A whole-of-community adolescent mental health promotion and suicide prevention intervention (the Live4Life model) in regional Victoria, Australia: protocol for a mixed-methods implementation study

Many school-based mental health and wellbeing interventions are not sustained beyond initial implementation. Embedding these interventions within communities may promote their sustainability. However, relatively little is known about their implementation and how this is linked to purported outcomes. This paper describes the protocol for a flagship study of the [REMOVED FOR BLIND PEER REVIEW] exploring the implementation of Live4Life, a whole-of-community youth mental health education and suicide prevention intervention for Australian rural and regional communities, guided by three research questions: 1) How is Live4Life implemented? 2) What are the community- and organisation-, school- and individual-level factors that impact the implementation and sustainability of Live4Life? and 3) Are there any associations between implementation factors and any mental health and wellbeing outcomes? This study is part of a larger three-year longitudinal evaluation which examines the effect of Live4Life on mental health and wellbeing. It follows a cohort of adolescents when they are in Year 8 (T1), Year 9 (T2), and Year 10 (T3). Data collection for the current study will occur once school communities have implemented all components of the Live4Life model regardless of their implementation phase (e.g., beginning, established) and in parallel with the longitudinal evaluation analyses (i.e., between T2 and T3). This study will employ a mixed methods convergent parallel design using quantitative and qualitative data from surveys, semi-structured individual and group interviews, and documents. Theoretical frameworks guiding the study include the Behavior Change Consortium framework, the Theoretical Domains Framework, and the Consolidated Framework for Implementation Research. Approximately 40 participants in total from five communities in Victoria, Australia will be recruited from among school leaders and staff, community partnership group members, and students. Qualitative data will primarily undergo framework synthesis and quantitative data will be analysed using descriptive statistics. As the first implementation study of Live4Life, findings will address evidence gaps in implementing whole-of-community adolescent mental health interventions. Findings will be disseminated widely to communities, academic, government, and public audiences.