Abstract
OBJECTIVE: To evaluate the BIZI program, a Spanish-language gatekeeper training program with a novel online self-learning format that is brief and open-access. It was developed as part of the suicide prevention strategy in Euskadi (Spain) to improve community-based suicide prevention. METHODS: A group of experts from different fields created the program and tested its usability in a preliminary phase. A single-group design was used for the evaluation, with repeated measurements (before, immediately after, and after three months). Online questionnaires were used to evaluate the program's impact on core competencies for gatekeepers, as well as adherence to content and user satisfaction. Community agents (educators and social workers, among others) who responded to an invitation sent by regional public health coordinators were included in the study. RESULTS: In total, 728 people accessed the training, and 86% completed it; 569 people completed the assessment (81.2% women, mean age 41.4 years). The core gatekeeper competencies of attitude, self-efficacy, and knowledge improved significantly, and improvement was sustained ≥3 months in a subsample (P = 0.0001). CONCLUSIONS: The results are promising and suggest that BIZI is useful in improving the capacity and willingness of community agents to identify people at risk and refer them to specialized resources. Its novel format gives it important advantages over other more common gatekeeper training programs, facilitating its dissemination in low-resource environments. It is the first program of its kind whose effectiveness has been demonstrated and also the first available in Spanish.