Conectar
To contextualise an existing suicide prevention programme, and to assess the effectiveness, feasibility and acceptability of the contextualised suicide prevention programme among secondary school students in eastern Nepal.
A multi-method study is planned across four phases. The study will be informed by the Socio-Ecological Model. The first phase is a systematic review to identify available suicide prevention programmes, their effects and their contextualisation status. The second phase will be a descriptive qualitative study to contextualise the safeTALK suicide prevention programme for use among adolescents in a public school of Eastern Nepal, involving adolescents, teachers, parents, healthcare providers and policymakers. The third phase will be a single-group pre-post-test design to test the preliminary effects of the contextualised safeTALK programme among 110 adolescents at the public school. Outcomes measured in the third study will be suicidal ideation and help-seeking behaviours, using the Suicidal Ideation Attributes Scale, and General Help-Seeking Questionnaire. The final phase will evaluate the feasibility and acceptability of the safeTALK suicide prevention programme through in-depth interviews with adolescents, teachers, parents, healthcare providers and policymakers. Quantitative and qualitative data will be analysed using the Statistical Package of Social Sciences v.30 and NVivo v.14 respectively.
Ethical approval has been obtained from the Western Sydney University Human Research Ethics Committee and the Nepal Health Research Council. The findings will be disseminated via conference presentations and peer-reviewed publications.
There are no reported structured suicide prevention programmes for adolescents in low-middle-income countries, including Nepal. This study is expected to assist in mitigating the shortfall of contextualised adolescent suicide prevention programmes in low-middle-income countries. Additionally, evidence will be added to the global nursing literature, helping to contribute to evidence-based nursing practice.
Australian New Zealand Clinical Trials Registry (ANZCTR): 12624000634572
To assess factors associated with the adoption of the WHO Package of Essential Non-Communicable Diseases (PEN) Protocol 1 at primary healthcare (PHC) facilities in Nepal after healthcare workers received training.
Cross-sectional study.
PHC facilities across various provinces in Nepal.
A total of 180 healthcare workers trained in PEN, recruited from a random selection of 105 basic healthcare facilities.
The adoption of PEN Protocol 1 components: blood pressure measurement, blood glucose screening, 10-year cardiovascular disease (CVD) risk assessment using WHO/International Society of Hypertension risk charts and body mass index (BMI) assessment. Factors associated with protocol adoption were assessed using generalised estimating equations for ORs.
Among participants, 100% reported measuring blood pressure, while 56% measured blood sugar, 28% assessed CVD risk and 27% assessed BMI. The adoption of the CVD risk prediction chart was positively associated with the availability of amlodipine (adjusted OR (aOR) 3.00; 95% CI 1.09 to 8.27). The adoption of BMI assessment was positively associated with access to a stadiometer (aOR 3.23; 95% CI 1.26 to 8.30) and a glucometer (aOR 3.07; 95% CI 1.12 to 8.40), and negatively associated with lack of motivation/inertia of previous practice (aOR 0.60; 95% CI 0.42 to 0.87) and environmental factors such as lack of time and resources (aOR 0.57; 95% CI 0.37 to 0.89). Blood glucose level measurements were positively associated with being at a PHC centre (aOR 7.34; 95% CI 2.79 to 19.3) and the availability of metformin (OR 2.40; 95% CI 1.08 to 5.29).
Adoption of PEN Protocol 1 varied by component and was influenced by resource availability, provider motivation and system barriers. Addressing these factors is key to optimising implementation in low-resource settings.
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