Kognito's Avatar‐Based Suicide Prevention Training for College Students: Results of a Randomized Controlled Trial and a Naturalistic Evaluation

Abstract

Objective To evaluate the efficacy and effectiveness of Kognito At Risk for College Students, an online, interactive suicide prevention gatekeeper training. Methods In Study 1, a randomized controlled trial was conducted to test the efficacy of Kognito. Retention of participants at follow‐up was strong. In Study 2, administrative records were used to follow the help‐seeking behavior of Kognito trainees for one academic year, contrasted with untrained students. Results In Study 1, between‐group changes in gatekeeper attitudes were large at time‐two, but attenuated modestly by 2‐month follow‐up. Kognito trainees referred more peers at 2‐month follow‐up (Cohen's d = .56, p < .05) ‐ training 4 students in Kognito produces 1 more peer referred. In Study 2, the help‐seeking rate of Kognito trainees (14.4%) was two‐times the rate (6.8%) of untrained students (p < .001). Training 14 students in Kognito leads to 1 more self‐referral to the Counseling Center. Conclusions This first randomized controlled trial of the college student version of Kognito validates the findings of less rigorous studies. Few brief suicide prevention trainings have shown changes in trainee behaviors such as referrals of at‐risk peers and trainees actual help‐seeking behavior. These results are promising that Kognito may outperform other similar suicide prevention trainings.

Preventing suicide in post-secondary students: a scoping review of suicide prevention programs

“…In an RCT evaluating Kognito's effectiveness for students, it was found that self-reported prevention behaviours improved following training, with the likelihood of seeking help for themselves also improving, but this was not sustained at follow-up. An examination of archival records also showed that students who had completed the training had greater help-seeking behaviours/practices than those who had not completed the training [33].…”

“…Two studies evaluated the effectiveness of 'Kognito' which was the sole online gatekeeper training program. Kognito uses avatar-based training involving realistic virtual scenarios to train staff and students on identifying individuals at risk, selecting interventions and talking about suicide [21,33]. This training program seeks to prepare individuals to support students at risk, but also to improve participants' own help-seeking attitudes and behaviours [33].…”

“…Kognito uses avatar-based training involving realistic virtual scenarios to train staff and students on identifying individuals at risk, selecting interventions and talking about suicide [21,33]. This training program seeks to prepare individuals to support students at risk, but also to improve participants' own help-seeking attitudes and behaviours [33]. Several modules are tailored to specific populations including general at-risk students, LGBTQ students, and student veterans.…”

Innovative Virtual Role Play Simulations for Managing Substance Use Conversations: Pilot Study Results and Relevance During and After COVID-19

“…These studies have found that virtual role play practices can provide an efficacious means of delivering screening and brief intervention training for health care providers [29][30][31][32][33][34], and have proven to successfully change attitudinal constructs and behaviors in K12 and higher education settings related to identifying; talking to; and, if necessary, referring students in psychological distress. [29,[35][36][37][38][39]. Virtual role play simulations that integrated MI techniques were equally effective across multiple races and ethnicities including people who were Black, Hispanic, Latinx, White, Asian, and American Indian or Alaska Native [40,41].…”

Implementation and feasibility considerations of an avatar‐based intervention for military family caregivers

“…Avatar‐based interventions refer to a computer‐simulated interaction where the user has some level of control over a character in the simulation. Avatar‐based interventions offer the following benefits compared with in‐person interactions (e.g., role play, standardized patient interaction): Accessible to more people, adherence to the intervention protocol, controlled alteration of scenarios, ability to collect participants’ data, and access not bound by time or location (Albright et al, 2012; Coleman, Black, Ng, & Blumenthal, ; Hayes‐Roth et al, ). Avatar‐based interventions can provide constant and immediate feedback, which triggers in‐depth thinking, helps with learning from mistakes, and enhances engagement in the intervention (Albright et al, 2012; Cate & Albright, ; Wilson, ).…”