• Overall Program Organization
• Program Content:
• Program Presentation:
• Overall Value to You:
• How well did the course meet your expectations?
• Did the instructor demonstrate a thorough knowledge of the subject matter?
• How would you rate the instructor's presentation of the material?
• To what degree did the course provide practical applications for your work?
• What is your overall evaluation of this course?
• How do you see yourself utilizing the QPR training module?
• Suggestions for future QPR certification trainings?

• Successful passing 25-item post course quiz
• Writing and passing at least 5 essay questions based on training content
• Successful passing of a telephone interview with a QPR Institute staff member

• Likert scale ratings mentoring training program
• Likert scale ratings on knowledge about suicide (risk factors, protective factors, history, current practices, Surgeon General’s report, etc.)
• Likert scale ratings on perceived self-competence to teach QPR to others
• Ratings on new editions and updates of multimedia media and audio-visual presentations

• Have you ever had contact with someone you thought was suicidal? If yes, did you talk to them about your concerns (yes, no, indirectly, not sure, had no contact)
• Did you ask them if they were thinking about killing themselves? (yes, no, indirectly, not sure, had no contact)
• Did you get the person you were worried about to accept help, e.g., see a professional? (yes, no, indirectly, not sure, had no contact)
• How many suicidal people have you encountered in the past year?
• How many suicidal people have you encountered in the past month?

• Likert scale suicide facts
• Likert scale knowledge of suicide warning signs
• Likert scale how to ask someone about suicide
• Likert scale how to persuade someone to get help
• Likert scale on how to get someone help (local resources)
• Likert scale do you feel that asking someone about suicide is appropriate
• Likert scale on perceived likelihood to act to prevent a suicide
• Likert scale rating on level of understanding about suicide and suicide prevention
• Likert scale (5 point) overall rating of training
• Would you recommend QPR to others?
• 12-item knowledge quiz (pass at 75% correct)
• Likert scale (5 point) Do you believe this training will help you in helping someone suicidal?

• Pre-post list as many suicide warning signs as possible
• Pre-post resource/referral knowledge
• Likert scales for reactions to training
• Yes-no recommend training to other

• Repeat above post-training measures (retention measure)
• Retention of QPR (what do the letters mean)?
• Did you read the QPR booklet following training? Was it helpful (Likert scale rating)
• Do you have the QPR folding card? Where is it?
• To your knowledge has anyone else read the QPR booklet? How many persons?
• Would you recommend QPR training to others? If not, why not?

• Have you intercepted a suicidal communication since your QPR training?
  If yes, please describe what happened? ______________________
• Were you able to apply the QPR method? Y/N
• If not, why not?
• If yes, with what result? (please explain)
• Did the person you tried to help see a professional for evaluation? Y/N
• What kind of professional? Did counseling or treatment begin?
• Do you believe the intervention you conducted was effective? If not, why not?
• Do you believe the intervention you conducted helped save a life?
• What more did you need to know to have done a better job helping someone who was suicidal? Please explain___________________.

Resource utilization measures for the QPR on CD-ROM program

• same as above in self-report by participants plus
• utilization of web-linked resources (e.g., survivor of suicide support group)
• utilization of web-linked depression or other mental health screening
• utilization of web-linked referral information
• utilization of online provider appointment schedule

External Measures of QPR gatekeeper training (setting perceptions):
Focus group qualitative response of evaluation of overall program effect, to include threaded discussion and recordings of:

• perceived benefits
• impact on community
• impact on institution/school
• impact on individuals
• perceived burdens or problems
• too time consuming
• was not relevant
• safety (program had an adverse effects)

External outcome and impact measures:
Given the QPR program philosophy (that those most at risk do not seek help), program efficacy should result in:

• A greater total number of referrals to resources
• Increased non-traditional referrals to suicide prevention resources
• Increased numbers of survivors of suicide attending support groups
• More depression screenings
• More 1st mental health appointments
• More 1st substance abuse treatment appointments
• More 1st appointments for families in distress
• More 1-800 or other suicide related calls
• More consultations for 3rd parties by QPR trained citizens
• Fewer injury-related ER visits for suicide attempts, but more pre-injury evaluations
• Lower absenteeism rates at work sites (depression related)
• Fewer school drop outs (including college) (depression related)
• More emergency/urgent evaluations of suicidal persons
• More psychiatric admissions
• Fewer jail suicides
• More persons per capita on psychotropic medications

Outcome measures for QPR Institute Professional Training Programs
These will not be listed here, but the following needs assessment survey was developed to determine educational and training needs of a variety of professional gatekeepers. The QPR Institute has developed a competency-based assessment and credentialing process for professionals trained in our suicide risk assessment and risk management programs. These outcome measures include quizzes, supervised role plays, and medical records reviews.

Professional Suicide Knowledge and Skill Survey

Age_________
Sex__________
Position/profession/job__________________________________________

Suicide attempts or completions are frequently preceded by “warning signs”(suicidal communications, threats or behaviors). A warning sign would include statements such as, “I can’t stand the pain any longer, I just want to end it all.” Or, “I’d be better off dead.” Or, “I think I’m going to kill myself.” Any of the following behaviors might also be warning signs of a pending suicide attempt: a previous suicide attempt, serious depression, changes in behavior, irritability or anger, giving away prized possessions, preparing a will, stockpiling pills, purchasing a firearm, saying goodbye, and any other word or deed that suggests the person may be planning to die by suicide. Vulnerable persons suddenly caught up in a crises from which they cannot escape and which may prove personally humiliating would also fit this definition.

1. In your role as a professional, have you ever suspected and/or intercepted a suicidal communication or seen one or more warning signs in someone to whom you were providing service?
Yes ___ No ___

1a. If yes, how many suicidal persons have you identified/encountered in the past 12 months? ____ .

1b. Did any of them attempt suicide? Yes___ No ___ How many? ___
How many died? ____.
Comments:
2. In your role as a citizen (non-professional life) have you ever suspected and/or intercepted a suicidal communication or seen one or more warnings signs of suicide?
Yes ___ No___

2a. If yes, how many suicidal persons have you identified in the past 12 months? ____

2b. Did any of them attempt suicide? Yes___ No ___ How many? ___
How many died? ____.

Comments:

3. As a professional, have you been involved in the assessment of someone who made a suicide attempt?
Yes ___
No ___
If yes, how many in the past 12 months ____.
Comment:

4. Elective question: Have you personally known anyone who ended his or her life by suicide?
Yes ___ No___
If yes, was this person or these persons a (circle one or more letters)?
a. Blood relative/family member (number____)
b. Friend(s) (number ____)
c. Consumer of my professional services (number ____)
Comments:

5. When confronted with a potentially suicidal consumer of your services, did you make some attempt to intervene?
Yes___ No___ Can’t recall ___ Didn’t know what to do/did nothing ___

6. If you did attempt an intervention, please indicate how felt while handling the crisis:
I felt:

I felt

7. Overall, I believe my knowledge of suicide, its causes and prevention is (circle one):
a. Poor
b. Fair
c. Good
d. Excellent

8. For persons in my position, education in suicide risk detection, assessment and referral skills:
Are not necessary ___ Necessary ____ Should be required____

9. How many hours of training have you had on the topic of suicide prevention, intervention or assessment (course, seminar, CME, etc.)? Number of hours ____.

10. In my professional role, I believe I have some duty to assist suicidal persons and, therefore, some exposure to legal action if I fail to take reasonable and prudent steps to reduce the risk of a suicide attempt or completion.
Yes ___ No ___

11. Personally, I would be willing to participate in and learn more about suicide and its prevention.
Yes___ No___ Uncertain ___

12. Given my current professional role, duties and commitments to continuing education and skill enhancement, I could commit the following time to suicide prevention training (circle one letter):
a. 0 hours e. 8 hours
b. 1-2 hours f. More than 8 hours
c. 2-3 hours
d. 3-4 hours

13. My preferred educational platform for suicide prevention training would be (circle one letter):
a. An in vivo professional seminar or presentation
b. Multi-media online tutorial
c. Multi-media online tutorial and in vivo review/Q&A
d. Read-only print text

14. As a professional who may have “last contact” with a potentially suicidal person or consumer of my services like mine, do you feel persons in your profession would benefit from additional training in detecting suicidal communications and basic assessment and referral or intervention skills?
Yes_____ No_____

15. Are you aware that the Surgeon General of the United States has recently published the National Strategy for Suicide Prevention: Goals and Objectives for Action?
Yes ___ No ___

16. Do you believe persons in your profession should be included in the national effort to reduce disability and premature death associated with suicide attempts and completions?
Yes ___ No ___


Please elaborate on any item above and/or additional comments regarding this survey:




If we may quote any of your comments, please supply your name, address and signature here: