The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts
The impact of two universal randomized first- and second-grade classroom interventions on young adult suicide ideation and attempts
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DOI：
10.1016/j.drugalcdep.2008.01.005
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发表时间：
2008-06-01
影响因子：
4.2
通讯作者：
Anthony, James C.
中科院分区：
文献类型：
--
作者：
Wilcox, Holly C.;Kellam, Sheppard G.;Anthony, James C.
目的：本文报告了两个一年级和二年级的教室为基础的普遍预防干预措施的影响自杀意念（SI）和自杀企图（SA）的风险，由年轻的成年人。良好行为游戏（GBG）的目的是让孩子们成为学生，减少攻击性和破坏性行为。掌握学习（ML）旨在提高学术成就。两者都是由老师实施的。方法：该设计以流行病学为基础，在学校和教室层面进行随机化，并在教室之间平衡儿童。该试验涉及19所学校和41个教室的一年级儿童，并在一年级和二年级进行干预。一个复制实施与下一个队列的一年级儿童相同的教师，但很少指导或monitoring.Results：在第一个队列，有一致的和强大的GBG相关的自杀意念的风险降低年龄在19-21岁相比，青年在标准设置（对照）教室，无论任何类型的协变量调整。发现GBG相关的自杀企图风险降低，尽管在一些协变量调整模型中，该效应在统计学上并不稳健。ML对这些结局无统计学显著影响。GBG对自杀意念和企图的影响大大减少了复制试验涉及第二cohol.Conclusions：一个普遍的预防性干预措施，针对社会化的儿童和课堂行为管理，以减少侵略性，破坏性的行为可能会延迟或防止自杀意念和企图的发作。必须准确地实施性别平等基础教育，并得到教师的持续支持。(c)2008爱思唯尔爱尔兰有限公司保留所有权利。
Objective: This paper reports the impact of two first- and second-grade classroom based universal preventive interventions on the risk of Suicide Ideation (SI) and Suicide Attempts (SA) by young adulthood. The Good Behavior Game (GBG) was directed at socializing children for the student role and reducing aggressive, disruptive behavior. Mastery Learning (ML) was aimed at improving academic achievement. Both were implemented by the teacher.Methods: The design was epidemiologically based, with randomization at the school and classroom levels and balancing of children across classrooms. The trial involved a cohort of first-grade children in 19 schools and 41 classrooms with intervention at first and second grades. A replication was implemented with the next cohort of first grade children with the same teachers but with little mentoring or monitoring.Results: In the first cohort, there was consistent and robust GBG-associated reduction of risk for suicide ideation by age 19-21 years compared to youths in standard setting (control) classrooms regardless of any type of covariate adjustment. A GBG-associated reduced risk for suicide attempt was found, though in some covariate-adjusted models the effect was not statistically robust. No statistically significant impact on these outcomes was found for ML. The impact of the GBG on suicide ideation and attempts was greatly reduced in the replication trial involving the second cohort.Conclusions: A universal preventive intervention directed at socializing children and classroom behavior management to reduce aggressive, disruptive behavior may delay or prevent onset of suicide ideation and attempts. The GBG must be implemented with precision and continuing support of teachers. (c) 2008 Elsevier Ireland Ltd. All rights reserved.