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22: Targeted Messaging to At-Risk Populations

Risk Management and Treatment » Community-Based Interventions
22: Targeted Messaging to At-Risk Populations

There is insufficient evidence to recommend for or against the use of targeted messaging to at-risk populations to reduce suicidal ideation and improve help-seeking behavior.

Strength:

Neither for or against

Category:

ReviewedNew-added

Grades and Definitions

Strong for
or "We recommend offering this option …"
Weak for
or "We suggest offering this option …"
No recommendation
or "There is insufficient evidence …"
Weak against
or "We suggest not offering this option …"
Strong against
or "We recommend against offering this option …"

Categories and Definitions

Evidence Reviewed* Recommendation Category* Definition*
Reviewed New-added New recommendation following review of the evidence
New-replaced Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence
Not changed Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed based on review of the evidence
Not reviewed Not changed Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed
Amended Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made
Deleted Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG
*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72.

Recommendation Resources

Targeted messaging refers to the use of persuasive messages that are strategically designed to change awareness, attitudes, or behaviors among a well-defined audience. Messages can take different formats (e.g., public service announcement (PSA), videos, social media ads, billboards, flyers, brochures, etc.) and can be used together (i.e., as a part of a larger campaign) or separately (e.g., flyers in clinics) to reach and engage the targeted audience. Key considerations when designing messages include a rich understanding of who the audience is, how messages should be framed to resonate and motivate audience members, who the message is coming from, and what the desired outcomes are. Targeted messages for suicide prevention often aim to promote help-seeking behavior, decrease stigma, and increase awareness, and include a clear “call to action” that is appropriate for the audience. Public health approaches for suicide prevention often include targeted messaging as part of their community-level interventions.

Training and Clinical Resources

This section includes recommended trainings and/or clinical resources about targeted messaging to at-risk populations.

Communicating about Suicide (Suicide Prevention Resource Center, SPRC)
This includes resources to inform the development of suicide prevention messages, reporting on suicide in the media, and links to relevant research.
Framework for Successful Messaging (National Action Alliance)
The Framework was created by the National Action Alliance for Suicide Prevention as part of its priority to change the public conversation about suicide. The Framework is a research-based resource that outlines four key factors to consider when developing public messages about suicide.
Guidelines for safe, effective suicide prevention messages (National Action Alliance)
The Guidelines listed here offer a few resources for key areas to inform message design and use that were developed by the National Action Alliance.
2024 National Strategy for Suicide Prevention (NSSP)
The 2024 NSSP includes a specific goal related to targeted messaging. Specifically, Goal 7 states, “Implement research-informed suicide prevention communication activities in diverse populations using best practices from communication science.”
The Health Communication Gateway (Centers for Disease Control and Prevention, CDC)
This is a one-stop shop for health communicators. Whether you work in public health at a federal level, a state or local level, or in the healthcare arena, the Gateway offers relevant, up-to-date information to help you communicate your message.
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Manuals

This section includes recommended manualized resources about targeted messaging to at-risk populations.

Cover graphic for VA GuideVA Guide on How to Communicate and Write about Veteran Suicide
Cover graphic for DSPO report GuideLeaders Suicide Prevention: Safe Messaging Guide (Department of Defense, DoD)
988 Suicide & Crisis Lifeline: Messaging and Communications to People at Higher Risk for or Disproportionately Impacted by Suicide
Considering Health Equity when designing Messaging (CDC)
Health Communication Playbook: Resources to Create Effective Material (CDC)
Making Health Communication Programs Work (National Cancer Institute)
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Videos

This section includes recommended videos about targeted messaging to at-risk populations.

Strategic Communication Planning (SPRC)
Includes five-to-six-minute webinar clips feature expert advice on developing a clear communication plan, understanding your audience, and evaluating your efforts. Adapted from SPRC’s Strategic Communication Workshop Series, each video has a free, downloadable worksheet to help you put these skills into practice.
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Webinars

This section includes recommended webinars about targeted messaging to at-risk populations.

Strategic Communication Planning (SPRC)
A series of webinars focused across the spectrum of communication processes from conceptualization to implementation and evaluation
Webinar icon Part 1: Laying the Foundation: Strategies for Effective Communication Presented by: Irene Cho, Ashleigh Husbands, Kerri Nickerson
Webinar icon Part 2: Knowing Your Audience and How to Reach Them Presented by: Robert Cottingham & Stephanie Craig Rushing
Webinar icon Part 3: Measuring the Impact of Your Communication Efforts Presented by: Dr. Rajeev Ramchand
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Podcasts

This section includes recommended podcasts that provide best practices for effectively communicating to your target audience.

Listen Up! A podcast for health communicators by health communicators (CDC)
Podcast icon Listen Up! hosted by Dr. Betsy Mitchell in CDC’s Office of Communications. Listen Up! is a professional development podcast for health communication professionals, including those working at the federal, state, and local levels, public health students, and others.
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Articles

This section includes recommended articles about targeted messaging to at-risk populations.

Ftanou, M., Cox, G., Nicholas, A., Spittal, M. J., Machlin, A., Robinson, J., & Pirkis, J. (2017). Suicide Prevention Public Service Announcements (PSAs): Examples from Around the World. Health communication, 32(4). 493–501. https://doi.org/10.1080/10410236.2016.1140269
Karras, E., Arriola, N., McCarten, J. M., Britton, P. C., Besterman-Dahan, K., & Stecker, T. A. (2022). Perceptions of Public Messaging to Facilitate Help Seeking during Crisis among US Veterans at Risk for Suicide. Archives of suicide research: official journal of the International Academy for Suicide Research, 26(2). 581–594. https://doi.org/10.1080/13811118.2020.1811183
Karras, E., Arriola, N., McCarten, J. M., Britton, P. C., Besterman-Dahan, K., & Stecker, T. A. (2021). Veteran Perspectives of Barriers and Facilitators to Campaigns Promoting Help Seeking During Crisis. Community mental health journal, 57(6). 1045–1051. https://doi.org/10.1007/s10597-020-00729-x
Karras, E., Lu, N., Elder, H., Tu, X., Thompson, C., Tenhula, W., Batten, S. V., & Bossarte, R. M. (2017). Promoting Help Seeking to Veterans. Crisis, 38(1). 53–62. https://doi.org/10.1027/0227-5910/a000418
Karras, E., Stokes, C. M., Warfield, S. C., & Bossarte, R. M. (2024). Designing mental health promotion campaigns: segmenting US Veteran audiences to address public stigma. Journal of mental health (Abingdon England), 33(3). 341–347. https://doi.org/10.1080/09638237.2022.2069712
Karras, E., Stokes, C. M., Warfield, S. C., Barth, S. K., & Bossarte, R. M. (2019). A randomized controlled trial of public messaging to promote safe firearm storage among US military veterans. Social science & medicine (1982), 241. 112205. https://doi.org/10.1016/j.socscimed.2019.03.001
Karras, E., Stokes, C. M., Warfield, S. C., & Bossarte, R. M. (2024). Designing mental health promotion campaigns: segmenting US Veteran audiences to address public stigma. Journal of mental health (Abingdon England), 33(3). 341–347. https://doi.org/10.1080/09638237.2022.2069712
Niederkrotenthaler, T., Till, B., Kirchner, S., Sinyor, M., Braun, M., Pirkis, J., Tran, U. S., Voracek, M., Arendt, F., Ftanou, M., Kovacs, R., King, K., Schlichthorst, M., Stack, S., & Pirkis, J., Rossetto, A., Nicholas, A., Ftanou, M., Robinson, J., & Reavley, N. (2019). Suicide Prevention Media Campaigns: A Systematic Literature Review. Health communication, 34(4). 402–414. https://doi.org/10.1080/10410236.2017.1405484
Spittal, M. J. (2022). Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis. The Lancet. Public health, 7(2). e156–e168. https://doi.org/10.1016/S2468-2667(21)00274-7
Till, B., Arendt, F., Rothauer, P., & Niederkrotenthaler, T. (2024). The Role of the Narrative in Educative Suicide Awareness Materials: A Randomized Controlled Trial. Health communication, 39(2). 403–416. https://doi.org/10.1080/10410236.2023.2167580
Torok, M., Calear, A., Shand, F., & Christensen, H. (2017). A Systematic Review of Mass Media Campaigns for Suicide Prevention: Understanding Their Efficacy and the Mechanisms Needed for Successful Behavioral and Literacy Change. Suicide & life-threatening behavior, 47(6). 672–687. https://doi.org/10.1111/sltb.12324
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