Validation and Testing of a Suicide Prevention Program in Preventing Suicidal Ideation and Improving the Mental Well-Being of School-Going Adolescents: Protocol for a Pre-Post Intervention Study
Bibliographic record
Abstract
BACKGROUND: Globally, around 800,000 people die by suicide annually, with 77% of these deaths occurring in low- and middle-income countries. Suicidal ideation, frequently observed among adolescents, is directly linked to suicide attempts. Pakistan has witnessed a marked escalation in suicide rates in recent years, with Gilgit-Baltistan (GB) reporting the highest incidence. Extensive research indicates that tailored suicide prevention strategies can mitigate suicidal ideation, attempts, and related fatalities. OBJECTIVE: This study aims to validate and evaluate the efficacy of suicide prevention programs, RAAHI (the guide) and safeTALK, tailored to the cultural and social context of GB, Pakistan, in preventing suicidal ideation and improving the mental well-being of school-going adolescents. METHODS: The investigation will assess the efficacy of the RAAHI intervention among 267 adolescents across 4 private schools in GB using an interrupted time-series design with a pre-post test framework. The first intervention, RAAHI, a suicide literacy module, is designed to empower participants with the knowledge and skills to recognize signs of suicidal ideation, engage them empathetically, and connect individuals in crisis with appropriate support. The second intervention, safeTALK, a 4-hour educational workshop, incorporates presentations, videos, discussions, and interactive sessions to teach participants the tell, ask, listen, and keep safe steps. Outcome measures include changes in knowledge, confidence, willingness to intervene, and help-seeking behaviors, analyzed using descriptive statistics, 2-tailed paired t tests, and ANOVA. Ethics approval was granted by the Aga Khan University Ethics Review Committee (2023-8509-24844). RESULTS: As of April 2025, 267 participants have been recruited from 2 of the 4 schools; data collection commenced in March 2025 and is projected to conclude in August 2025. Final results are expected to be published by February 2026. CONCLUSIONS: This study will offer critical insights into the adaptation and effectiveness of the RAAHI suicide prevention intervention in a low-resource, culturally specific setting. The findings are anticipated to inform scalable suicide prevention initiatives in school settings across Pakistan and similar low- and middle-income contexts, ultimately contributing to reduced suicidal ideation and attempts among adolescents. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67193.
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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 | 0.030 | 0.023 |
| Meta-epidemiology (narrow) | 0.004 | 0.003 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.029 | 0.006 |
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".