The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury asked RAND to draw from the scientific literature and create a toolkit to guide future evaluations of suicide prevention programs. This report is a companion to the RAND Suicide Prevention Program Evaluation Toolkit and provides additional background on its development and testing.

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Development and Pilot Test of the RAND Suicide Prevention Program Evaluation Toolkit

by Joie D. Acosta, Rajeev Ramchand, Amariah Becker, Alexandria Felton

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Research Questions

  1. What are the most common types of suicide prevention programs, and what are their specific evaluation needs?
  2. Which evaluation measures and evaluation approaches have been used and tested by previous studies, and how can program staff incorporate them into their own evaluations?
  3. The RAND Suicide Prevention Program Evaluation Toolkit was developed to help program staff design an evaluation that is appropriate for their program type and available resources and expertise, but how successful will it be in practice?
  4. How can the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury ensure that the toolkit remains useful as suicide prevention programs across the U.S. Department of Defense continue to evolve, and what are some dissemination strategies that it could use to ensure that the toolkit reaches those who need it?

Evaluations are critical for assessing the impact of U.S. Department of Defense investments in suicide prevention and can be used as the basis for decisions about whether to sustain or scale up existing efforts. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury asked RAND to draw from the scientific literature and create a toolkit to guide future evaluations of suicide prevention programs. The resulting toolkit is designed to help program staff determine whether their programs produce beneficial effects and, ultimately, to guide the responsible allocation of scarce resources. This report summarizes the three complementary methods used to develop the RAND Suicide Prevention Program Evaluation Toolkit: an examination of the peer-reviewed evaluation literature and clinical trials, a review of other evaluation toolkits, and feedback from staff responsible for implementing suicide prevention programs in the Department of Defense. It is intended to serve as both a companion and supplement to the toolkit and offers additional background on its development and testing.

Key Findings

There Is a Need for a Comprehensive Toolkit to Help the U.S. Department of Defense Evaluate Its Suicide Prevention Efforts

  • The U.S. Department of Defense (DoD) has been actively engaged in preventing suicides among service members, but evaluations of new and existing programs are critical for assessing the impact of DoD investments in suicide prevention.
  • The DoD Task Force on the Prevention of Suicide Among Members of the Armed Forces and a RAND project on preventing suicide in the U.S. military both recommended that all DoD suicide prevention initiatives include an evaluation component.
  • Such evaluations can be used to determine whether programs achieve their intended goals (e.g., raising awareness and promoting self-care among service members) and can be used as the basis for decisions about whether to sustain, scale up, or discontinue efforts.

The RAND Suicide Prevention Program Evaluation Toolkit Incorporates the Latest Scientific Research and Feedback from Program Staff Across DoD

  • The toolkit's development included a rigorous examination of the program evaluation literature, which offers guidance and measures for a vast range of program types, resource levels, and expertise.
  • It is important that the toolkit remain user-friendly while guiding program staff through the evaluation process. Pilot testing the toolkit with program directors and coordinators helped ensure that users would be comfortable using the tools and that the instructions were clear and applicable to the goals of their evaluations.

Recommendations

  • Although the toolkit is a comprehensive, user-friendly resource for program evaluation and draws on the latest scientific literature, program needs will continue to evolve. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) should develop a plan to regularly review the toolkit so that it can be updated and optimized on a regular basis.
  • During pilot testing, users expressed an interest in an interactive, online version of the toolkit resources to animate some of the data analysis features of the toolkit and link toolkit worksheets together so they "fill forward," streamlining completion of the toolkit steps. DCoE should consider offering the toolkit in such a format, which would also make it easier to update.
  • DCoE should continue partnering with the Suicide Prevention and Risk Reduction Committee and the Defense Suicide Prevention Office, which includes suicide prevention program managers from each military service, to identify dissemination strategies and ensure that the toolkit is widely available across the U.S. Department of Defense. It would also be helpful to provide programs with training and technical support to ensure that they can make the best use of the process and materials as they conduct their evaluations.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Development of the Suicide Prevention Program Evaluation Toolkit

  • Chapter Three

    Review and Feedback on the Toolkit by DoD Suicide Prevention Program Staff

  • Chapter Four

    Recommendations for Disseminating the Toolkit

  • Appendix

    Feedback Form Used in the Pilot Test of the RAND Evaluation Toolkit for Suicide Prevention Programs

Research conducted by

The research described in this report was prepared for the Office of the Secretary of Defense (OSD). The research was conducted within the RAND National Defense Research Institute, a federally funded research and development center sponsored by OSD, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

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