TY  - JOUR
PY  - 2022//
TI  - Gatekeeper training for vendors to reduce pesticide self-poisoning in rural South Asia: a study protocol for a stepped-wedge cluster randomised controlled trial
JO  - BMJ open
A1  - Weerasinghe, Manjula
A1  - Pearson, Melissa
A1  - Turner, Nicholas
A1  - Metcalfe, Chris
A1  - Gunnell, David J.
A1  - Agampodi, Suneth
A1  - Hawton, Keith
A1  - Agampodi, Thilini
A1  - Miller, Matthew
A1  - Jayamanne, Shaluka
A1  - Parker, Simon
A1  - Sumith, Jayakody Arachchige
A1  - Karunarathne, Ayanthi
A1  - Dissanayaka, Kalpani
A1  - Rajapaksha, Sandamali
A1  - Rodrigo, Dilani
A1  - Abeysinghe, Dissanayake
A1  - Piyasena, Chathuranga
A1  - Kanapathy, Rajaratnam
A1  - Thedchanamoorthy, Sundaresan
A1  - Madsen, Lizell Bustamante
A1  - Konradsen, Flemming
A1  - Eddleston, Michael
SP  - e054061
EP  - e054061
VL  - 12
IS  - 4
N2  - INTRODUCTION: Pesticide self-poisoning kills an estimated 110 000-168 000 people worldwide annually. Data from South Asia indicate that in 15%-20% of attempted suicides and 30%-50% of completed suicides involving pesticides these are purchased shortly beforehand for this purpose. Individuals who are intoxicated with alcohol and/or non-farmers represent 72% of such customers. We have developed a 'gatekeeper' training programme for vendors to enable them to identify individuals at high risk of self-poisoning (gatekeeper function) and prevent such individuals from accessing pesticides (means restriction). The primary aim of the study is to evaluate the effectiveness of the gatekeeper intervention in preventing pesticide self-poisoning in Sri Lanka. Other aims are to identify method substitution and to assess the cost and cost-effectiveness of the intervention. <br><br>METHODS AND ANALYSIS: A stepped-wedge cluster randomised trial of a gatekeeper intervention is being conducted in rural Sri Lanka with a population of approximately 2.7 million. The gatekeeper intervention is being introduced into 70 administrative divisions in random order at each of 30 steps over a 40-month period. The primary outcome is the number of pesticide self-poisoning cases identified from surveillance of hospitals and police stations. Secondary outcomes include: number of self-poisoning cases using pesticides purchased within the previous 24 hours, total number of all forms of self-harm and suicides. Intervention effectiveness will be estimated by comparing outcome measures between the pretraining and post-training periods across the divisions in the study area. The original study protocol has been adapted as necessary in light of the impact of the COVID-19. ETHICS AND DISSEMINATION: The Ethical Review Committee of the Faculty of Medicine and Allied Sciences, Rajarata University, Sri Lanka (ERC/2018/30), and the ACCORD Medical Research Ethics Committee, Edinburgh University (18-HV-053) approved the study. <br><br>RESULTS will be disseminated in scientific peer-reviewed journals. TRIAL REGISTRATION NUMBER: SLCTR/2019/006, U1111-1220-8046.<p />  <p>Language: en</p>
LA  - en
SN  - 2044-6055
UR  - http://dx.doi.org/10.1136/bmjopen-2021-054061
ID  - ref1
ER  -