Development and Validation of the Gatekeeper Behavior Scale
A Tool to Assess Gatekeeper Training for Suicide Prevention
Abstract
Abstract.Background: Community-based gatekeeper trainings are effective tools in increasing gatekeeper skills but few validated measures assess impact. Aims: This study aimed at determining the validity of an 11-item Gatekeeper Behavior Scale (GBS) to assess gatekeeper skills that predict behavior. Method: To validate the scale, 8,931 users were administered GBS surveys at pretraining, posttraining, and follow-up periods. The training was one of five from the suite of online At-Risk mental health learning simulations for university faculty/staff or students or high/middle school educators. Results: A confirmatory factor analysis revealed the three-factor model based on the subscales of preparedness, likelihood, and self-efficacy fit the data best. Factor loadings showed all items correlated highly with theoretical constructs (r ≥ .84, p < .001). The GBS had high internal consistency (α = 0.93). Criterion-related validity for likelihood to discuss concerns at posttraining was significantly related to approaching students believed to be in psychological distress (r = .219, p < .001). Likelihood to refer significantly correlated with the number of students referred (r = .235, p < .001). Convergent validity was established via a correlation between self-efficacy in motivating someone to seek help and general self-efficacy (r = .519, p < .001). Conclusion: The GBS appears to be a valid tool in measuring the impact of online gatekeeper training simulations and holds promise for assessing other delivery methods.
References
(2009). Confirmatory factor analysis using Amos, LISREL, Mplus, SAS/STAT CALIS (UITS Working paper). Indiana University, Center for Statistical and Mathematical Computing. Retrieved from http://www.indiana.edu/~statmath/stat/all/cfa/index.html
(2011). Using an avatar-based simulation to train families to motivate veterans with post-traumatic stress to seek help at the VA. Games for Health, 1(1), 21–28. 10.1089/g4h.2011.0003
(2004). An outcome evaluation of the SOS suicide prevention program. American Journal of Public Health, 94, 446–451.
(1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. 10.1037/0033-295X.84.2.191
(2009). School-based suicide prevention: Research advances and practice implications. School Psychology Review, 38(2), 233
(2015). Gatekeeper training for suicide prevention: A theoretical model and review of the empirical literature. Santa Monica, CA: Rand National Defense Research Institute.
. (2010). Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: National Center for Injury Prevention and Control. Retrieved from http://www.cdc.gov/injury/wisqars/index.html
(2001). Suicide prevention in Aboriginal communities: Application of community gatekeeper training. Australian and New Zealand Journal of Public Health, 25(4), 315–321.
(2007). Control-group study of an intervention training program for youth suicide prevention. Suicide and Life-Threatening Behavior, 37, 135–144.
(2001). Validation of a new general self-efficacy scale. Organizational Research Methods, 4, 62–83.
(2011). Suicidal thoughts and behaviors among adults aged ≥18 years – United States, 2008–2009. CDC Morbidity and Mortality Weekly Report (no. SS-13). Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6013a1.htm
(2007). Proximate outcomes of gatekeeper training for suicide prevention in the workplace. Suicide and Life-Threatening Behavior, 37(6), 659–670. 10.1521/suli.2007.37.6.659
(2011). Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. The Journal of Primary Prevention, 32(3), 195–211. 10.1007/s10935-011-0250-z
(2010). Standardization in psychological research. International Journal of Psychological Research, 3(1), 88–96.
(1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
(2001). Youth suicide prevention. Suicide and Life-Threatening Behavior, 31(Suppl), 6–31. 10.1521/suli.31.1.5.6.2421
(1994). Prevention of suicide: Aspirations and evidence. BMJ (Clinical Research Ed.), 308(6938), 1227–1233.
. (2009). Gatekeeper training as a preventative intervention for suicide: A systematic review. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 54(4), 260.
(2012). Randomized trial of suicide gatekeeper training for social work students. Research on Social Work Practice, 22(3), 270–281. 10.1177/1049731511436015
(1996). The use of simulations in an educational context: Broad and narrow foci. Suicide and Life-Threatening Behavior, 25, 123–133.
(1996). The use of simulations to assess the impact of an adolescent suicide response curriculum. Suicide and Life-Threatening Behavior, 26(4), 359–364.
(1996). Great ideas revisited. Techniques for evaluating training programs. Revisiting Kirkpatrick's four-level model. Training and Development, 50(1), 54–59.
(2006). Evaluating training programs: The four levels (3rd ed.). San Francisco, CA: Berrett-Koehler Publishers.
(2013). The impact of universal suicide-prevention programs on the help-seeking attitudes and behaviors of youths. Crisis, 34(2), 82–97. 10.1027/0227-5910/a000178
(2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention program in the US Air Force: Cohort study. British Journal of Medicine, 327, 1376–1378.
. (2015). Products. Retrieved from http://www.kognito.com/products/
(1992). A comparison of the theory of planned behavior and the theory of reasoned action. Personality and Social Psychology Bulletin, 18(1), 3–9. 10.1177/0146167292181001
(2005). Suicide prevention strategies: A systematic review. JAMA, 294(16), 2064–2074. 10.1001/jama.294.16.2064
(2008). Evaluation of gatekeeper training for suicide prevention in veterans. Archives of Suicide Research, 12(2), 148–154. 10.1080/13811110701857491
(2009). Suicide prevention programs in the schools: A review and public health perspective. School Psychology Review, 38(2), 168.
(2010). Mplus (Version 6) [Computer software]. Los Angeles, CA: Muthén & Muthén.
(1997). The suicide intervention response inventory: A revision and validation. Death Studies, 21(1), 59–81. 10.1080/074811897202137
(2006). Reporting structural equation modeling and confirmatory factor analysis results: A review. Journal of Educational Research, 99(6), 323–338.
(2003). Many helping hearts: An evaluation of peer gatekeeper training in suicide risk assessment. Death Studies, 27(4), 321–333.
(2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104–115. 10.1037/0022-006X.76.1.104
(2013). A systematic review process to evaluate suicide prevention programs: A sample case of community-based programs. Journal of Community Psychology, 41(1), 35–51. 10.1002/jcop.21509
