TY  - JOUR
PY  - 2023//
TI  - Efficacy of a digitally supported regional systems intervention for suicide prevention (SUPREMOCOL) in Noord-Brabant, the Netherlands
JO  - General hospital psychiatry
A1  - van der Feltz-Cornelis, Christina M.
A1  - Hofstra, Emma
A1  - Elfeddali, Iman
A1  - Bakker, Marjan
A1  - Metz, Margot J.
A1  - de Jong, Jacobus J.
A1  - Van Nieuwenhuizen, Chijs
SP  - 73
EP  - 81
VL  - 84
IS  - 
N2  - OBJECTIVE: We evaluated the effect of a digitally supported systems intervention for suicide prevention (SUPREMOCOL) in Noord-Brabant, the Netherlands. <br><br>METHOD: Non-randomized stepped wedge trial design (SWTD). Stepwise implementation in the five subregions of the systems intervention. Pre-post analysis for the whole province (Exact Rate Ratio Test, Poisson count). SWTD Hazard Ratios of suicides per person-years for subregional analysis of control versus intervention conditions over five times three months. Sensitivity analysis. <br><br>RESULTS: Suicide rates dropped 17.8% (p = .013) from 14.4 suicides per 100,000 before the start of implementation of the systems intervention (2017), to 11.9 (2018) and 11.8 (2019) per 100, during implementation; a significant reduction (p = .043) compared to no changes in the rest of the Netherlands. Suicide rates dropped further by 21.5% (p = .002) to 11.3 suicides per 100,000 during sustained implementation in 2021. Sensitivity analysis confirmed the reduction (p = .02). The SWTD analysis over 15 months in 2018-2019 did not show a significant association of this reduction with implementation per subregional level, probably due to insufficient power given the short SWTD timeframe for implementation and low suicide rates per subregion. <br><br>CONCLUSIONS: During the SUPREMOCOL systems intervention, over four years, there was a sustained and significant reduction of suicides in Noord-Brabant.<p />  <p>Language: en</p>
LA  - en
SN  - 0163-8343
UR  - http://dx.doi.org/10.1016/j.genhosppsych.2023.06.010
ID  - ref1
ER  -