JMIR Publications

ABSTRACT

Roots of Hope (RoH) is a multi-site Canadian community-based suicide prevention initiative developed by the Mental Health Commission of Canada (MHCC). Each site develops local activities in five “pillars”: Specialized Supports, Training and Networks, Public Awareness Campaigns, Means Safety and Evaluation Research. Its evaluation plan uses an Implementation Research (Implementation Science) (IR) approach to understand the RoH model for reducing suicidal behaviors and their impact in communities and lessons learned for the equitable development and implementation of RoH in different contexts. IR seeks to understand how the program is implemented in relation to the context, causal pathways and factors influencing successful implementation. In addition, this evaluation plan includes assessments of short-term and intermediate effects of the programs at each site and overall, according to an ecological model. The Principal Investigator has developed a consensus on common approaches and indicators and will summarize evaluation results across sites. The RoH Theory of Change and Evaluation Model shows how evaluation activities from the Planning Phase through the Implementation of activities in each of the pillars can help clarify the viability of the RoH model and identify factors that facilitate and inhibit effective and equitable implementation in different contexts. Beginning with a Situational Analysis to identify resources in each community and local specificities, we will examine implementation characteristics of: conformity, dosage, coverage, quality, utility, equity, appreciation, facilitators and impediments. Evaluation of short-term effects will focus on changes in: knowledge, attitudes, behaviours, help seeking, use of services, sigma, media reports, empowerment and experiences of care. Intermediate effects, long-term effects and impact include assessments of changes in suicides, suicide attempt rates, and suicide risk indicators. A variety of data sources, both quantitative and qualitative will be used, including: standardized questionnaires, examination of key documents, focus groups and interviews with coordinators, stakeholders, key informants, clients, persons with lived experience, and data on the incidence of suicidal behaviors that are available. The quantitative and qualitative data from all sites will be summarized by the Principal Investigator in order to draw conclusions to help the MHCC in its improvements to the RoH model, and to inform communities about how to better implement the RoH approach in an efficacious and equitable manner. Since the Covid-19 pandemic occurred at the beginning of program implementation, the impact of the pandemic on the implementation and evaluation activities and its influence on the RoH project will be documented. Overall, we aim to clarify the validity of RoH in contributing to preventing suicides and suicidal behaviors in a variety of contexts. The evaluation results should be of use to the MHCC, current RoH communities and those who are considering adopting the RoH model.