***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study employed a self-report question naire in a Solomon four-groups design to assess the efficacy of suicide intervention classes in achieving their instructional objectives . Because adolescents are often the first to know of a peer 's suicidal thoughts or plans , the goal of the classes was to increase the likelihood that students who come into contact with potentially suicidal peers can more readily identify them and will be consistently inclined to take responsible action on their behalf . Students who participated in the classes as compared to controls showed significant gains in relevant knowledge about suicidal peers and significantly more positive attitudes toward help seeking and intervening with troubled peers . Results of this study will be used to strengthen components of the lessons aim ed at enhancing the likelihood of performance of responsible interventions Background Implementation outcome measures are essential for monitoring and evaluating the success of implementation efforts . Yet , currently available measures lack conceptual clarity and have largely unknown reliability and validity . This study developed and psychometrically assessed three new measures : the Acceptability of Intervention Measure ( AIM ) , Intervention Appropriateness Measure ( IAM ) , and Feasibility of Intervention Measure ( FIM ) . Methods Thirty-six implementation scientists and 27 mental health professionals assigned 31 items to the constructs and rated their confidence in their assignments . The Wilcoxon one- sample signed rank test was used to assess substantive and discriminant content validity . Exploratory and confirmatory factor analysis ( EFA and CFA ) and Cronbach alphas were used to assess the validity of the conceptual model . Three hundred twenty-six mental health counselors read one of six r and omly assigned  vignettes depicting a therapist contemplating adopting an evidence -based practice ( EBP ) . Participants used 15 items to rate the therapist ’s perceptions of the acceptability , appropriateness , and feasibility of adopting the EBP . CFA and Cronbach alphas were used to refine the scales , assess structural validity , and assess reliability . Analysis of variance ( ANOVA ) was used to assess known-groups validity . Finally , half of the counselors were r and omly assigned to receive the same vignette and the other half the opposite vignette ; and all were asked to re-rate acceptability , appropriateness , and feasibility . Pearson correlation coefficients were used to assess test-retest reliability and linear regression to assess sensitivity to change . Results All but five items exhibited substantive and discriminant content validity . A trimmed CFA with five items per construct exhibited acceptable model fit ( CFI = 0.98 , RMSEA = 0.08 ) and high factor loadings ( 0.79 to 0.94 ) . The alphas for 5-item scales were between 0.87 and 0.89 . Scale refinement based on measure-specific CFAs and Cronbach alphas using vignette data produced 4-item scales ( α ’s from 0.85 to 0.91 ) . A three-factor CFA exhibited acceptable fit ( CFI = 0.96 , RMSEA = 0.08 ) and high factor loadings ( 0.75 to 0.89 ) , indicating structural validity . ANOVA showed significant main effects , indicating known-groups validity . Test-retest reliability coefficients ranged from 0.73 to 0.88 . Regression analysis indicated each measure was sensitive to change in both directions . Conclusions The AIM , IAM , and FIM demonstrate promising psychometric properties . Predictive validity assessment is planned CONTEXT Universal screening for mental health problems and suicide risk is at the forefront of the national agenda for youth suicide prevention , yet no study has directly addressed the potential harm of suicide screening . OBJECTIVE To examine whether asking about suicidal ideation or behavior during a screening program creates distress or increases suicidal ideation among high school students generally or among high-risk students reporting depressive symptoms , substance use problems , or suicide attempts . DESIGN , SETTING , AND PARTICIPANTS A r and omized controlled study conducted within the context of a 2-day screening strategy . Participants were 2342 students in 6 high schools in New York State in 2002 - 2004 . Classes were r and omized to an experimental group ( n = 1172 ) , which received the first survey with suicide questions , or to a control group ( n = 1170 ) , which did not receive suicide questions . MAIN OUTCOME MEASURES Distress measured at the end of the first survey and at the beginning of the second survey 2 days after the first measured on the Profile of Mood States adolescent version ( POMS-A ) instrument . Suicidal ideation assessed in the second survey . RESULTS Experimental and control groups did not differ on distress levels immediately after the first survey ( mean [ SD ] POMS-A score , 5.5 [ 9.7 ] in the experimental group and 5.1 [ 10.0 ] in the control group ; P = .66 ) or 2 days later ( mean [ SD ] POMS-A score , 4.3 [ 9.0 ] in the experimental group and 3.9 [ 9.4 ] in the control group ; P = .41 ) , nor did rates of depressive feelings differ ( 13.3 % and 11.0 % , respectively ; P = .19 ) . Students exposed to suicide questions were no more likely to report suicidal ideation after the survey than unexposed students ( 4.7 % and 3.9 % , respectively ; P = .49 ) . High-risk students ( defined as those with depression symptoms , substance use problems , or any previous suicide attempt ) in the experimental group were neither more suicidal nor distressed than high-risk youth in the control group ; on the contrary , depressed students and previous suicide attempters in the experimental group appeared less distressed ( P = .01 ) and suicidal ( P = .02 ) , respectively , than high-risk control students . CONCLUSIONS No evidence of iatrogenic effects of suicide screening emerged . Screening in high schools is a safe component of youth suicide prevention efforts High school principals ' acceptability ratings of three school-based programs for the prevention of adolescent suicide were examined . From a r and om sample of members from the 1994 - 1995 membership directory of the National Association of Secondary School Principals ( NASSP ) , a total of 185 ( 40 % ) respondents completed the  Suicide Prevention Program Rating Profile ( SPPRP ) , a measure design ed to evaluate the acceptability of suicide prevention programs , after reading a description of a particular prevention program . Programs evaluated for their acceptability included ( 1 ) curriculum-based programs presented to students , ( 2 ) in-service presentations to school staff  , and ( 3 )  student self-report screening measures .  The results indicated that the curriculum-based and staff in-service programs were significantly more acceptable to principals than was the schoolwide student screening program . No significant differences between the acceptability of curriculum-based and inservice programs were found . Limitations of the study and implication s for practice and research are discussed School-based depression screening and education programs are recommended for addressing the high rates of children ’s mental illness . The objectives of this study were to ( 1 ) identify Minnesota parent attitudes regarding the provision of school-based depression and suicide screening and education and ( 2 ) identify predictors of parent support for these school-based programs . A r and om sample of 1,300 Minnesota households with children ages 5–18 years was surveyed by mail . Chi-square tests and regression analyses were used to detect differences in parent support for  depression and suicide screening and education across demographic categories , and parent beliefs and knowledge about depression and suicide . The response rate of eligible households was 43 % ( N = 511 ) . Overall , 84–89 % of parents supported school-based depression and suicide screening and education . After adjusting for all variables , parent support for depression screening was associated with greater knowledge [ OR 8.48 , CI(1.30–55.21 ) ] and fewer stigmatizing beliefs [ OR 0.03 , CI(0.01–0.12 ) ] . Support for suicide screening was associated with fewer stigmatizing beliefs [ OR 0.03 , CI(0.01 - 0.10 ) ] . Support for depression education was associated with fewer stigmatizing beliefs [ OR 0.32 , CI(0.10–1.00 ) ] and lower educational attainment [ OR 0.59 , CI(0.40–0.89 ) ] . Support for suicide education was associated with greater knowledge [ OR 7.99 , CI(1.02–62.68 ) ] , fewer stigmatizing beliefs [ OR 0.26 , CI(0.07–0.92 ) ] , and lower educational attainment [ OR 0.60 , CI(0.38–0.94 ) ] . Parent support for school-based depression and suicide screening and education was high . Parent education to decrease stigmatizing beliefs and increase knowledge about depression and suicide may increase support among the minority of parents who do not endorse such programs From a r and om sample of members of the 2000 - 2001 membership directory of the American Association of School Administrators ( AASA ) , public school administrators ' acceptability ratings of three school-based programs for the prevention of adolescent suicide were examined . A total of 210 ( 46 % ) respondents examined a description of a suicide prevention program and completed a measure design ed to evaluate the acceptability of suicide prevention programs . Three suicide prevention programs were evaluated for their acceptability , and included : ( a ) school-wide curriculum-based programs presented to students ; ( b ) in-service presentations to school staff ; and ( c ) self-report screening programs for students . The results indicated that superintendents rated the staff in-service training and curriculum-based programs as significantly more acceptable than the school-wide screening program . In addition , the school-wide screening program was rated as significantly more intrusive by school psychologists than the staff in-service training or curriculum-based prevention programs . Limitations of the study and future research directions are discussed BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application Attendance and grade point average ( GPA ) data are universally maintained in school records and can potentially aid in identifying students with concealed behavioral problems , such as substance use . Research ers evaluated attendance ( truancy ) and GPA as a means to identify high school students at risk for substance use , suicide behaviors , and delinquency in 10 high schools in San Antonio , Texas , and San Francisco , California , during the spring and fall of 2002 . A screening protocol identified students as “ high risk ” if ( 1 ) in the top quartile for absences and below the median GPA or ( 2 ) teacher referred . Survey responses of 930 high-risk students were compared with those from a r and om sample of 393 “ typical ” students not meeting the protocol . Bivariate and multivariate analyses assessed associations between the screening protocol variables and demographics , risk and protective factors , and problem outcomes . The individual contribution of each of the variables was also assessed . Students identified as high risk were significantly more likely than typical students to use cigarettes , alcohol , and marijuana , evidence suicide risk factors , and engage in delinquent behavior . Norms varied between the two districts ; nevertheless , high-risk students showed consistent differences in risk and protective factors , as well as problem behaviors , compared with typical students . Because of site differences in data collection and teacher participation , the comprehensive protocol is recommended , rather than individual indicators alone ( e.g. , truancy ) . Strengths of the screening protocol are the ready availability of school record data , the ease of use of the adapted protocol , and the option of including teacher referral . More research is recommended to test the generalizability of the protocol and to ensure that there are no unintended negative effects associated with identification of students as high risk BACKGROUND Although school-based programmes for the identification of children and young people ( CYP ) with mental health difficulties ( MHD ) have the potential to improve short- and long-term outcomes across a range of mental disorders , the evidence -base on the effectiveness of these programmes is underdeveloped . In this systematic review , we sought to identify and synthesis e evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD , as measured by accurate identification , referral rates , and service uptake . METHOD Electronic bibliographic data bases : MEDLINE , Embase , PsycINFO , ERIC , British Education Index and ASSIA were search ed . Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3 - 18 years 
    Output:
    
The majority focused on behavioural and socioemotional problems or suicide risk , examined universal screening models , and used cross-sectional design s. In general , school-based programmes for identifying MHD aligned with schools ’ priorities , but their appropriateness for students varied by condition .
Time , re source , and cost concerns were the most common barriers to feasibility across models and conditions .