AAS Program Evaluation & Outcomes 4 — Questions and Answers
Question 1: In a zero-suicide framework evaluation, which metric BEST reflects the 'transition of care' element?
- Percentage of at-risk patients who receive a warm handoff or follow-up contact after discharge (Correct answer)
- Average number of safety plan items completed per patient
- Rate of staff completion of suicide risk training
- Volume of crisis calls handled per month
Correct answer: Percentage of at-risk patients who receive a warm handoff or follow-up contact after discharge
Transition of care quality is measured by whether high-risk patients successfully connect to follow-up services after leaving a care setting.
Question 2: Which of the following is a key limitation of using administrative data (e.g., hospital discharge records) as the sole outcome measure in suicide prevention evaluations?
- Administrative data are too expensive to access
- Administrative data often undercount suicide attempts due to miscoding or incomplete reporting (Correct answer)
- Administrative data cannot be linked to program participation records
- Administrative data are not accepted by IRBs for research purposes
Correct answer: Administrative data often undercount suicide attempts due to miscoding or incomplete reporting
Administrative records frequently undercount suicide attempts because many are coded as accidental injuries or self-harm without suicidal intent noted.
Question 3: A program evaluator wants to assess whether a school-based prevention program reduced suicidal ideation. Which study design provides the strongest evidence?
- Post-only survey of participating students
- Pre-post survey of participating students only
- Cluster randomized trial with matched control schools (Correct answer)
- Expert consensus panel review of the curriculum
Correct answer: Cluster randomized trial with matched control schools
A cluster randomized trial with control schools provides the highest level of causal evidence by randomly assigning schools to conditions.
Question 4: Fidelity monitoring in an evidence-based suicide prevention program serves primarily to:
- Ensure the program is delivered as designed so outcomes can be validly attributed to it (Correct answer)
- Reduce the cost of program delivery over time
- Satisfy mandatory reporting requirements to funders
- Measure participant satisfaction with facilitators
Correct answer: Ensure the program is delivered as designed so outcomes can be validly attributed to it
Fidelity monitoring confirms that the program is implemented as intended, which is essential for interpreting whether outcomes are due to the program itself.
Question 5: Which evaluation framework explicitly links the concept of 'suicide as a preventable public health problem' to measurable community-level outcomes?
- The medical model of individual psychopathology
- The public health approach to suicide prevention (Correct answer)
- The criminal justice diversion model
- The clinical risk stratification framework
Correct answer: The public health approach to suicide prevention
The public health approach frames suicide as preventable and uses population-level data to set measurable community outcome targets.
Question 6: When interpreting a statistically significant reduction in suicide attempts after a program, an evaluator should also report:
- The p-value only, as significance determines practical importance
- Effect size and confidence intervals to convey practical and clinical significance (Correct answer)
- The raw number of attempts only without statistical context
- The program cost per session as the primary metric
Correct answer: Effect size and confidence intervals to convey practical and clinical significance
Effect size quantifies the magnitude of change and confidence intervals express precision, both of which are necessary alongside p-values for full interpretation.
Question 7: A suicide hotline program wants to measure caller outcomes beyond call resolution. Which follow-up method is considered best practice?
- Mandatory in-person follow-up at 72 hours
- Structured telephone or text follow-up within 24-72 hours using a validated brief instrument (Correct answer)
- Annual mailed survey to all prior callers
- No follow-up, as caller confidentiality prohibits contact
Correct answer: Structured telephone or text follow-up within 24-72 hours using a validated brief instrument
Brief structured follow-up calls or texts within 24-72 hours using validated tools (e.g., brief ideation checklist) are considered best practice for hotline outcome monitoring.
AAS Program Evaluation & Outcomes 4
In a zero-suicide framework evaluation, which metric BEST reflects the 'transition of care' element?