Proposal For a Key Informant Study and Community Readiness Survey in the Village of Kalenga, Iringa District, Tanzania to Determine Awareness and Attitudes Toward Suicide.
A recent participatory action research survey in the village of Kalenga demonstrates an unusually high rate of suicide in this area. That project drew the conclusion that a wider study incorporating the nearby villages of Mkoga, Isakalilo and Tosamaganga (the Ward of Kalenga) should be undertaken. It also recommended that emphasis be placed on the recruitment of female participants in future projects. This Community Readiness Survey of awareness and attitude towards suicide is proposed in order to achieve that latter goal and to elucidate aspects of the local cultural narrative regarding suicide that should be considered before further steps are taken. The study is proposed for the Village of Kalenga to serve as a pilot for similar studies to take place throughout the ward of Kalenga and possibly in the Town of Iringa, where recent anecdotal reports suggest frequent suicidality.
Rationale: A corner-stone of the Community Readiness model as described by Edwards et al[1] is the Key Informant Interview[2]. When conducted at appropriate points along the time-line of research, intervention, planning and implementation, key informant studies have been shown to enhance positive outcome for prevention efforts. They are therefore seen as a cost-effective measure that can lead to
· greater investment and utility of local resources
· improved 'ownership' of prevention resources and programs by communities
· deeper commitment of local stake-holders
· increased sustainability of intervention(s)
The objective, scientific or medical view of a problem such as substance abuse, or in the case of this study, suicide, may look very different from within the community in which it occurs, than it does from the clinic proposing to treat it or the institute proposing to research it. Prevention efforts are more successful when the communities to which they are directed are involved in their design and implementation.
The Key Informant Study is a useful tool to
· capture general, descriptive information sufficient to aid in decision-making and development of intervention strategies
· determine underlying motivations and attitudes of a target population toward a given subject matter
· gather information necessary for the interpretation of quantitative data collected through other methods
· generate suggestions and recommendations for further study
The Community Readiness model suggests nine stages of community readiness (Appendix 2) from no awareness through vague awareness to professionalization. The Key Informant interview is used as a 'yardstick' to measure the perceptual gap between local and professional narratives on a given topic and determine the goals of intervention most suited to the communities' stage of readiness. The Community Readiness model has been extensively field-tested as a pre- intervention tool in areas such as alcohol and substance abuse, intimate partner violence and suicide. Most pertinent to this study, the "Key Informant" interview has been used by Alem [3] to determine the awareness and attitude to suicide of a rural community in Butajira, Ethiopia. The questions used in that study are the model for questions in this study. (Appendix 3)
Design and Implementation
The proposed Key Informant Study for Kalenga is designed to capture two sets of data:
· basic demographics of interviewee
· 'anchor statements' regarding awareness and attitude to the subject matter
The intention of this study is to survey a large number of households (more than half)of the total, 962) in the Village of Kalenga representing a wide cross-section of the population and to run gender and age based focus groups with adults and young people. A standardized questionnaire will be administered by local, trained, interviewers, both male and female. The Study will be administered over a one-month period in early 2012.
John T. McInerney L.C.S.W., Henry H. Kellam Ph.D.
Global Mental Health Initiatives,
24 East 12th St., Suite #503,
New York, NY 10003
(212) 645 8059
wwww.gmhi.org
[1] Edwards, R. W., Jumper-Thurman. P., Plested, B. A., Oetting, E. R., & Swanson, L. (2000). Community readiness: Research to practice. Journal of Community Psychology, 28(3), 291-307
[1] Aponte, J. F. (1978). A need in search of a theory or an approach. Journal of Community Psychology, 6, 42-44.
[3] A. Alem, L. Jacobsson, D. Kebede G. Kullgren Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour: A key informant study in Butajira, Ethiop Acta Psychiatrica Scandinavica Volume 100, Issue Supplement S397, pages 65–69, April 1999