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Table 7 Process evaluation interview/focus group topic summary

From: SAFETEL: a pilot randomised controlled trial to assess the feasibility and acceptability of a safety planning and telephone follow-up intervention to reduce suicidal behaviour

Context

• Past experience of mental health services, use of safety plan, or similar

• Existing/usual coping strategies

• Existing/usual support (formal/informal)

Recruitment

• Acceptability of trial procedures

• Motivation to take part/expectations

• Suggested improvements/changes acceptability of randomisation

Intervention (SPI + TAU participants only)

• SPI session

°Location, timing, setting

°Barriers/facilitators

°Level of understanding

°Expectations of SP use

•SAFETEL intervention researcher

° Engagement with researcher — barriers/facilitators

° Acceptability/level of participant comfort

° Helpful/unhelpful aspects

• Safety plan use

° Use in practice

° Circumstances of use

° Barriers/facilitators

• Follow-up calls

° Facilitators/barriers to engaging

° Acceptability

° Helpful/unhelpful aspects

° Using call — changes to SP/coping strategies

• Overall

° Level of support

° Changes implemented

° Comparison to other services/interventions/coping strategies used

° Suggestions for improvement

Since recruitment (3 months in Phase II, 6 months in Phase III)

• Changes made/experienced

• Other services or support

• Use of Safety Plan or related coping strategies

General

• Helpful or unhelpful aspects of participation

• Suggested improvements of other feedback

NHS Liaison Psychiatry staff

• Level of contact with SAFETEL team, knowledge of study

• Current context and services available at site, e.g. discharge/referral procedures

• Acceptability of trial procedures and fit within hospital context

• Acceptability of intervention elements

• Feasibility of delivering the intervention

• Barriers/facilitators for implementing

• Knowledge of other similar interventions/services

• Suggestions for improvements/other feedback

SAFETEL researchers delivering intervention

Recruitment

• Acceptability, feasibility, and facilitators/barriers affecting the following:

° Identification of potential participants

° Approaching potential participants

° Recruitment procedures: information, consent, baseline data collection, randomisation

SPI session

• Setting — appropriateness, acceptability, variability

• Factors affecting SPI development — barriers/facilitators, strategies used to overcome issues

Follow-up calls

• Acceptability

• Feasibility

• Practical changes implemented

• Barriers and facilitators to engaging participants

• How participants used calls

Safety Plan use

• Participant engagement with SP

• Perceived barriers/facilitators to implementing SP use

Participant feedback

• Perceived/reported helpful/unhelpful elements of intervention

• Perceived/reported barriers/facilitators to engaging with study/intervention

• Participant suggestions for improvement

• Awareness of past SP use or other similar service use

Overall

• Other reflections on trial and intervention procedures — positive/negative aspects, facilitators/barriers

• Impact on staff — wellbeing, training, support

• Perceived impact on participants of study and intervention engagement

Suggested adaptations