By Jane Pirkis, Jason Bantjes, Rakhi Dandona, Duleeka Knipe, Alexandra Pitman, Jo Robinson, Morton Silverman, Keith Hawton 

 A public health approach to suicide prevention recognizes the powerful influence of social determinants. In this paper—the fifth in a Series on a public health approach to suicide prevention—we consider four major risk factors for suicide (alcohol use, gambling, domestic violence and abuse, and suicide bereavement) and examine how their influence on suicide is socially determined. Cultural factors and societal responses have an important role in all four risk factors. In the case of alcohol use and gambling, commercial entities are culpable. This Series paper describes a range of universal, selective, and indicated interventions that might address these risk factors and focuses particularly on key universal interventions that are likely to yield substantial population-level benefits

The Lancet Public Health Available online 10 September 2024 In Press, Corrected Proof

 By Keith Hawton, Duleeka Knipe, Jane Pirkis 

 One of the most effective public health measures to prevent suicide is the restriction of access to means used in suicidal acts. This approach can be especially effective if a method is common and readily accessible. Suicide methods vary widely, and there have been several examples where means restriction has been applied, often with considerable success. Factors contributing to the availability of suicide methods can include access to physical means as well as cognitive awareness of methods. In this paper, which is the second in a Series on a public health approach to suicide prevention, we focus primarily on examples of restricting access to physical means of suicide, such as pesticides, firearms, and medication. We also discuss restricting the cognitive availability of means through attention to media and other representations of suicide methods. There are challenges associated with restricting access to means, including resistance to measures required to change the availability of some methods (which might, in part, be commercially determined) and method substitution, whereby one suicide method is replaced by another. Nevertheless, this means restriction must be an integral part of all national and local suicide prevention strategies

The Lancet, The Lancet Public Health, Volume 0, Issue 0, Online first, Sept. 2024.

By Cynthia Fraga Rizo and Tonya Van Deinse

Intimate partner violence (IPV)—the intentional physical or nonphysical violence between current or former intimate partners—and sexual violence (SV)—non-consensual sexual activities—are pervasive, serious criminal legal system and public health problems in the United States (Centers for Disease Control [CDC], 2017; CDC, 2019; Smith et al., 2018). Survivors of IPV and SV bear the burden of numerous deleterious short- and long-term consequences. To address their myriad service needs, survivors must navigate multiple systems, organizations, and professionals. The complexity of navigating multiple service sectors means IPV/SV survivors often do not receive the help they need at the time when services are most needed. Recognizing this barrier, IPV/SV service providers, including advocates, criminal legal system professionals, and healthcare providers, have been increasingly interested in using cross-sectoral approaches (CSA) to coordinate service delivery to IPV/SV survivors (Gwinn et al., 2007). Family Justice Centers (FJC) and Multi-Agency Model Centers (MAMC) are two commonly implemented CSA models (Alliance for Hope International, 2024; Rizo et al., 2022; Shorey et al., 2014; Simmons et al., 2016). A key underlying assumption of FJCs and MAMCs is that colocation, collaboration, and coordination of services across multiple providers and disciplines will increase survivors’ access to services and ultimately lead to better outcomes. However, limited research exists regarding the implementation and effectiveness of these co-located models. To address these gaps, the research team conducted an evaluability assessment and formative evaluation of IPV/SV CSAs, with a focus on the similarities and differences across colocated models. The project was comprised of two phases: • Phase 1: Evaluability assessment of IPV/SV co-located CSAs. • Phase 2: Formative evaluation of IPV/SV co-located CSAs. The project was conducted in North Carolina, with eight co-located centers participating in the evaluability assessment and six participating in the formative evaluation.

Approach The evaluability assessment was guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework (Aarons et al., 2011) and followed the four steps outlined by Trevisan and Walser’s (2014) evaluability assessment model: (1) focus the assessment, (2) develop the program theory and logic, (3) gather feedback, and (4) apply the assessment findings. Prior to developing the proposal and launching the project, our team worked with a group of statewide leaders to determine the focus of the assessment (e.g., goals, objectives, research questions). The research team then engaged in three primary data collection activities— document review, affiliate interviews, and client-survivor interviews—to document the program theory and logic model of co-located service models and to identify promising strategies for evaluating co-located IPV/SV service models. In total, the team reviewed 199 documents and conducted interviews with 58 affiliates and 30 client-survivors. Following these activities, the research team sought feedback from our Expert Advisory Group (EAG) and partnering sites and used the evaluability assessment findings to develop practice and research materials. The formative evaluation comprised three components—a process evaluation focused on implementation, a client outcome evaluation, and an assessment of the evaluation’s overall feasibility. The implementation evaluation research activities consisted of gathering four different types of data: (1) aggregate annual programmatic data from six partnering sites; (2) client-level service need data (n = 764 completed service navigation logs); (3) staff collaboration survey data (n = 126); and (4) adaptive fidelity self-assessment data (n = 11). The outcome evaluation research activity involved collecting survey data from clients at three-time points (i.e., intake/baseline: n = 41; 3-month follow-up: n = 28; 6-month follow-up: n = 24). The feasibility assessment was based on focus group data with leaders and key contacts at partnering centers (n = 12) to explore their perspectives on the overall evaluation and specific research activities.       

Chapel Hill, NC: University of North Carolina Chapel Hill, 2024.146p.

By Sara Naicker

Data analysis shows how violence in childhood is connected to health and social problems almost three decades later.

This policy brief uses the adverse childhood experiences framework, coupled with data from the Birth to Thirty cohort study, to show the impact of violence and adversity on the lives of South Africans. It connects violence and adversity in childhood to health and social problems almost three decades later. Understanding, foregrounding and addressing the effects of violence and adversity are essential for national development

Policy Brief 174

South Africa: Institute for Security Studies, 2022. 16p.

By Katherine Sorrels, Lora Arduser, Danielle Bessett, Vanessa Carbonell, Michelle McGowan, and Edward Wallace

In early March of 2020, Americans watched with uncertain terror as the novel coronavirus pandemic unfolded. One week later, Ohio announced its first confirmed cases. Just one year later, the state had over a million cases and 18,000 Ohioans had died. What happened in that first pandemic year is not only a story of a public health disaster, but also a story of social disparities and moral dilemmas, of lives and livelihoods turned upside down, and of institutions and safety nets stretched to their limits. Ohio under COVID tells the human story of COVID in Ohio, America’s bellwether state. Scholars and practitioners examine the pandemic response from multiple angles, and contributors from numerous walks of life offer moving first-person reflections. Two themes emerge again and again: how the pandemic revealed a deep tension between individual autonomy and the collective good, and how it exacerbated social inequalities in a state divided along social, economic, and political lines. Chapters address topics such as mask mandates, ableism, prisons, food insecurity, access to reproductive health care, and the need for more Black doctors. The book concludes with an interview with Dr. Amy Acton, the state’s top public health official at the time COVID hit Ohio. Ohio under COVID captures the devastating impact of the pandemic, both in the public discord it has unearthed and in the unfair burdens it has placed on the groups least equipped to bear them.

Ann Arbor: University of Michigan Press. 2023, 341pg