Evaluating primary suicide prevention in adolescents with risk factors (ESPAIR): study protocol for a cluster-randomized controlled trial
Bibliographic record
Abstract
BACKGROUND: Suicide is the leading cause of death among young people. Because it is preventable, suicide prevention has become a critical public health priority worldwide. Current evidence suggests that primary suicide prevention interventions are effective in promoting suicide awareness and reducing suicidal thoughts among adolescents. However, scarce research has been conducted in vulnerable populations who may be at increased risk of suicidal behaviour. This project aims to test the effectiveness of a primary suicide prevention intervention on suicide awareness, knowledge of suicide and local resources, suicidal thoughts, psychological distress, and safety. METHODS: This study is an open-label, multi-centre, superiority, cluster-randomized controlled trial with two parallel arms (randomization 1:1 in at least 8 study sites) of a primary suicide prevention intervention based on psychoeducation versus an art-based control intervention. Four groups of youth aged 14-25 with high suicide risk will be recruited (in total, n = 240), including those (1) detained in juvenile detention centres, (2) disconnected from school, (3) in treatment for psychiatric disorders, (4) belonging to a sexual or gender diversity, (5) affected by chronic conditions, and (6) with relational/familial problems. Participants will be randomly assigned to the suicide prevention or control intervention. The primary outcome is suicide awareness measured on a validated scale. Secondary outcomes include knowledge of suicide, knowledge of local resources, suicidal behaviour, psychological distress, access to primary suicide prevention, and safety. Measures will be collected at baseline, at 1-week, and 3-month follow-ups. Analyses will be conducted as intention-to-treat using mixed-effects models. DISCUSSION: We expect that a brief primary suicide prevention intervention (psychoeducation) will be effective and safe in vulnerable adolescents. TRIAL REGISTRATION: ClinicalTrials.gov NCT06551038. Registered on August 13, 2024.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.031 |
| Meta-epidemiology (narrow) | 0.007 | 0.003 |
| Meta-epidemiology (broad) | 0.018 | 0.008 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.007 | 0.008 |
| Insufficient payload (model declined to judge) | 0.075 | 0.010 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".