What is the major question that this program evaluation seeks to answer? How was the dependent variable(s) operationalized? Briefly describe the methodology used to determine if the program was successful.

Read the attached article by Aakre and colleagues (2016) and answer the following questions.

(article attached in file sharing)

1. Provide the complete citation in APA format.

2. What is the major question that this program evaluation seeks to answer?

3. How was the dependent variable(s) operationalized?

4. Briefly describe the methodology used to determine if the program was successful.

5. Did the study involve a sample of clients? If yes, how many were in the sample? Was the sample size adequate?

6. What did you learn about evaluating a program of this type? (Be as specific as possible.)

7. What possible limitations does this study have? 400 words

Requirements: as mentioned

EvaluationofYouthMentalHealthFirstAidUSA:AProgramtoAssistYoungPeopleinPsychologicalDistressJenniferM.AakreDepartmentofVeteransAffairsMarylandHealthCareSystem,Baltimore,Maryland,andUniversityofMarylandSchoolofMedicineAliciaLuckstedUniversityofMarylandSchoolofMedicineLeaAnnBrowning-McNeeMentalHealthAssociationofMaryland,Baltimore,MarylandYouthMentalHealthFirstAidUSA(YMHFA)isamanualizedtrainingprogramdesignedtoeducatemembersofthepubliconcommonemotionalproblemsandpsychologicaldisordersamongyouthandtoprovidetraineeswithtoolsanyonecanusetoassistyoungpeopleinpsychologicaldistress.Thepresentstudyusedapreversuspostdesigntoassesstheabilityofsocialserviceemployeestogenerateappropriatestrategiestouseinhypotheticalsituationsfeaturingayoungpersonindistress,beforeversusafterparticipationinthe8-hrYMHFAtraining.Traineeresponsesdemonstratedsignificantoverallimprovement(M1.32,SD0.80pretrainingvs.M1.87,SD1.1posttraining,t6.6,p.001)byincludingfourofthefivecentralYMHFAstrategiessignificantlymoreoftenaftertraining.Increasedconfidencein,likelihoodof,andcomfortwithhelpingayoungpersoninemotionaldistressorcrisiswerealsoreportedposttrainingcomparedtopretraining(allp.001).ResultssuggestthatindividualsparticipatinginYMHFAtrainingarebetterinformedregardingwhentoassessforriskofsuicide,listennonjudgmentally,encourageappropriateprofessionalhelp,andencourageself-helpstrategieswithyoungpeopleinpsychologicaldistress.Keywords:mentalhealthliteracy,healthpromotion,mentalhealthandillness,youthMentalhealthneedsarecommoninU.S.youngpeople,with13%–20%ofchildrenexperiencingadiagnosablepsychologicalconditioninagivenyear(Perouetal.,2011).Themajorityofsuchyouthdonotreceiveanytreatment(Merikangasetal.,2011);thisisparticularlytroublinggiventhatearlyinterventionisassociatedwithsuperioroutcomesforavarietyofpsychologicalconditions(Ghio,Gotelli,Marcenaro,Amore,&Natta,2014;Marshalletal.,2005).Accurateknowledgeandbeliefsaboutpreventing,recog-nizing,andrespondingtopsychologicaldistressinoneselfandothers,knownasmentalhealthliteracy,isproposedtoaffectaccesstoappropriatecareforatrainee’sselfandlovedones(Jorm,2012;Jormetal.,1997).Improvingthementalhealthliteracyofandprovidinghelpfulinterventionstrategiestoadultswhointeractregularlywithyoungpeoplearevitallyimportant,especiallybe-causeyoungpeoplemaybeparticularlyunlikelyorunabletoself-referforpsychologicalproblems.YouthMentalHealthFirstAidUSA(YMHFA;www.mentalhealthfirstaid.org)isamanualizedtrainingprogramde-signedtoeducatethegeneralpubliconcommonemotionalprob-lemsandpsychologicaldisordersamongyouthandtoprovidetraineeswithtoolsanyonecanusetoassistyoungpeopleinemotionaldistress(e.g.,byencouragingthemtoseekprofessionalhelp),therebyimprovingmentalhealthliteracy(Kellyetal.,2011).YMHFAisamodifiedversionofMentalHealthFirstAid(MHFA),aprogramemployingaskills-basedapproachtoteachthegeneralpublichowtorecognizesignsofemotionaldistressorcrisisinothersandhowtoassistthem(Kitchener,Jorm,&Kelly,2009,2012).OriginallydevelopedinAustraliaasa12-hrgrouptraining(Kitchener&Jorm2002a,2002b),MHFAhasbeenim-plementedin23countriestodate,inboth8-hrand12-hrformatsandinbothadult-andyouth-focusedversions.MHFAwasmod-ifiedforuseintheUnitedStatesin2008;asofNovember2014,morethan280,000peoplehavecompletedMHFA-USAtraining(NationalCouncilofBehavioralHealth,2014).YMHFA,likeMHFA,featurestwocentralstrategiestoin-creasementalhealthliteracyandtheabilitytorespondappro-Editor’sNote.ThisarticleispartofaspecialissueonPublicMentalHealthInnovations.JenniferM.Aakre,VACapitolHealthcareNetwork(VISN5)MentalIllnessResearch,Education,andClinicalCenter,DepartmentofVeteransAffairsMarylandHealthCareSystem,Baltimore,MarylandandDepart-mentofPsychiatry,UniversityofMarylandSchoolofMedicine;AliciaLucksted,DepartmentofPsychiatry,UniversityofMarylandSchoolofMedicine;LeaAnnBrowning-McNee,MentalHealthAssociationofMaryland,Baltimore,Maryland.TheworkreportedinthisarticlewassupportedbyacontractfromtheMentalHealthAssociationofMarylandtotheUniversityofMarylandandbytheVACapitolHealthCareNetwork(VISN5)MentalIllnessResearch,Education,andClinicalCenter.CorrespondenceconcerningthisarticleshouldbeaddressedtoJenniferM.Aakre,BaltimoreVAMedicalCenter,VISN5MIRECC(Annex),10N.GreeneStreet,Baltimore,MD21201.E-mail:[email protected],Vol.13,No.2,121–126http://dx.doi.org/10.1037/ser0000063121

priatelytoemotionalcrisis.Thefirststrategyistoeducatetraineesontheidentificationandtreatmentofcommonmentalhealthchallengesforyoungpeople,includingdepression,anx-iety,suicidality,eatingdisorders,psychosis,substanceusedis-orders,andattention-deficitdisorders.Thesecondstrategyistoteachtraineestoapplyfivehelpfulactionstoassistayoungpersonexperiencingemotionalcrisisordistress.Thesefiveactions,referredtobytheacronym“ALGEE”includethefollowing:(A)Assessforriskofsuicideorharm,(L)Listennonjudgmentally,(G)Givereassuranceandinformation,(E)Encourageappropriateprofessionalhelp,and(E)Encourageself-helpandothersupportstrategies.ExistingresearchonMHFAhasfocusedonthreemainout-comes:(a)changesintraineeknowledge,typicallyoperation-alizedastheabilitytocorrectlyidentifyapsychologicalprob-lemoreffectivetreatments;(b)changeinattitudes,suchasdecreasedsocialdistancingandstigma;and(c)self-reportedintentionorprovisionofhelpingbehavior,suchasmakingareferralforpsychologicalservices,posttraining(Hadlaczky,Hökby,Mkrtchian,Carli,&Wasserman,2014).Resultsofarecentmeta-analysisinvolving15MHFAstudiessuggestim-provementsonallthreeofthesevariableswithamoderateeffectsize(Hadlaczkyetal.,2014).Althoughtheseresultsarepromising,significantgapsremain.First,themajorityofthe15includedstudiesinvolvedtheMHFAadultversion,andtherewasvariabilityinwhetheran8-hror12-hrversionwasem-ployed.AdditionalresearchonYMHFA,whichremainsrela-tivelyunstudied,isneeded.Second,noneoftheincludedstud-iesinvolvedMHFAconductedintheUnitedStates.MHFA-USAissomewhatdifferentfromtheAustralianoriginal,anddifferencesbetweenAustraliaandtheU.S.culturalcontextsmayaffecttheeffectivenessofMHFAtrainingintheUnitedStates,highlightingtheimportanceofstudyingtheuseandeffectivenessofMHFAintheUnitedStates.ThereisonlyonepublishedstudyofMHFA-USA(12-hr,adultversion)todate;participantsreportedincreasesinknowledge,improvedatti-tudes,andchangesinrelatedbehaviors(Mendenhall,Jackson,&Hase,2013).Mostimportant,researchonMHFAhasnotassessedwhetherparticipationinthistrainingincreasesatrain-ee’sabilitytorespondappropriatelytoanindividualinemo-tionaldistressbyusingthestrategiestaughtinMHFA.Al-thoughthereisstrongevidencethatMHFAgraduateshaveimprovedabilitytoidentifypsychologicalproblemsandoppor-tunitiesforservicedelivery(Hadlaczkyetal.,2014),thecor-respondingabilitytooffersensitive,appropriateassistancewhenneededhasnotbeentested.OneoftheessentiallessonsinMHFAandYMHFAishowtorespondtoothersinemotionaldistressinahelpfulway,opera-tionalizedasALGEE.Researchthusfarhasfocusedoninvesti-gatingincreasesinknowledgeaboutthecharacteristicsofvariouspsychologicalconditions,changeinattitudes,andself-reportedincreaseinhelpingbehaviors.ThepresentstudyisdesignedtoassesswhetherparticipantsleaveYMHFAtrainingabletoapplyknowledgeofconcretestepstotakewhenanindividualisexpe-riencingemotionaldistress,byaskinghimorhertorespondtoawrittenhypotheticalsituation.Furthermore,thisstudyinvolvestraineesfromtheyouth-focused,U.S.versionofMHFA,addingtothescantresearchavailableonYMHFAandMHFA-USA.Wehypothesizethatindividualscompletingthetrainingwillshow(a)improvedskillsinidentifyinganappropriateresponsetoyoungpeopleinemotionaldistressusingALGEEand(b)increasedself-reportedconfidence,intendedlikelihoodof,andcomfortwithrespondingtoyoungpeopleinemotionaldistressinfuturereal-lifesituations.MethodParticipantsDemographicinformationwasavailableforallYMHFAtrain-eeswhocompletedcourseevaluations,totaling384individuals.Alltraineeswereemployeesofthesamesocialservicesdepart-mentinurbanMarylandandtooktheYMHFAtrainingduringthesummerof2014.Themajorityofrespondentswerewomen(73%)andAfricanAmerican(71%).Theyrangedfrom25–80yearsold;53%wereoverage45years.Ofthe223respondingtoaquestionabouteducation,mosthadabachelor’s(38%)ormaster’s(37%)degree.Participantsreported(n227)workinginchildwelfarefor1–40years(M15;SD9).Eighty-threepercentsaidtheyattendedYMHFAtrainingbecausetheiremployeraskedorre-quiredthemto,althoughupto13%alsomarkedotherresponses(e.g.,personalinterest,professionaldevelopment).Becauseoftheanonymousnatureofdatacollectionmethods,itisnotpossibletoprovidedataonlyonthesubsetofthesamplewhosubmittedresponsestothevignettequestionnaires.MeasuresIdentificationofappropriateassistancebehaviors.UsingfourwrittenvignettesdevelopedbyJorm,Wright,andMorgan(2007),wecreatedaquestionnairetoassessparticipants’helpingresponsestoyoungpeopleexperiencingdifferenttypesofemotionaldistress:depression,depressionwithalcoholmisuse,socialphobia,andpsychosis.SeeTable1forthevignettes.Halfofthevignettesofeachtypeusedthename“John”andhalfused“Jane”tosignalgender.Followingthevignettewasthequestion,“Whatareseveralthingsyouwouldsayordotohelpthispersonduringasingleinitialconversa-tion?”Theformallowedaboutonethirdofapageforrespondentstowriteintheiranswerwithnootherdirections.Researchinvolvingtheuseofvignettesproducesecologicallyvalidresults,usingthesespecificvignettes(Yap&Jorm,2012)andusingvignettemethodologymorebroadly(forareview,seeEvansetal.,2015).Likelihoodofprovidinghelp.Thequestionnairealsoin-cludedthreequestionsdesignedtoassessthelikelihoodoffuturehelpingbehaviors:“Howconfidentwouldyoubeinyourabilitytohelpthispersonintheway(s)youdescribedabove?”“Howlikelydoyouthinkyouwouldbetoactuallytrytohelpsomeoneinthissituation,intheways(s)youdescribedabove?”and“Howcom-fortablewouldyoubetryingtohelpsomeoneinthissituation,intheway(s)youdescribedabove?”Responseoptionsrangedfromnotatall(1)toextremely(5),withahigherscoreindicatinggreaterconfidence,likelihood,andcomfort.Thetraining’sstandardsat-isfactionformincludedanadditionalquestionasking,“Howpre-paredbytheMHFAtrainingdoyoufeeltorespondtosituationslikethis?”usingthesame5-pointLikertscale.MHFAknowledgequestionnaire.StandardMHFAtrainingrequiresparticipantstopassa10-itemposttrainingknowledge122AAKRE,LUCKSTED,ANDBROWNING-MCNEE

quiz,withascoreof6/10orhigher,beforetheyareconsideredcertifiedinMHFA.Likeallmeasuresinthisstudy,theknowledgequizwasadministeredinpaper-and-pencilformattotheentiretraineegroupbytheMHFAtrainers.Wewerenotabletoaddapretrainingadministrationofthequizforthisstudy.ProceduresParticipationinthisstudywasanonymousandvoluntary,andtherelevantinstitutionalreviewboard(IRB)determinedittobeexemptfromIRBreview.QuestionnairesweredistributedbytheYMHFAinstructorsim-mediatelybeforestarting(Pre)andimmediatelyafter(Post)fin-ishingeach1-day8-hrYMHFAtraining,toalltraineespresentandfollowingstandardizedinstructions.PacketswereprearrangedsothattraineeswouldreceiveadifferentvignetteatPreversusPost,andsoeachofthefourvignettesandbothgendersweresystem-aticallydistributedacrossthestudyandtimepoints.AtPost,traineeswerealsoaskedtocompleteatrainingsatisfactionform;thesedataarenotreportedhere.Nopaymentorotherincentivewasprovidedforcompletingthestudyforms.Thetraininginstructorscollectedeachsetofquestionnairesafterabout10minandsealedtheminaprovidedenvelope.Studystaffthenarrangedtopickupthecompletedpacketsforprocessing.Neitherparticipantsnorinstructorsweretoldhowvignettere-sponseswouldbescored.Writtenresponsestothestudyvignettesrangedfromafewwordstoashortparagraph.Studystaffscoredeachresponseblind(Prevs.Post)accordingtowhetherornotitcontainedthefiveelementsofALGEE:(A)Assessforriskofsuicideorharm,(L)Listennonjudgmentally,(G)Givereassuranceandinformation,(E)Encourageappropriateprofessionalhelp,and(E)Encourageself-helpandothersupportstrategies.Aresponsewasawarded1pointforeachofthefiveelementsitin-cluded.Ascoreof0.5wasgivenifanelementwasincludedbutinapartial,minimal,orambiguousway.Thus,eachvignetteresponsecouldreceiveascoreof0(noALGEEelements)through5(allelements).Responsesscoredas0.5or1.0onindividualALGEEcomponentswerecategorizedas“correct”forchi-squareanalyses.AllscoringwascompletedbytwoclinicalpsychologistswithknowledgeofMHFA.Initially,theraterscreatedscoringcriteria,andbothscoredthesamerandomlyselected20vignetteresponses,discussinghoweachinterpretedthecriteria.BothPreandPostresponseswereselected.Afterrefiningthescoringcriteria,theratersnexttestedtheirinterraterreliabilitybyindependentlyscor-ingthesamesetandthencomparingscores.Scoresdifferingbyoneormorepointsbetweenscorersweredeemednonreliable.Ratersweresufficientlyreliableon19of20scores.Remainingquestionnaireswerethendividedbetweenraters,withoneraterscoringeachresponse.Thetworatersscoredallvignettesinthesameroomtoenablediscussionofresponsesthatdidnoteasilyfitthecriteriaandmakeconsistentdecisions,whichwerenotedinthecriteria.Reliabilitywastestedagainhalfwaythroughscoringonasampleof20randomlyselectedPreandPostvignetteresponses.Noneofthe20vignetteresponsesscoresdifferedbetweenratersbymorethan1point.AnalysesDescriptivestatistics(means,standarddeviations,percentages)werecompletedondemographicvariablesandMHFAknowledgequestionnaires.Pairedsamplettestswereusedtoassesschangeinpre-versusposttrainingvignettescores(identificationofappropri-ateassistancebehaviorsaccordingtoALGEE)andlikelihoodofprovidinghelp.Chi-squareanalyseswereusedtocompareper-centageofcorrectresponsesforeachofthefiveALGEEstrategiesTable1ContentofVignettesofYoungPersonsinDistressConditionVignetteContentDepressionJohn/Janeisa15-year-oldwhohasbeenfeelingunusuallysadandmiserableforthelastfewweeks.He/sheistiredallthetimeandhastroublesleepingatnight.John/Janedoesn’tfeellikeeatingandhaslostweight.He/shecan’tkeephis/hermindonhis/herstudiesandhis/hergradeshavedropped.He/sheputsoffmakinganydecisionsandevenday-to-daytasksseemtoomuchforhim/her.His/herparentsandfriendsareveryconcernedabouthim/her.DepressionwithalcoholmisuseJane/Johnisa15-year-oldwhohasbeenfeelingunusuallysadandmiserableforthelastfewweeks.She/heistiredallthetimeandhastroublesleepingatnight.Jane/Johndoesn’tfeellikeeatingandhaslostweight.She/hecan’tkeepher/hismindonher/hisstudiesandher/hisgradeshavedropped.She/heputsoffmakinganydecisionsandevenday-to-daytasksseemtoomuchforher/him.Jane/Johnhasbeendrinkingalotofalcoholoverthelastyearandrecentlylosther/hisweekendjobbecauseofher/hishangovers.Her/hisparentsandfriendsareveryconcernedabouther/him.SocialphobiaJohn/Janeisa15-year-oldlivingathomewithhis/herparents.Sincestartinghis/hernewschoollastyear,he/shehasbecomeevenmoreshythanusualandhasmadeonlyonefriend.He/Shewouldreallyliketomakemorefriendsbutisscaredthathe’ll/she’lldoorsaysomethingembarrassingwhenhe’s/she’saroundothers.AlthoughJohn’s/Jane’sworkisOK,he/sherarelysaysawordinclassandbecomesincrediblynervous,trembles,blushes,andseemslikehe/shemightvomitifhe/shehastoansweraquestionorspeakinfrontoftheclass.Athome,John/Janeisquitetalkativewithhis/herfamilybutbecomesquietifanyonehe/shedoesn’tknowwellcomesover.He/sheneveranswersthephoneandhe/sherefusestoattendsocialgatherings.He/sheknowshis/herfearsareunreasonablebuthe/shecan’tseemtocontrolthemandthisreallyupsetshim/her.PsychosisJane/Johnisa15-year-oldwholivesathomewithher/hisparents.She/hehasbeenattendingschoolirregularlyoverthepastyearandhasrecentlystoppedattendingaltogether.Overthepast6months,she/hehasstoppedseeingher/hisfriendsandhasbegunlockingherself/himselfinher/hisbedroom.She/herefusestoeatwiththefamilyortohaveabath.Her/hisparentsalsohearher/himwalkingaboutinher/hisbedroomatnightwhiletheyareinbed.Eventhoughtheyknowshe/heisalone,theyhaveheardher/himshoutingandarguingasifsomeoneelseisthere.Whentheytrytoencourageher/himtodomorethings,she/hewhispersthatshe/hewon’tleavehomebecauseshe/heisbeingspieduponbytheneighbor.Theyrealizeshe/heisnottakingdrugsbecauseshe/heneverseesanyoneorgoesanywhere.123YOUTHMHFAUSA

atpre-versusposttrainingassessment.Becausethesedatawerecollectedanonymously,thereisnowaytolinkPreandPostdatabyperson.Thus,theresultscompareallPretoallPostresponses,ratherthaninvestigatingindividualchangescores.ResultsWereceiveddatafrom20trainingclassesranginginsizefrom17–30attendees,inwhich406individualsweretrainedand384submittedcourseevaluations.WereceivedcompletePreandPostdatafrom12ofthe20classes,Postdataonlyfrom6classes,andPredataonlyfrom2classes.Missingdatafromthoseeightclasseswereattributabletoproceduralerror(e.g.,theinstructordidnotremembertodistributetheforms).Atotalof246validPreques-tionnairesand334Postquestionnaireswerereceivedbythere-searchteam.IdentificationofAppropriateAssistanceBehaviorsAtthepretrainingassessment,themeanscoreonthevignettequestionnairewas1.32(SD0.80),indicatingthattheaverageresponseincludedfewerthan1.5ALGEEcomponents.PairedsamplettestswereusedtoassessPreversusPostresponsestovignettes.Traineeresponsesdemonstratedsignificantoverallim-provementatposttrainingassessment(M1.87,SD1.1),t6.6,p.001.TraineeresponsestoavignetteafterYMHFAtraining(Post)scoredsignificantlyhigherthanthosebeforetrain-ing(Pre)onfouroffiveelementsofALGEE,althoughinsomecases,theincreaseswerenotlarge.“Assessingforriskofsuicide”(theAinALGEE)increasedalmostthreefold,butfromalow9%inclusioninPretrainingresponsestoastillmodest23%inclusioninPost.“Listeningnonjudgmentally”alsoincreasedsignificantly,althoughitwasincludedinmanyresponsesfromthestart(66%atPreto79%atPost).“Giveinformationandreassurance”wastheoneelementthatdidnotincreasesignificantly(23%Pre,29%Post).“Encourageprofessionalhelp”wasfoundinamoderatenumberofresponsesbothbefore(38%)andafter(47%)training,asignificantifmodestincrease.“Encourageself-helpandothersupports”increasedmoresubstantially,from19%Preto31%Post.TheresultsaresummarizedinTable2.LikelihoodofProvidingHelpPairedsamplettestsindicatethatYMHFAtraineesratedthem-selvessignificantlymoreconfidentinhelping,morelikelytotrytohelp,andmorecomfortableinhelpingsomeoneindistressaftertheYMHFAtrainingthanbeforeit(seeTable3).WhenaskedhowwellMHFAequippedthemtorespondtothetypeofsituationpresentedintheirposttrainingvignette,71%ofthe335peoplerespondingmarked“quiteabit”or“extremely”withanadditional21%marking“moderately.”MentalHealthFirstAidKnowledgeOfthe361ten-itemposttrainingknowledgequizscoreswereceived,99%(allbutthree)hadapassingscoreof6ormorecorrect,and83%(n300)scoreda9or10.Onlytwoitemswereansweredincorrectlymorethan10%ofthetime.DiscussionThecentralaimofthisstudywastoassesschangesinabilityofparticipantsinan8-hrYMHFAtrainingtorespondhelpfullytoayoungpersoninemotionaldistressorcrisis,usingawrittenhy-potheticalsituation.Resultsindicatesignificant,positivechangesintrainees’abilitytoapplyfourofthefiveelementsofALGEE:(A)Assessforriskofsuicideorharm,(L)Listennonjudgmentally,(E)Encourageprofessionalhelp,and(E)Encourageself-helpandothersupportstrategies.Nosignificantchangesin(G)Givereas-suranceandinformationwereobserved.Thus,trainees’writtenresponsestotheposttrainingvignettecontainedsignificantlymoreelementsofALGEEthantheirpretrainingresponsestoavignette.TheseresultssuggestthatYMHFAtrainingresultsinimprovedknowledgeofhowtorespondtoayoungpersonappropriatelyinpsychologicaldistressviatraineeslearningtheALGEEelements.Thisfindingisbolsteredbythesignificantincreasesreportedinparticipants’confidencein,likelihoodof,andcomfortwithassist-ingayoungpersoninemotionaldistress,similartopreviousresearchfindingaself-reportedincreaseinhelpingbehaviors(Hadlaczkyetal.,2014).FutureresearchonthedurabilityoftheseimprovementsconnectedwiththeYMHFAtrainingisnecessaryinordertoevaluateandensurethelong-termpositiveimpactofMHFAtrainingonhelpingbehaviors.Thefactthatscoresimprovedsignificantlyinthisstudyisespeciallynoteworthywhenoneconsidersthatthesampleiscomposedofemployeesinasocialservicesagency,themajorityofwhomhadcompletedpostsecondaryeducation.YMHFAandMHFAaredesignedforusewiththegeneralpublic,thatis,peoplewhodonothavetraininginmentalhealth–relatedfields.Infact,Table2PreVersusPostALGEEScoresofTraineeWrittenResponsestoVignettesofYoungPersonsinDistressALGEEcomponentPre,percentcorrect(n243)Post,percentcorrect(n271)Chi-squarepAssessforriskofsuicideorharm92328.1.001Listennonjudgmentally66798.6.003Giveinformationandreassurance23292.2.139Encourageprofessionalhelp38474.6.032Encourageself-helpandothersupports19319.1.002Note.ALGEEAssessforriskofsuicideorharm,Listennonjudgmentally,Giveinformationandreassur-ance,Encourageprofessionalhelp,Encourageself-helpandothersupports.124AAKRE,LUCKSTED,ANDBROWNING-MCNEE

previousresearchhassuggestedthatthistrainingisnotoptimallyusefulforindividualswithadvancedtraining(Lucksted,Mendenhall,Frauenholtz,&Aakre,2015).Differencesinimpactofsuchtrainingonindividualswitharangeofbaselineknowledgeofhowtorespondtoayoungpersonindistresswarrantfutureresearch.Althoughsignificantimprovementswereobservedinmostcom-ponentsofALGEE,manywerenotlarge.Fortheactionof“listennonjudgmentally,”changesmayhavebeenmodest(66%Preto79%Post)becausethemajorityofrespondentsalreadyincludedthisactionstepbeforeparticipatinginthetraining.Potentialrea-sonsforthemodestincreasesintheothercomponentsofALGEEaremoredifficulttoidentify.Itisimportanttonotethatmanyfactorsinadditiontoknowledgeortrainingshapeparticipants’responsesonquestionnaireslikethis,includingparticipants’moods,theirattitudesaboutbeingatthetraining,andwrittenexpressionskills.Similarly,thetimingofadministrationinpartic-ularrequirescomment:respondentscompletedthepostquestion-nairesimmediatelyfollowingtheconclusionofthetraining,anditispossiblethattheresponseswerebrieforunelaboratedbecauseofparticipantfatigueattheendofalongday.Additionally,severalinstructorsinformallycommentedthatsomeparticipantswereinahurrytoleave.Futureresearchcanaddressthischallengebyemployingalessimmediateortime-pressuredfollow-upassess-ment.LimitationsAlthoughtheconductofthisstudyinareal-worldsettingcontributestoitsecologicalvalidity,thismethodologyalsocon-ferredsomelimitations.Mostnotably,someassessmentpacketswereadministeredoutoforder,andafewwereneverreturnedtotheresearchteam.Wethinkthisissuewasprimarilytheresultofaddingtheburdenofquestionnaireadministrationtothealreadysignificantinstructorresponsibilities.Infutureprojects,thiscouldbeimprovedbyhavingstudyresearchstaffadministertheques-tionnairesinsteadofinstructors.Additionally,studyconditionsatPostmayhavebeenmoreharriedforparticipantsthanatPre,whichmayhaveaffectedthewrittendata.AlthoughdatafromtheMHFAknowledgequestionnaire,administeredonlyatPost,werenottheprimaryfocusofthisstudy,theinclusionofthisquestion-naireatPrewouldhavepermittedadditionalanalysisoftheutilityofYMHFA.Anothernotablelimitationofthisstudyisitslackofacontrolgroup.Finally,therearenoexistingbenchmarkstowhichwecancomparethecurrentresults;thus,wearenotabletodemonstratethattheseresultscorrespondwithreal-worldbehav-iors.Results,althoughpromising,shouldbeconsideredprelimi-nary.Subsequentresearchshouldemployincreasedmethodolog-icalrigor;infact,several(non-U.S.)randomizedcontrolledtrialsofMHFAareunderway(Crawfordetal.,2015;Jensen,Morthorst,Vendsborg,Hjorthøj,&Nordentoft,2015).ImplicationsandConclusionMHFAresearchintheUnitedStatesandelsewhereisstrivingtomovebeyondonlyrecordingimprovementsinknowledgeandabstractconfidenceorintention.Ourstudysuggeststhatthehy-potheticalvignettemethodologycanbesuccessfullycarriedouteveninuncontrolledsituations(e.g.,instructorsratherthanstudystaffdistributingforms).ThisissignificantbecausethemethodisclosertoactualbehavioralsamplingbeforeandafterMHFAtrainingandthereforemorerelevanttoreal-lifeMHFAusage.Additionally,resultsfromthisstudyaddtotheevidenceofMHFA’seffectivenessinarangeofsituationsandspecificallytothegraduallygrowingandmuch-neededtestingoftheMHFA-USAprograms.YMHFAtraineesdemonstratedsignificantimprovementsintheapplicationofALGEEstrategiesfollowingcompletionofthetrainingprogram,aswellasincreasedconfidencein,likelihoodof,andcomfortwithhelpingayoungpersoninemotionaldistressorcrisis.Consideredtogether,thesefindingsbolstertheevidencethatMHFAandYMHFAtraininghavethepotentialtocreatebetterinformedandmoresupportivecommunitiesregardingmentalhealth.Futureresearchshouldinvestigatethe“real-world”impactsofMHFA,includingmeasurementofobservedbehaviorchangefollowingtrainingandcommunity-wideimpactsonstigma,socialdistancing,andmentalhealth.ReferencesCrawford,G.,Burns,S.K.,Chih,H.J.,Hunt,K.,Tilley,P.J.,Hallett,J.,…Smith,S.(2015).Mentalhealthfirstaidtrainingfornursingstudents:Aprotocolforapragmaticrandomisedcontrolledtrialinalargeuniversity.BMCPsychiatry,15,26.http://dx.doi.org/10.1186/s12888-015-0403-3Evans,S.C.,Roberts,M.C.,Keeley,J.W.,Blossom,J.B.,Amaro,C.M.,Garcia,A.M.,…Reed,G.M.(2015).Vignettemethodologiesforstudyingclinicians’decision-making:Validity,utility,andapplicationinICD-11fieldstudies.InternationalJournalofClinicalandHealthPsychology,15,160–170.http://dx.doi.org/10.1016/j.ijchp.2014.12.001Ghio,L.,Gotelli,S.,Marcenaro,M.,Amore,M.,&Natta,W.(2014).Durationofuntreatedillnessandoutcomesinunipolardepression:Asystematicreviewandmeta-analysis.JournalofAffectiveDisorders,152–154,45–51.http://dx.doi.org/10.1016/j.jad.2013.10.002Table3PreandPostYouthMentalHealthFirstAidTrainingSelf-RatingsRegardingResponsetoVignetteofYoungPersoninDistressQuestionMean:Pre(n243)Mean:Post(n271)ttestpHowconfidentwouldyoubeinyourabilitytohelpthispersonintheway(s)youdescribedabove?3.48(.92)3.86(.73)5.25.001Howlikelydoyouthinkyouwouldbetoactuallytrytohelpsomeoneinthissituation,intheways(s)youdescribedabove?3.51(.95)3.85(.95)4.44.001Howcomfortablewouldyoubetryingtohelpsomeoneinthissituation,intheway(s)youdescribedabove?3.59(.99)3.85(.80)3.36.001125YOUTHMHFAUSA

Hadlaczky,G.,Hökby,S.,Mkrtchian,A.,Carli,V.,&Wasserman,D.(2014).MentalHealthFirstAidisaneffectivepublichealthinterventionforimprovingknowledge,attitudes,andbehaviour:Ameta-analysis.InternationalReviewofPsychiatry,26,467–475.http://dx.doi.org/10.3109/09540261.2014.924910Jensen,K.B.,Morthorst,B.R.,Vendsborg,P.B.,Hjorthøj,C.R.,&Nordentoft,M.(2015).Theeffectofthementalhealthfirst-aidtrainingcourseofferedemployeesinDenmark:Studyprotocolforarandomizedwaitlist-controlledsuperioritytrialmixedwithaqualitativestudy.BMCPsychiatry,15,80.http://dx.doi.org/10.1186/s12888-015-0466-1Jorm,A.F.(2012).Mentalhealthliteracy:Empoweringthecommunitytotakeactionforbettermentalhealth.AmericanPsychologist,67,231–243.http://dx.doi.org/10.1037/a0025957Jorm,A.F.,Korten,A.E.,Jacomb,P.A.,Christensen,H.,Rodgers,B.,&Pollitt,P.(1997).“Mentalhealthliteracy”:Asurveyofthepublic’sabilitytorecognisementaldisordersandtheirbeliefsabouttheeffec-tivenessoftreatment.MedicalJournalofAustralia,166,182–186.Jorm,A.F.,Wright,A.,&Morgan,A.J.(2007).Wheretoseekhelpforamentaldisorder?NationalsurveyofthebeliefsofAustralianyouthandtheirparents.TheMedicalJournalofAustralia,187,556–560.Re-trievedfromhttps://www.mja.com.au/journal/2007/187/10/where-seek-help-mental-disorderKelly,C.M.,Mithen,J.M.,Fischer,J.A.,Kitchener,B.A.,Jorm,A.F.,Lowe,A.,&Scanlan,C.(2011).Youthmentalhealthfirstaid:Adescriptionoftheprogramandaninitialevaluation.InternationalJour-nalofMentalHealthSystems,5,4.http://dx.doi.org/10.1186/1752-4458-5-4Kitchener,B.A.,&Jorm,A.F.(2002a).Mentalhealthfirstaidmanual.Canberra,Australia:CentreforMentalHealthResearch.Kitchener,B.A.,&Jorm,A.F.(2002b).Mentalhealthfirstaidtrainingforthepublic:Evaluationofeffectsonknowledge,attitudesandhelpingbehavior.BMCPsychiatry,2,10.http://dx.doi.org/10.1186/1471-244X-2-10Kitchener,B.A.,Jorm,A.F.,&Kelly,C.M.(2009).MentalHealthFirstAidUSA[manual].Annapolis,MD:AnneArundelCountyMentalHealthAgency,Inc.Kitchener,B.A.,Jorm,A.F.,&Kelly,C.M.(2012).YouthMentalHealthFirstAidUSAforadultsassistingyoungpeople[manual].Baltimore,MD:MentalHealthAssociationofMaryland,Inc.Lucksted,A.,Mendenhall,A.N.,Frauenholtz,S.I.,&Aakre,J.M.(2015).ExperiencesofgraduatesoftheMentalHealthFirstAid-USAcourse.InternationalJournalofMentalHealthPromotion,17,169–183.http://dx.doi.org/10.1080/14623730.2015.1013670Marshall,M.,Lewis,S.,Lockwood,A.,Drake,R.,Jones,P.,&Croudace,T.(2005).Associationbetweendurationofuntreatedpsychosisandoutcomeincohortsoffirst-episodepatients:Asystematicreview.Ar-chivesofGeneralPsychiatry,62,975–983.http://dx.doi.org/10.1001/archpsyc.62.9.975Mendenhall,A.N.,Jackson,S.,&Hase,S.(2013).MentalHealthFirstAidUSAinaruralcommunity:Perceivedimpactonknowledge,attitudes,andbehavior.SocialWorkinMentalHealth,11,563–577.http://dx.doi.org/10.1080/15332985.2013.812542Merikangas,K.R.,He,J.P.,Burstein,M.,Swendsen,J.,Avenevoli,S.,Case,B.,…Olfson,M.(2011).ServiceutilizationforlifetimementaldisordersinU.S.adolescents:ResultsoftheNationalComorbiditySurvey-AdolescentSuppl.(NCS-A).JournaloftheAmericanAcademyofChild&AdolescentPsychiatry,50,32–45.http://dx.doi.org/10.1016/j.jaac.2010.10.006NationalCouncilofBehavioralHealth.(2014).Astate-by-statecountoffirstaiderstrained.RetrievedMay27,2015,fromwww.mentalhealthfirstaid.org/cs/external/2014/11/algee-ometer-state-state-count-first-aiders-trained-4/Perou,R.,Bitsko,R.H.,Blumberg,S.J.,Pastor,P.,Ghandour,R.M.,Gfroerer,J.C.,…theCentersforDiseaseControlandPrevention(CDC).(2013).Mentalhealthsurveillanceamongchildren—UnitedStates,2005–2011.MorbidityandMortalityWeeklyReport,62(Suppl.2),1–35.Yap,M.B.,&Jorm,A.F.(2012).Youngpeople’smentalhealthfirstaidintentionsandbeliefsprospectivelypredicttheiractions:FindingsfromanAustralianNationalSurveyofYouth.PsychiatryResearch,196,315–319.http://dx.doi.org/10.1016/j.psychres.2011.10.004ReceivedMay28,2015RevisionreceivedSeptember1,2015AcceptedSeptember9,2015126AAKRE,LUCKSTED,ANDBROWNING-MCNEE

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.