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Representations and impact of educative and prevention websites on suicide

Last registered on October 27, 2015
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Pre-Trial

Trial Information

General Information

Title
Representations and impact of educative and prevention websites on suicide
RCT ID
AEARCTR-0000924
Initial registration date
October 27, 2015

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
October 27, 2015, 4:49 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Austria
Region

Primary Investigator

Name
Benedikt Till
Affiliation
Medical University of Vienna, Center for Public Health, Department of Social and Preventive Medicine
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Other Primary Investigator(s)

PI Name
Thomas Niederkrotenthaler
PI Affiliation
Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit
Contact Investigator

Additional Trial Information

Status
Completed
Start date
2014-03-03
End date
2015-01-30
Keywords
Health
Additional Keywords
JEL code(s)
Secondary IDs
Abstract
Public health organizations dedicated to suicide prevention frequently use websites to educate the public about suicide, but studies investigating the impact of these websites on individuals with varying degree of suicidality are scarce. We investigated the impact of three educative suicide prevention websites compared to a website not related to suicide and tested the moderating effect of the participants’ baseline suicidality on the effects. We conducted a randomized controlled trial with 160 adults who were assigned to four groups. Data on the audience’s risk factors for suicide and knowledge about suicide were collected before the experiment (T1, baseline), immediately after website exposure (T2) and one week later (T3). We stratified the sample into two groups by the median of suicidality at baseline. We investigated the impact of websites further with qualitative interviews of 12 participants.
External Link(s)

Registration Citation

Citation
Niederkrotenthaler, Thomas and Benedikt Till. 2015. "Representations and impact of educative and prevention websites on suicide." AEA RCT Registry. October 27. https://doi.org/10.1257/rct.924-1.1
Former Citation
Niederkrotenthaler, Thomas and Benedikt Till. 2015. "Representations and impact of educative and prevention websites on suicide." AEA RCT Registry. October 27. https://www.socialscienceregistry.org/trials/924/history/198361
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
We investigated the impact of three educative suicide prevention websites compared to a website not related to suicide and tested the moderating effect of participants’ baseline suicidality on the effects. Group 1 viewed the website of the Youth-Life-Line, Group 2 was exposed to the website of U25 Freiburg, and participants of Group 3 were presented with the website of Friends for Life. The control group viewed the website of the Austrian boy scouts. The participants were instructed that they had 10 minutes to browse through the website, search for information on suicide and suicide prevention, and learn about all aspects of the topic they perceived as relevant. Questionnaires on mood, suicidal ideation, suicide-related knowledge, and attitudes toward suicide and seeking professional help were completed before (T1) and immediately after exposure to the website (T2) as well as approximately one week later (T3) to test the persistence of any effect. The participants were instructed to not search for information on suicide or suicide prevention between T2 and T3 or talk with other participants about this study. Based on ethical considerations, suicidal participants, defined as individuals with a score of ≥ 34 on the German version of the Beck Hopelessness Scale, which was completed at T1, were offered counselling by a psychologist and excluded from the study. After the intervention, we offered psychological counselling to all participants to help them cope with any distress resulting from exposure to the website or from answering questions related to suicidality. All participants received a gift voucher amounting to 5 Euro for their participation in the study. The study was conducted at the Center for Public Health, Medical University of Vienna, Austria, and was approved by the ethical review board (study protocol 2063/2013, date: 2014-01-27).
Intervention Start Date
2014-03-03
Intervention End Date
2015-01-30

Primary Outcomes

Primary Outcomes (end points)
Mood, suicidal ideation, suicide-related knowledge, and attitudes toward suicide and seeking professional help. All Parameters were assessed with questionnaires.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We investigated the impact of three educative suicide prevention websites compared to a website not related to suicide and tested the moderating effect of participants’ baseline suicidality on the effects.
Experimental Design Details
Randomization Method
The participants randomly selected their computer workstation, which were pre-programed with one of the four websites. This procedure was conducted until all groups included the maximum number of participants (n = 40).
Randomization Unit
This trial was a individually randomised controlled trial, not a cluster randomised controlled trial.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
160 individuals, no clusters
Sample size: planned number of observations
160
Sample size (or number of clusters) by treatment arms
40 individuals in each of the 3 interventions groups and 40 individuals in the control group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Ethikkommission der Medizinischen Universität Wien
IRB Approval Date
2014-01-27
IRB Approval Number
2063/2013
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
January 09, 2015, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
January 16, 2015, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
161
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
161
Final Sample Size (or Number of Clusters) by Treatment Arms
Intervention: n = 121; Control: n = 40
Data Publication

Data Publication

Is public data available?
Yes
Public Data URL
https://figshare.com/articles/dataset/Dataset_sav/4898147

Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Abstract
Background
Suicide prevention organizations frequently use websites to educate the public, but evaluations of these sites are lacking.
Aims
To examine the effects of educative websites and the moderating effect of participant vulnerability.
Method
One-hundred and sixty-one adults were randomized to either view an educative website on suicide prevention or an unrelated website in a single-blinded randomized controlled trial. The primary outcome was suicidal ideation; secondary outcomes were mood, suicide prevention-related knowledge, and attitudes towards suicide/seeking professional help. Data were collected using questionnaires before (T1), immediately after exposure (T2), and one week after exposure (T3) and analysed using linear mixed models.
Results
No significant intervention effect was identified for the entire intervention group with regards to suicidal ideation, but a significant and sustained increase in suicide prevention-related knowledge (T3 vs. T1: p < .001, d = 1.12 [95% CI: 0.96, 1.28]) and a non-sustained worsening of mood (p < .001, T2 vs. T1: d = -0.59 [-0.75, -0.43]) were observed. Participants with increased vulnerability experienced a partially sustained reduction of suicidal ideation (T3 vs. T1: p < .001, d = -0.34 [-0.50, -0.19]).
Conclusions
Educative professional suicide prevention websites appeared to increase suicide prevention-related knowledge, and among vulnerable individuals, website exposure may be associated with a reduction of suicidal ideation.

Declaration of interest
None.
Citation
Till, B., Tran, U. S., Voracek, M., & Niederkrotenthaler, T. (2017). Beneficial and harmful effects of educative suicide prevention websites: randomised controlled trial exploring Papageno v. Werther effects. British Journal of Psychiatry, 211(2), 109-115. doi: 10.1192/bjp.bp. 115.177394.
URL
https://doi.org/10.1192/bjp.bp.115.177394

Reports & Other Materials