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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

• Past experience of mental health services, use of safety plan, or similar
• Existing/usual coping strategies
• Existing/usual support (formal/informal)
• 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
°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
• 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
• 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
• 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