BACKGROUND:Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. They are easier to generalize to an entire population than other forms of intervention. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and mailings, according to a predefined algorithm. It was implemented gradually in the Nord-Pas-de-Calais (NPC), France, between 2015 and 2018. Here, we evaluate the effectiveness of VigilanS, in terms of SA reduction, using annual data collected by participating centers. Hypothesis tested: the higher the VigilanS implementation in a center (measured by penetrance), the greater the decrease in the number of SA observed in this center. METHODS:The study period was from 2014 to 2018, across all of NPC centers. We performed a series of linear regressions, each center representing a statistical unit. The outcome was the change in the number of SA, relative to the initial number, and the predictive variable was VigilanS' penetrance: number of patients included in VigilanS over the total number of SA. Search for influential points (points beyond threshold values of 3 influence criteria) and weighted least squares estimations were performed. RESULTS:Twenty-one centers were running VigilanS in 2018, with an average penetrance of 32%. A significant relationship was identified, showing a sharp decrease in SA as a function of penetrance (slope = - 1.13; p = 3*10- 5). The model suggested that a 25% of penetrance would yield a SA decrease of 41%. CONCLUSION:VigilanS has the potential to reduce SA. Subgroup analyzes are needed to further evaluate its effectiveness. Subgroup analyses remain to be done, in order to evaluate the specific variations of SA by group.

译文

背景:自杀未遂(SA)后的简短接触干预(BCI)是预防SA和自杀的重要因素。与其他形式的干预措施相比,它们更容易推广到整个人群。 VigilanS根据预定义的算法将整个BCI推广到整个法国地区,该BCI结合了资源卡,电话和邮件。在2015年至2018年之间,该方法已在法国的北加来海峡(NPC)逐步实施。在这里,我们使用参与中心收集的年度数据评估VigilanS在减少SA方面的有效性。检验的假设:中心中VigilanS实施的程度越高(通过渗透率测量),在该中心中观察到的SA数量的减少就越大。
方法:研究期间为2014年至2018年,涵盖所有NPC中心。我们执行了一系列线性回归,每个中心代表一个统计单位。结果是SA数量相对于初始数量的变化,预测变量是VigilanS的外显率:VigilanS中包括的患者数占SA总数的比。搜索影响点(超过3个影响标准的阈值的点)并进行加权最小二乘估计。
结果:2018年有21个中心运行VigilanS,平均渗透率为32%。鉴定出显着的关系,显示出SA随渗透率的急剧下降(斜率=-1.13; p = 3 * 10- 5)。该模型表明,渗透率的25%将使SA降低41%。
结论:VigilanS具有降低SA的潜力。需要进行亚组分析以进一步评估其有效性。为了评估各组SA的特定变异,还需要进行亚组分析。

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