Utilisation and application of implementation science in complex suicide prevention interventions: A systematic review

Sadhvi Krishnamoorthy; Sharna Mathieu; Gregory Armstrong; Victoria Ross; Jillian Francis; Lennart Reifels; Kairi Kõlves

doi:10.1016/j.jad.2023.02.140

Utilisation and application of implementation science in complex suicide prevention interventions: A systematic review

J Affect Disord. 2023 Jun 1:330:57-73. doi: 10.1016/j.jad.2023.02.140. Epub 2023 Mar 3.

Authors

Sadhvi Krishnamoorthy¹, Sharna Mathieu², Gregory Armstrong³, Victoria Ross², Jillian Francis⁴, Lennart Reifels⁵, Kairi Kõlves²

Affiliations

¹ Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Queensland, Australia. Electronic address: sadhvi.krishnamoorthy@griffithuni.edu.au.
² Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Queensland, Australia.
³ Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia.
⁴ School of Health Sciences, The University of Melbourne, Victoria, Australia; Department of Health Services Research, Peter MacCallum Cancer Centre, Victoria, Australia; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
⁵ Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.

PMID: 36870455
DOI: 10.1016/j.jad.2023.02.140

Abstract

Objectives: Little is known about how complex, multilevel, and multicomponent suicide prevention interventions work in real life settings. Understanding the methods used to systematically adopt, deliver, and sustain these interventions could ensure that they have the best chance of unfolding their full effect. This systematic review aimed to examine the application and extent of utilisation of implementation science in understanding and evaluating complex suicide prevention interventions.

Methods: The review adhered to updated PRISMA guidelines and was prospectively registered with PROSPERO (CRD42021247950). PubMed, CINAHL, PsycINFO, ProQuest, SCOPUS and CENTRAL were searched. All English-language records (1990-2022) with suicide and/or self-harm as the primary aims or targets of intervention were eligible. A forward citation search and a reference search further bolstered the search strategy. Interventions were considered complex if they consisted of three or more components and were implemented across two or more levels of socio-ecology or levels of prevention.

Results: One hundred thirty-nine records describing 19 complex interventions were identified. In 13 interventions, use of implementation science approaches, primarily process evaluations, was explicitly stated. However, extent of utilisation of implementation science approaches was found to be inconsistent and incomprehensive.

Limitations: The inclusion criteria, along with a narrow definition of complex interventions may have limited our findings.

Conclusion: Understanding the implementation of complex interventions is crucial for unlocking key questions about theory-practice knowledge translation. Inconsistent reporting and inadequate understanding of implementation processes can lead to loss of critical, experiential knowledge related to what works to prevent suicide in real world settings.

Keywords: Complex interventions; Implementation approaches; Implementation science; Suicide prevention; Suicide research.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Implementation Science*
Suicide Prevention*