Scale-Up Component

规模扩大研究总结 研究实施过程对于确定集成的 干预是可持续的，同时在更大范围内实施，并最终蔓延到 其他背景。在扩大研究部分，研究人员旨在探索和评估 综合干预计划的翻译和公共卫生影响，通过研究 以下要素： A）在预防自杀综合干预中的不同子元素的范围 古吉拉特邦农村地区的目标人口（青少年和成年人） B）综合干预在降低自杀率和自杀行为方面的有效性 古吉拉特邦农村地区的目标人群 C）在村庄、学校和初级保健机构实施综合自杀预防方案 古吉拉特邦农村地区的医疗保健系统 D）在实施复杂的自杀预防计划方面的一致性和成本效益 古吉拉特邦农村的一个地区 为了实现这些目标，将在古吉拉特邦的Mehsana区实施上述干预措施 农村人口占74%。在其9个分区（talukas/街区）和618个村庄中， 将选择60个村庄进行干预， 控制条件。干预组将接受综合自杀预防 干预措施（在选定村庄的学校、 在选定的村庄进行社区保健工作者把关培训）。我们将 比较结果（自杀率，自杀企图和自杀意念）在村庄， 一个密集的，综合的自杀预防计划，以可比的控制村庄，分层为 人口变量，以保持那些村庄在两种条件下的可比性， 同一地区的人只接受现有初级和初级保健机构提供的“常规护理”， 二级卫生保健系统。

Scale Up Study Summary Researching implementation processes is important to determine whether the integrated intervention is sustainable while being implemented on a wider scale, and eventually, spread to other contexts. Within the scale-up study component, researchers aim to explore and assess the translation and public health impact of the integrated intervention program by studying the following elements: A) Reach of the different sub-elements of the complex suicide prevention intervention in the target population in a district in rural Gujarat (adolescents & adults) B) Effectiveness of the integrated intervention in reducing suicide rates and suicidal behaviors in the target populations in a district in rural Gujarat C) Adoption of the complex suicide prevention program by villages, schools and primary health care system in a district in rural Gujarat D) Consistency and cost effectiveness of the delivery of complex suicide prevention program in a district in rural Gujarat To achieve these aims, the said intervention will be implemented in Gujarat’s Mehsana district which has 74% rural population. Of its 9 sub-districts (talukas/blocks) and 618 villages, 60 villages will be selected and randomized to the intervention, and 60 villages will be randomized to the control condition. The intervention group will receive the integrated suicide prevention intervention (implementation in schools in selected villages, community storage facilities in selected villages, and community health worker gatekeeper training in selected villages). We will compare outcomes (suicide rates, suicide attempts and suicide ideation) in villages that receive an intensive, integrated suicide prevention program to comparable control villages, stratified for demographic variables in order to keep the villages in both conditions comparable within the same district who are only exposed to ‘usual care’ as delivered by the existing primary and secondary health care system.