致命手段安全咨询干预的系统回顾:对安全行为和自我导向暴力的影响。

IF 5.2 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiologic Reviews Pub Date : 2024-09-16 DOI:10.1093/epirev/mxae001
Elizabeth G Spitzer, Kelly A Stearns-Yoder, Adam S Hoffberg, Hannah M Bailey, Christopher J Miller, Joseph A Simonetti
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引用次数: 0

摘要

要想通过致命手段安全咨询干预(LMSC)降低人群自杀率,必须在多种环境和人群中采取干预措施。我们在六个数据库中进行了系统性检索,回顾了不同研究设计、环境、信息传递者、人群和伤害预防水平(如普遍性)的致命手段安全咨询干预的现状。资格标准为:任何接受 LMSC 干预的个人或团体,该干预涉及人与人之间的关系,旨在影响与致命自杀方法相关的成人行为,并对储存行为和/或自杀性自我导向暴力(SDV)进行结果评估。采用有效公共卫生实践项目(EPHPP)质量评估工具对偏倚风险进行了评估。采用描述性综合方法进行分析。共纳入了 22 项报告 LMSC 后药物和/或枪支储存行为和/或 SDV 的研究。在 19 项评估行为变化的研究中,有 14 项报告了安全储藏行为的显著改善,所有评估可接受性的研究都报告了参与者对干预措施的好评。证据质量有限。没有研究被评为低偏倚风险,77%的研究被评为高偏倚风险。在环境、人群、伤害预防水平、实施方法和干预要素方面存在很大的异质性。许多纳入的研究侧重于儿科人群的护理人员,很少有研究对 SDV 结果进行评估。我们需要在各种环境下进行更高质量的试验,尤其是针对有自杀风险的成年人的试验。本综述未获得任何资助,已在系统综述国际前瞻性注册中心 (PROSPERO) 预先注册(ID:CRD42021230668)。
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A systematic review of lethal means safety counseling interventions: impacts on safety behaviors and self-directed violence.

For lethal means safety counseling (LMSC) interventions to reduce population-level suicide rates, interventions must be deployed across many settings and populations. We conducted a systematic search in 6 databases to review the current state of LMSC interventions across study designs, settings, intervention providers, populations, and injury prevention levels (eg, universal). Eligibility criteria were as follows: any individual or group receiving an LMSC intervention involving a human-to-human component aiming to influence adult behaviors related to lethal suicide methods, and outcome assessment of storage behaviors and/or suicidal self-directed violence (SDV). Risk of bias was assessed using the Effective Public Health Practice Project quality assessment tool. A descriptive synthesis approach was used for analysis. Twenty-two studies were included that reported medication- and/or firearm-storage behaviors and/or SDV after LMSC. Of the 19 studies assessing behavioral change, 14 reported a significant improvement in safe storage behaviors, and all studies measuring acceptability reported that participants found the interventions favorable. The quality of evidence was limited. No studies were rated low risk of bias, and 77% were rated high risk of bias. There was substantial heterogeneity in the settings, populations, injury prevention levels, delivery methods, and intervention elements. Many included studies focused on caregivers of pediatric populations, and few studies assessed SDV outcomes. Higher-quality trials conducted across a variety of settings, particularly those focusing on adults at risk of suicide, are needed. This review was preregistered with the International Prospective Register of Systematic Reviews (no. CRD42021230668).

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来源期刊
Epidemiologic Reviews
Epidemiologic Reviews 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
0.00%
发文量
10
期刊介绍: Epidemiologic Reviews is a leading review journal in public health. Published once a year, issues collect review articles on a particular subject. Recent issues have focused on The Obesity Epidemic, Epidemiologic Research on Health Disparities, and Epidemiologic Approaches to Global Health.
期刊最新文献
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