Module 2 > Community-informed strategy development

Community-informed strategy development involves considering local context, populations, and conditions when planning for suicide prevention strategies.  Over the past 20 years, many fields have become increasingly reliant on evidence-based practices (EBPs) when implementing and evaluating programs across populations. Evidence-based practices are practices that have been shown through research to produce positive outcomes, such as coverage of mental health conditions in health insurance policies to help prevent suicide.

However, relying exclusively on EBPs means omitting practices that haven’t been thoroughly researched but may be effective. It also means not testing emerging ideas that could prove to be more effective than anything in the EBP toolkit. Because the untested or emerging strategies are oftentimes the ones that are informed by communities of color or communities with high levels of poverty, relying exclusively on EBPs could end up perpetuating health inequities. For example, coverage of mental health conditions in health insurance policies benefits those who have health insurance, but does not help to prevent suicide among those who are uninsured.  To develop suicide prevention strategies that achieve equitable outcomes, it’s important to consider strategies that are recommended by communities in addition to those that have already been thoroughly researched. Learn more here: Redefining Evidence-Based Practices: Expanding our View of Evidence.

The CDC’s Framework for Thinking about Evidence, pictured below, expands the definition of evidence to account for local context and experience.

In addition to the Best Available Research Evidence, the framework includes:

  • Experiential Evidence, which is the collective insight, understanding, skill, and expertise of those who have practiced or lived in a particular setting over time. Some examples of data sources and methods for gathering experiential evidence include reflective questions, communities of practice, expert panels, and team decision-making and other consensus processes.

For example, although there is a lack of nationwide data on risk factors and outcomes for transgender youth, trans youth report significantly increased rates of suicide risk factors. Practitioners, community members, and LGBTQ+ allies have knowledge about the factors that trans youth face. With this experiential evidence, they can advocate for the needs of trans youth in suicide prevention planning and advocate for further data collection.

  • Contextual Evidence, which is based on “factors that address whether a strategy is useful, feasible to implement, and accepted by a particular community.” Community history, organizational capacity, and social norms are some factors that may impact the success of a prevention strategy.

For example, the success of a strategy may depend on the capacity of existing social infrastructure, such as community- and faith-based organizations that have rapport with populations at elevated risk. During the COVID-19 pandemic, an increase in the demand for nonprofit services coincided with a contraction in these organizations’ resources. In many cases, organizations adjusted their programming to meet community needs based on the COVID-19 context.

The Veto Violence online training Understanding Evidence provides further explanation on each of these types of evidence.


Spotlight

  • When the COVID-19 pandemic made in-person gatherings unsafe, After School Matters, a nonprofit in Chicago, IL that provides after school and summer program opportunities to high school teens, surveyed youth to understand who was less likely to have internet access, and then worked to bridge the gap. The organization’s community-informed strategy for adjusting to COVID-19 took into account the contextual factor of internet access, without which their provision of online internships wouldn’t have been successful.

  • Stigma surrounding mental health treatment can be a barrier to accessing support. In the wake of California wildfires, Humanidad Therapy and Education Services hosted convivencias, or community gatherings, as a culturally responsive way to foster community healing for those affected.

Reflection question: What is one experiential or contextual factor in your community that impacts how you approach suicide prevention during a catastrophic event?


Some contextual factors are organic aspects of community culture, while others are the result of inequitable policies or systems. For example, data shows that federal COVID-19 relief provided to small businesses through the Paycheck Protection Program was unevenly distributed, with businesses in majority-white neighborhoods receiving loans more quickly than those in majority-Black and majority-Latinx neighborhoods. The program’s reliance on traditional banks disadvantaged businesses in communities of color that are less likely to have existing relationships with large banks, a contextual factor that rendered the program (as designed) less feasible for and helpful to these businesses and communities. Changes to the program in 2021, including a two-week exclusive application period for small businesses and a stipulation that loans cannot be denied to those who are overdue on student loan payments, seek to make the program’s distribution of aid more equitable. To think more about how policies impact success at the local level, review the section Strategies to promote equity in policymaking.

Standards of program implementation and evaluation that are both data driven and community informed can better serve communities. For example, the Suicide Prevention Resource Center has assembled a collection of video clips and other resources highlighting indigenous perspectives on suicide prevention. When we recognize lived experience as evidence and account for community and cultural context, we can employ programs that work in the communities they serve and begin to dismantle structural inequities. 

Catastrophic events nearly always have disproportionate impact in certain communities because of longstanding systemic inequities. For example, there is increasing evidence that people of color are being disproportionately affected by COVID-19. These communities often develop creative, home-grown solutions with particular resonance for that community. State and local officials should consult with community innovators before importing evidence-based practices developed in a different context.


 

Activity

Select one or more of your local initiatives or programs and describe how they are informed by multiple forms of evidence. Type your answers into the chart below, and once you've entered your responses, move your mouse over the tool until the icons appear. Then click the "download" icon.

If you prefer to download the chart before filling it in, or if the tool doesn't appear in your browser, you can download it here.

 


Next lessons in this section
 

Continue to the next lessons of the "Community-informed strategy development" section of Module 2 to dig deeper into the importance of data:

  • Data sources - Data is critical in identifying who is most affected and better characterizing risk and protective factors impacting suicide.

 

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