Sadhvi Krishnamoorthy is a PhD candidate at the Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Australia. She has had experience of working with large-scale, community-based complex implementation programs in low-resource settings in India. She is interested in understanding the mechanisms involved in translation of research into practice. Her doctoral work aims to explore pathways for harnessing implementation science for suicide prevention.
Understanding what works in preventing suicidal behaviour is complex and remains largely unaddressed. A clear evidence-practice gap exists. One of the ways to bridge this gap is to understand the influence of determinants on intervention delivery, adoption, and sustainment along with experiences and lessons learned on the ground. This study examines barriers, facilitators and lessons learned from implementing complex suicide prevention interventions across the world.
This study reports on data from a comprehensive systematic review of complex suicide prevention interventions, using updated PRISMA guidelines. All English language records (including grey literature) between 1990-2022 were searched on PubMed, CINAHL, PsycINFO, ProQuest, SCOPUS and CENTRAL. Interventions were defined as being complex if they consisted of three or more components, implemented across two or more levels of the social ecology. Data on barriers, facilitators and lessons learned was extracted from clusters of reports on interventions and were mapped using the updated Consolidated Framework for Implementation Research (CFIR).
The most common barriers were reported in the setting within which the intervention was implemented and were related to the compatibility of the intervention, culture and maintaining relational connections. The most frequently reported facilitators were related to the individual motivation, capability, and need. Lessons learned focused on the importance of adaptation and ensuring responsiveness to contextual needs.
Data on barriers, facilitators and lessons learned was inferred from the reports included in the study and hence was limited in its understanding of implementation experiences.
This study emphasises the importance of documenting and analysing important influences on the implementation process. This information can help develop a better understanding of how the evidence-practice translation happens in suicide research and prevention.