Scale-Up Component

纵向扩展研究摘要 研究实施过程对于确定整合的 干预是可持续的，同时在更大范围内实施，并最终蔓延到 其他上下文。在扩大研究部分，研究人员的目标是探索和评估 通过研究综合干预方案的翻译和公共卫生影响 以下元素： A)复杂的自杀预防干预措施的不同次级要素在 古吉拉特邦农村地区的目标人口(青少年和成年人) B)综合干预措施在减少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)村庄、学校和初级保健机构采用复杂的自杀预防方案 古吉拉特邦农村地区的护理体系 D)实施复杂的自杀预防方案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，上述干预将在古吉拉特邦的梅萨纳区实施 那里有74%的农村人口。在其9个分区(塔鲁卡/街区)和618个村庄中，有60个 村庄将被选择并随机进行干预，60个村庄将被随机 恢复到控制状态。干预组将接受综合自杀预防 干预措施(在选定村庄的学校、#年的社区储存设施中实施 选定的村庄，以及选定村庄的社区卫生工作者看门人培训)。我们会 比较接受治疗的村庄的结果(自杀率、自杀未遂和自杀意念) 密集、综合的自杀预防计划，针对可比的对照村庄，分层实施 人口变量，以保持两个条件下的村庄在 同样的地区，只接受现有小学和小学提供的“常规护理” 二级医疗保健系统。

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.