Background: Suicide is a major public health problem. Educational interventions for preventing suicidal behaviour are widely used, although little is known regarding the collective effectiveness of these interventions. Aim: We evaluated the existing evidence for the effectiveness of education interventions in the prevention of suicidal behaviour. Methods: In this systematic review and meta-analysis, we searched multiple databases using terms related to suicide prevention. The articles were reviewed by two independent reviewers, and the quality of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data from individual studies were combined in meta-analyses. Results: We identified 41 studies evaluating two different types of interventions: school-based education interventions and gatekeeper training. Education interventions showed significant gains in terms of knowledge and attitudes, though the effects seem to vary depending on subjects’ personal characteristics. School-based education interventions significantly reduced suicidal ideation and suicide attempts in youths. Gatekeeper training showed no significant effect on suicide attempts or gatekeeper skills, though the quality of evidence for the estimate, according to GRADE criteria, was rated as very low. Conclusion: The results of this study indicate that school-based education interventions are effective in preventing suicidal ideation and suicide attempts. In clinical practice, as well as in research, the development and implementation of educational interventions should focus on participants’ individual characteristics.

The move towards evidence‐based medicine has generated rapid growth in reviews of research literature. The scoping review is one of the new literature reviews that has emerged from traditional systematic reviews. A scoping review aims to map the literature on a particular topic or research area. As scoping reviews become more popular, methods for conducting scoping reviews are rapidly increasing. In light of these recent developments, this paper investigates how complex scoping reviews are conducted. As an analytical framework, we draw on previous work about (in)formalities (ie, the interplay of formalities and informal judgments in scientific research). We show how the process of constructing a population, intervention, comparison, and outcome (PICO), searching and selecting relevant literature, requires informal deliberations, judgments, and choices that are not considered in the formal methodology used when conducting scoping reviews. This paper asks the following questions: What could be learned from this empirical case of conducting a scoping review by applying theoretical insights about (in)formalities? What are the possible implications for future development of scoping reviews? We provide three suggestions. First, PICO served as a starting point for the review process, supported decisions continuously during the process, and served as an image of the end product of the scoping review. We suggest that these three roles need to be considered to a larger extent in the future development of scoping review methods. Second, the contextual constraints of scoping reviews such as time, resources, and the jurisdiction of the commissioning agency need to be made explicit in the reporting of scoping reviews. Third, the findings in this paper indicate that the evolving emphasis on formalization in both the methods the reporting practices of scoping reviews could benefit if complemented with a more pronounced role for informalities. In addition, highlighting the informalities in scoping review methods may serve to create more realistic expectations of the methods, the validity, and the potentials of scoping reviews.

Background: Since the turn of the millennium, research within the field of substance-related problems has grown rapidly. This paper maps the effectiveness of existing research on substance use, misuse, abuse, and addiction prevention. Method: In this systematic mapping review, we searched the Web of Science, PubMed, and PsycINFO using multiple terms related to substance use, misuse, abuse, and addiction prevention to assess systematic reviews evaluating prevention interventions. All records were assessed by two independent reviewers. Information about population, substances targeted, and effectiveness were extracted for each of the included reviews. The evaluated interventions were categorized into 12 types of interventions. Result: For the 532 reviews mapped, we found 12 types of interventions dividedinto two major categories: individual-focused interventions (n = 451) and population-based interventions (n = 111). For each intervention category, many reviews showed positive effects for technology-based interventions, multimodal interventions, and drink-driving interventions. The mapping also highlights areas, including physical activity and interventions in specific arenas, where the reviews present very inconsistent results. Conclusions: The findings presented in this review serve as a guide of existing research that can be used to inform practitioners and policy makers about interventions conducted as well as highlighting important areas for future research.

Background: Promotion of healthy behaviour is increasingly highlighted worldwide as a way to improve public health, prevent disease incidence, and decrease long-term costs for healthcare. In Sweden the National Board of Health and Welfare (NBHW) used the well-established format of national guidelines to facilitate a more widespread use of approaches for promotion of healthy lifestyle habits in healthcare.Aims and objectives: The aim of this case study was to explore the tensions between public health knowledge and the tenets of evidence-based medicine (EBM) in the creation of national guidelines on lifestyle habits.Methods: Based on data from interviews with guideline professionals and the collected documents of the national guidelines, we examine how NBHW negotiated the conflicts between public health knowledge and the format of national guidelines. An analytical model based on approaches from the sociology of standardisation is used to explore the ramifications of these negotiations.Findings: In line with findings in the sociology of standardisation, we show how conflicts between public health knowledge and the format of national guidelines result in both having to yield on certain points. This, we claim, results in compromise, but perhaps also compromised notions of validity and causality.Discussion and conclusion: This case offers important learning about the general compatibility of public health and currently dominant methods of EBM. Important crossroads are outlined, concerning how validity and causality are configured in public health guidelines and how these require extensive epistemological deliberation.<br />Key messages<br /><ul><li>Epistemological commitments on validity and causality within public health have been compromised to fit the format of national guidelines;</li><br /><li>Similarly, the format of national guidelines has been subordinated to the public health valuation of risk assessments;</li><br /><li>Integrating public health into an EBM format requires extensive epistemological deliberation.</li></ul>

Background: Although increasingly accepted in some corners of social work, critics have claimed that evidence-based practice (EBP) methodologies run contrary to local care practices and result in an EBP straitjacket and epistemic injustice. These are serious concerns, especially in relation to already marginalised clients.Aims and objectives: Against the backdrop of criticism against EBP, this study explores the ramifications of the Swedish state-governed knowledge infrastructure, ‘management-by-knowledge’, for social care practices at two care units for persons with intellectual disabilities.Methods: Data generated from ethnographic observations and interviews were analysed by applying a conceptual framework of epistemic injustice; also analysed were national, regional and local knowledge products within management-by-knowledge related to two daily activity (DA) units at a social care provider in Sweden.Findings: In this particular case of disability care, no obvious risks of epistemic injustice were discovered in key knowledge practices of management-by-knowledge. Central methodologies of national agencies did include perspectives from social workers and clients, as did regional infrastructures. Locally, there were structures in place that focused on creating a dynamic interplay between knowledge coming from various forms of evidence, including social workers’ and clients’ own knowledge and experience.Discussion and conclusions: Far from being a straitjacket, in the case studied management-by-knowledge may be understood as offering fluid support. Efforts which aim at improving care for people with disabilities might benefit from organisational support structures that enable dynamic interactions between external knowledge and local practices.<br />Key messages<br /><ul><li>Examining one case of disability care in Sweden, both social workers’ and clients’ experiences were included in EBP infrastructures.</li><br /><li>In this study, Swedish EBP infrastructures functioned more like fluid support than a straitjacket.</li><br /><li>Organisational structures that combine different knowledge sources at service providers can minimise the risk of epistemic injustice within social care.</li></ul>