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dc.contributor.authorHegerl, Ulrichen_UK
dc.contributor.authorMaxwell, Margareten_UK
dc.contributor.authorHarris, Fionaen_UK
dc.contributor.authorKoburger, Nicoleen_UK
dc.contributor.authorMergl, Rolanden_UK
dc.contributor.authorSzékely, Andrásen_UK
dc.contributor.authorArensman, Ellaen_UK
dc.contributor.authorVan Audenhove, Chantalen_UK
dc.contributor.authorLarkin, Celineen_UK
dc.contributor.authorDitta Toth, Mónikaen_UK
dc.contributor.authorQuintão, Sóniaen_UK
dc.contributor.authorVärnik, Airien_UK
dc.contributor.authorGenz, Axelen_UK
dc.contributor.authorSarchiapone, Marcoen_UK
dc.contributor.authorMcDaid, Daviden_UK
dc.description.abstractThe ‘European Alliance Against Depression’ community-based intervention approach simultaneously targets depression and suicidal behaviour by a multifaceted community based intervention and has been implemented in more than 115 regions worldwide. The two main aims of the European Union funded project “Optimizing Suicide Prevention Programmes and Their Implementation in Europe” were to optimise this approach and to evaluate its implementation and impact. This paper reports on the primary outcome of the intervention (the number of completed and attempted suicides combined as ‘suicidal acts’) and on results concerning process evaluation analysis. Interventions were implemented in four European cities in Germany, Hungary, Portugal and Ireland, with matched control sites. The intervention comprised activities with predefined minimal intensity at four levels: training of primary care providers, a public awareness campaign, training of community facilitators, support for patients and their relatives. Changes in frequency of suicidal acts with respect to a one-year baseline in the four intervention regions were compared to those in the four control regions (chi-square tests). The decrease in suicidal acts compared to baseline in the intervention regions (-58 cases, -3.26%) did not differ significantly (2 = 0.13; p = 0.72) from the decrease in the control regions (-18 cases, -1.40%). However, intervention effects differed between countries (2 = 8.59; p = 0.04), with significant effects on suicidal acts in Portugal (2 = 4.82; p = 0.03). The interviews and observations explored local circumstances in each site throughout the study. Hypothesised mechanisms of action for successful implementation were observed and drivers for ‘added-value’ were identified: local partnership working and ‘in-kind’ contributions; an approach which valued existing partnership strengths; and synergies operating across intervention levels. It can be assumed that significant events during the implementation phase had a certain impact on the observed outcomes. However, this impact was, of course, not proven.en_UK
dc.publisherPublic Library of Scienceen_UK
dc.relationHegerl U, Maxwell M, Harris F, Koburger N, Mergl R, Székely A, Arensman E, Van Audenhove C, Larkin C, Ditta Toth M, Quintão S, Värnik A, Genz A, Sarchiapone M & McDaid D (2019) Prevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countries. PLoS ONE, 14 (11), Art. No.: e0224602.
dc.rights© 2019 Hegerl et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_UK
dc.titlePrevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countriesen_UK
dc.typeJournal Articleen_UK
dc.citation.jtitlePLoS ONEen_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderEuropean Commission (Horizon 2020)en_UK
dc.description.notesAdditional co-authors: Armin Schmidtke, György Purebl, James C Coyne, Ricardo Gusmão, on behalf of The OSPI-Europe Consortiumen_UK
dc.contributor.affiliationGoethe University Frankfurten_UK
dc.contributor.affiliationUniversity Leipzigen_UK
dc.contributor.affiliationUniversitat der Bundeswehr Munchenen_UK
dc.contributor.affiliationSemmelweis University Budapesten_UK
dc.contributor.affiliationUniversity College Corken_UK
dc.contributor.affiliationKU Leuvenen_UK
dc.contributor.affiliationUniversity College Corken_UK
dc.contributor.affiliationSemmelweis University Budapesten_UK
dc.contributor.affiliationNew University of Lisbonen_UK
dc.contributor.affiliationTallinn Universityen_UK
dc.contributor.affiliationOtto von Guericke University Magdeburgen_UK
dc.contributor.affiliationUniversity of Molise, Italyen_UK
dc.contributor.affiliationLondon School of Economicsen_UK
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles

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