Abstract
Background: Suicide rates are high among African American students because they are at a greater risk of depression. A commonly used suicide prevention approach is the gatekeeper training. However, gatekeeper training is neither evidence-based nor has it been identified as culturally-appropriate for African American college students. Therefore, the purpose of this study was to develop and evaluate an online peer-to-peer PRECEDE-PROCEED model based depression awareness and suicide prevention program that was culturally appropriate for African American college students.Methods: The setting was a predominantly Black institution in southern USA. A pre-experimental repeated measures one group design was used to measure changes in peer educators’ (n = 29) predisposing factors regarding knowledge, skills and attitudes pertaining to depression, reinforcing factors or receiving support from peers, healthcare professionals and teachers to help someone with depression, enabling factors or sureness of finding organizations to help someone with depression, and behavior for helping someone with depression at pretest, posttest and 1-month follow-up. A posttest only one group design was also used to measure effect on predisposing factors and behavior of students (n = 300) trained by peer educators.Results: There were statistically significant improvements in attitudes related to depression as disease (P = 0.003; η2 = 0.39), attitudes about managing depression (P = 0.0001; η2 = 0.30), skills(P = 0.0001; η2 = 0.41), reinforcing factors (P = 0.018; η2 = 0.13), enabling factors (P = 0.0001;η2 = 0.31), and behavior (P = 0.016; η2 = 0.14). Changes in knowledge about depression and attitudes about helping people with depression were not statistically significant over time for peer educators. The peer-to-peer training was not completely effective in transferring corresponding changes for students trained by peers.Conclusion: The program was effective for peer educators but peers could not significantly influence other students in all domains. This study provides a starting point toward evidencebased approaches for health promotion interventionists addressing depression awareness and suicide prevention among African American college students.
Highlights
Depression and suicide are 2 global public health concerns
For the first stage of the study that of peer educator training a total of 107 participants were recruited over that time period from which 29 finished all the requirements including providing the training to other students
Four peer educators or 13.8% reported ever being diagnosed with depression while 25 or 86.2% reported never been diagnosed with depression
Summary
Suicide is the second leading cause of death among 15-29-year-olds globally,[1] with an alarming rate among African-American college students. Abuse and Mental Services Health Administration’s (SAMSHA’s) 2013 report, men and women between the ages of 18 and 25 years had the highest percentage of major depressive episodes.[3] African-American college students have been described as having a greater risk for depression compared to other groups. The purpose of this study was to develop and evaluate an online peer-to-peer PRECEDE-PROCEED model based depression awareness and suicide prevention program that was culturally appropriate for African American college students. This study provides a starting point toward evidencebased approaches for health promotion interventionists addressing depression awareness and suicide prevention among African American college students
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