Scaling Up a Blended Digital and Face-to-Face School-Based Suicide Prevention Program for Adolescents: A Quasi-Experimental Study of the Reframe-IT+ Intervention in Santiago, Chile.

IF 2.2 3区医学 Q2 PSYCHIATRY

Archives of Suicide Research Pub Date : 2026-05-14 DOI:10.1080/13811118.2026.2672043

Jorge Gaete, Daniel Nuñez, Saray Ramírez, Daniela Meza, Jo Robinson

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引用次数: 0

Abstract

Objective: Adolescent suicide remains a major public health concern in Chile. Reframe-IT+ is a culturally adapted, school-based program that integrates digital cognitive-behavioral therapy with face-to-face sessions. Following a pilot randomized trial and a cluster RCT in southern Chile, this study aimed to evaluate the preliminary effectiveness under scale-up conditions of Reframe-IT+ in a new region and educational context.

Methods: A quasi-experimental, pre-post study without a control group was conducted between December 2023 and December 2024 in 11 schools in Santiago, Chile. A total of 75 adolescents with suicidal ideation were enrolled, and 71 completed the intervention and post-assessments. The intervention included 13 weekly sessions (8 digital and 5 face-to-face). Primary outcome measures assessed suicidal ideation and depression. Paired-samples t-tests and adjusted models were used to examine changes.

Results: Significant improvements were observed across all primary outcomes, including reductions in suicidal ideation (C-SSRS: -2.7; SIQ-JR: -13.2; p < 0.001) and depressive symptoms (PHQ-9: -3.7; p < 0.001). Secondary outcomes also showed improvements: anxiety (-3.9), hopelessness (-3.2), and psychotic-like experiences (-8.6) all declined (p < 0.001). Expressive suppression decreased (-0.9; p = 0.028). Protective factors increased significantly, including problem-solving skills (+5.3), behavioral activation (+1.9), cognitive reappraisal (+2.0), and quality of life (+3.8).

Conclusions: This study provides preliminary evidence for the effectiveness of Reframe-IT+ when scaled to a new educational and geographic context. The program significantly reduced suicidal ideation and emotional distress while enhancing protective factors. These findings support further implementation studies and potential integration into national school-based mental health policies. Trial Registration: Clinical Trials NCT06759441, December 26^th, 2024. [https://clinicaltrials.gov/study/NCT06759441].

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扩大混合数字和面对面学校为基础的青少年自杀预防计划：在智利圣地亚哥的框架- it +干预的准实验研究。

目标：青少年自杀仍然是智利一个主要的公共卫生问题。frame- it +是一个适应文化的、以学校为基础的项目，它将数字认知行为疗法与面对面的会议结合起来。在智利南部进行了一项随机试验和集群随机对照试验后，本研究旨在评估在新的地区和教育背景下frame- it +扩大规模条件下的初步效果。方法：于2023年12月至2024年12月在智利圣地亚哥市的11所学校进行了一项不设对照组的准实验前后研究。共有75名有自杀意念的青少年被纳入研究，其中71人完成了干预和后评估。干预包括13周会议（8次数字会议和5次面对面会议）。主要结局指标评估自杀意念和抑郁。配对样本t检验和调整模型用于检验变化。结果：所有主要结局均有显著改善，包括自杀意念减少（C-SSRS: -2.7; SIQ-JR: -13.2; p p p p = 0.028）。保护因素显著增加，包括解决问题的能力（+5.3）、行为激活（+1.9）、认知重新评估（+2.0）和生活质量（+3.8）。结论：本研究为frame- it +在新的教育和地理环境下的有效性提供了初步证据。该项目显著减少了自杀意念和情绪困扰，同时增强了保护因素。这些发现支持进一步的实施研究和可能纳入国家学校精神卫生政策。试验注册：临床试验NCT06759441, 2024年12月26日。[https://clinicaltrials.gov/study/NCT06759441]。

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来源期刊

Archives of Suicide Research Multiple-

CiteScore

6.10

自引率

7.10%

发文量

期刊介绍： Archives of Suicide Research, the official journal of the International Academy of Suicide Research (IASR), is the international journal in the field of suicidology. The journal features original, refereed contributions on the study of suicide, suicidal behavior, its causes and effects, and techniques for prevention. The journal incorporates research-based and theoretical articles contributed by a diverse range of authors interested in investigating the biological, pharmacological, psychiatric, psychological, and sociological aspects of suicide.