No abstract

Suicide among youth is a growing public health problem-particularly in some rural western states. This study assessed the feasibility, acceptability, and fidelity of using extension agents to deliver Youth Aware of Mental Health (YAM) to students attending rural U.S. schools. Involving extension agents as YAM facilitators is a novel delivery method for YAM and may represent an effective way to improve the disseminability of YAM as agents are skilled in working with rural youth and can deliver the intervention as part of the regular work duties. A within-subjects design was utilized for this study. During the 2017-2018 school year, 12 trained extension agents delivered YAM as part of normal school curriculum to 641 students. Acceptability was measured using student ratings upon program completion. Feasibility was measured by the proportion of schools willing to participate, fidelity of implementation, student attendance at YAM sessions, and extension agent feedback. Ten of 14 schools (71%) approached participated in the study. Among consented students, 269 (82.8%) completed pencil and paper baseline surveys and 217 (66.8%) completed both the baseline and 3 month follow-up survey. Positive results were reported by youth regarding openness to having the intervention in their schools, interest in participating in YAM again, and feeling that the intervention was appropriate for rural youth. Utilizing the Extension system is a feasible and acceptable way to deliver a universal mental health educational intervention program to rural youth. Public Health Significance StatementThis study tested the feasibility of using extension agents to deliver one of the leading suicide prevention interventions, Youth Aware of Mental Health (YAM), to high school youth in rural U.S. schools. The study showed that this method of delivering a mental health promotion intervention in schools was highly acceptable to students and extension agents and there were high rates of school and student participation.