models.

SUBMITTER: Cross WF

PROVIDER: S-EPMC4273242 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Measuring trainer fidelity in the transfer of suicide prevention training.

Cross Wendi F WF Pisani Anthony R AR Schmeelk-Cone Karen K Xia Yinglin Y Tu Xin X McMahon Marcie M Munfakh Jimmie Lou JL Gould Madelyn S MS

Crisis 20140101 3

<h4>Background</h4>Finding effective and efficient models to train large numbers of suicide prevention interventionists, including 'hotline' crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied.<h4>Aims</h4>To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments.<h4>Method</h4>We recorded ...[more]

PMID: 24901061

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Project description:BackgroundUntil now, there is no clear overview of how fidelity is assessed in school-based obesity prevention programmes. In order to move the field of obesity prevention programmes forward, the current review aimed to 1) identify which fidelity components have been measured in school-based obesity prevention programmes; 2) identify how fidelity components have been measured; and 3) score the quality of these methods.MethodsStudies published between January 2001-October 2017 were selected from searches in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library and ERIC. We included studies examining the fidelity of obesity prevention programmes (nutrition and/or physical activity and/or sitting) at school (children aged 4-18 year) measuring at least one component of implementation fidelity. A data extraction was performed to identify which and how fidelity components were measured. Thereafter, a quality assessment was performed to score the quality of these methods. We scored each fidelity component on 7 quality criteria. Each fidelity component was rated high (>?75% positive), moderate (50-75%) or low (<?50%).ResultsOf the 26,294 retrieved articles, 73 articles reporting on 63 different studies were included in this review. In 17 studies a process evaluation was based on a theoretical framework. In total, 120 fidelity components were measured across studies: dose was measured most often (N =?50), followed by responsiveness (N =?36), adherence (N =?26) and quality of delivery (N =?8). There was substantial variability in how fidelity components were defined as well as how they were measured. Most common methods were observations, logbooks and questionnaires targeting teachers. The quality assessment scores ranged from 0 to 86%; most fidelity components scored low quality (n =?77).ConclusionsThere is no consensus on the operationalisation of concepts and methods used for assessing fidelity in school-based obesity prevention programmes and the quality of methods used is weak. As a result, we call for more consensus on the concepts and clear reporting on the methods employed for measurements of fidelity to increase the quality of fidelity measurements. Moreover, researchers should focus on the relation between fidelity and programme outcomes and determine to what extent adaptations to programmes have been made, whilst still being effective.

Project description:BackgroundWidespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured.MethodsThis paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness.ResultsAlthough most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness).ConclusionAlthough difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as selecting programs with features that minimize complexity while maximizing flexibility. Time constraints in the classroom should be considered when choosing a program. Student behavior also influences program delivery, so schools should train teachers in the use of classroom management skills. This project involved comprehensive program monitoring and technical assistance that likely facilitated the identification and resolution of problems and contributed to the overall high quality of implementation. Schools should recognize the importance of training and technical assistance to ensure quality program delivery.

Project description:ObjectivesThis study was designed to evaluate the outcomes of a national summer 2020 'Opioids and the Workplace' Prevention and Response (OWPR) Train-the-Trainer (TTT) and Leadership training tool and program at 6-month follow-up. The TTT program goal is to help instructors plan and conduct education and training on opioids and the workplace awareness. The Leadership program goal is to help trainees, who are in a position to take organizational level actions, implement policies, and programs related to opioid and substance use and injury prevention.MethodsTrainees were from various backgrounds, such as labor unions, academic consortiums, health and safety professionals, government, and community organizations. About 6 months following each individual course date a follow-up survey was sent to each available participants' e-mail (n = 53 TTT, n = 28 Leadership) with a response rate of 47.2% for the TTT (n = 25) and 63.2% for Leadership (n = 12). Trainees were asked about individual or workplace level actions taken; any obstacles that prevented them or their coworkers from being involved in or conducting activities; if the OWPR training tool was used in their workplace for a training program; and whether the pandemic impacted their ability to address opioids in the workplace.ResultsAmong TTT trainees, about half of follow-up survey respondents from the 2020 training reported planning and conducting training and education, reaching out to coworkers to see how they are doing, sharing factsheets and information from the opioid training with coworkers, and re-focusing on self-care. Among Leadership trainees, about two-fifths of follow-up survey respondents from the 2020 training reported sharing factsheets and information from the opioid training. Some trainees described the COVID-19 pandemic as limiting their ability to take actions in addressing opioids and the workplace.ConclusionsEvidence supports that the 'Opioids and the Workplace' Train-the-Trainer program and materials have contributed to helping trainees plan and conduct opioids awareness training at their organizations. Evidence supports that the Opioids in the Workplace Leadership program helped contribute to trainees taking workplace level actions to implement policies and programs.

Project description:IntroductionIn behavioral health care settings, a workforce well trained in suicide prevention is critically important for behavioral health care professionals across different disciplines and service sectors who are likely to have considerable exposure to patients at risk for suicidal behavior. This study examined the types of training behavioral health care professionals received, their self-reported skills, comfort level and confidence related to suicide prevention, the association of types and length of training with skills, comfort level and confidence, and areas in which participants would like more training.MethodsThe Zero Suicide Workforce Survey was administered electronically to behavioral health care professionals at six behavioral health treatment centers with both inpatient and ambulatory programs in Connecticut, USA. Item numbers and percentages were calculated for 847 respondents with behavioral health care roles. The chi-square tests were performed to determine the statistical significance of group differences. Non-parametric sign tests were performed to determine the statistical significance of the collective differences in direction among items between groups.ResultsSuicide prevention training is associated with increased levels of behavioral health care professionals' skills and confidence, but one-third of behavioral health care professionals in the sample received no formal training in suicide prevention/intervention. Even brief training appears to have a positive impact on behavioral health care professionals' assessment of their skills and confidence. Prominent topics for additional training include suicide-specific treatment approaches, suicide prevention and awareness, and identification of risk factors and warning signs.ConclusionAlthough behavioral health care professionals may often encounter patients at risk for suicide, many have not obtained any relevant training. The findings highlight the need to strengthen suicide identification, assessment and treatment within behavioral health care treatment settings as part of an effort to prevent suicide.

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Measuring trainer fidelity in the transfer of suicide prevention training.

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Measuring trainer fidelity in the transfer of suicide prevention training.

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