Sources of Strength Research Project
The Sources of Strength project was originally developed and implemented in 1998 in North Dakota by founder Mark LoMurray. The project's use of peer leaders in partnership with caring adults was a core part of a statewide campaign from 2000-2004, while not statistically significant the project showed very encouraging reductions of teen fatalities and reductions in 3 of 4 suicide markers in North Dakota’s Youth Risk Behavior Survey. In 2005, the American Association of Public Health, epidemiology section, awarded the project their national Public Health Practice Award.
Peter Wyman, Mariya Petrova and Pat Breux at a Sources of Strength research school in rural New York.
From 2003-2007 Peter Wyman, Ph.D. (University of Rochester, NY) and Hendricks Brown, Ph.D. (University of South Florida) conducted the nation’s largest randomized trial on the effect of adult gatekeeper training in 32 middle and high schools (48,000 students) on adult staff in an extensive study on a gatekeeper-training program in Cobb County just north of Atlanta. Their findings reflected a medium to large effect on knowledge of suicide warning signs and perceived access to services, but only a small effect on trained adults asking students about suicide. Also included was a survey of 2,000 students in these schools indicating that suicidal students were much less willing to seek help from adults than their non suicidal peers. Implications of findings for this trial were threefold:
1) Adult training alone was unlikely to significantly increase detection and response to suicidal youth.
2) Suicidal peers were the least likely to seek adult help, and
3) Developmentally, adolescents seek help through their peer friendships.
So in 2006 Dr. Wyman and Dr. Brown began a nationwide search for a comprehensive peer approach toward suicide prevention and found themselves driving through the snow packed roads of North Dakota with Mark LoMurray to observe Sources of Strength first hand. After witnessing the strength based messages and the connection being built between youth and adults, it was decided to conduct an initial trial of Sources of Strength in six high schools in Cobb County, GA with a significant sample of Latino, African-American, and Caucasian students.
Sources of Strength had previously been involved in local and statewide evaluation efforts with rural and tribal communities and had spread to several other states, however Sources of Strength like almost all other suicide prevention efforts in the nation had not participated in a rigorous randomized trial. The 2008 Cobb County trial results (with six high schools, 177 peer leaders, and 4,300 students surveyed) showed positive intervention impact on peer leaders by increasing youth-adult connectedness - through help-seeking acceptance and communication with adults. It also had impact in more adaptive suicidal peer norms by increasing rejection of codes of silence and increasing expectations in the school that adults can help suicidal peers. The Cobb County trial showed that peer leaders had a four-fold increase of actually referring suicidal peers for adult help.
In 2009, the randomized trials continued with another dozen rural schools in upstate New York and in North Dakota measuring the impact of Sources of Strength. This appears to be the first population-based trial of peer leaders supported by adult advisors showing significant impact on key suicide markers; impacting norms across an entire student population, with the most positive impact being amongst students identifying themselves as suicidal and less connected than other students. The results of this study were published in the September 2010 issue of American Journal of Public Health: Schools and Mental Health.
The key findings highlighted in this article show:
-Increase in Peer Leader's connectedness to adults
-Increase in Peer Leaders's school engagement
-Peer Leaders in larger schools were four times more likely to refer a suicidal friend to an adult
-Among general student population the program increased positive perceptions of adult support for suicidal youth and the acceptability of seeking help
-Positive perception of adult support increased most in students with a history of suicidal ideation
-Sources of Strength is the first suicide prevention program involving Peer Leaders to enhance protective factors associated with reducing suicide at the school population level!
The University of Rochester, NY is expanding this ongoing trial of Sources of Strength into the National Peer Leadership Study with another 40 high schools being recruited into a longer five-year evaluation. This study will measure: impact on connectivity, school bonding, suicidal ideation and attempts. As well as further evaluation of the social networking model for spreading messages aimed at suicide prevention and other public health issues, this model examines how the connection between peers and adults, as well as peers and their friendship groups effect the dissemination of these messages.
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