Rates of suicide in the United States are at a more than 20-y high. Suicide contagion, or spread of suicide-related thoughts and behaviors through exposure to sensationalized and harmful content is a well-recognized phenomenon. Health authorities have published guidelines for news media reporting on suicide to help prevent contagion; however, uptake of recommendations remains limited. A key barrier to widespread voluntary uptake of suicide-reporting guidelines is that more sensational content is perceived to be more engaging to readers and thus enhances publisher visibility and engagement; however, no empirical information exists on the actual influence of adherence to safe-reporting practices on reader engagement. Hence, we conducted a study to analyze adherence to suicide-reporting guidelines on news shared on social media and to assess how adherence affects reader engagement. Our analysis of Facebook data revealed that harmful elements were prevalent in news articles about suicide shared on social media while the presence of protective elements was generally rare. Contrary to popular perception, closer adherence to safe-reporting practices was associated with a greater likelihood of an article being reshared (adjusted odds ratio [AOR] = 1.19, 95% confidence interval [CI] = 1.10 to 1.27) and receiving positive engagement (“love” reactions) (AOR = 1.20, 95% CI = 1.13 to 1.26). Mean safe-reporting scores were lower in the US than other English-speaking nations and variation existed by publisher characteristics. Our results provide empirical evidence that improved adherence to suicide-reporting guidelines may benefit not only the health of individuals, but also support publisher goals of reach and engagement.

美国的自杀率处于二十多年来的最高水平。自杀传染，或通过接触耸人听闻的有害内容传播与自杀相关的想法和行为，是一种众所周知的现象。卫生当局为新闻媒体报道自杀事件发布了指导方针，以帮助预防传染；然而，对建议的采纳仍然有限。广泛自愿采用自杀报告指南的一个主要障碍是，更耸人听闻的内容被认为更能吸引读者，从而提高出版商的知名度和参与度；然而，没有关于遵守安全报告实践对读者参与度的实际影响的经验信息。因此，我们进行了一项研究，分析社交媒体上分享的新闻对自杀报告指南的遵守情况，并评估遵守情况如何影响读者的参与度。我们对 Facebook 数据的分析显示，社交媒体上分享的有关自杀的新闻文章中有害元素普遍存在，而保护元素的存在通常很少。与普遍看法相反，更严格地遵守安全报告实践与文章被转发的可能性更大（调整后的比值比 [AOR] = 1.19，95% 置信区间 [CI] = 1.10 至 1.27）和获得积极参与（ “爱”反应）（AOR = 1.20，95% CI = 1.13 至 1.26）。美国的平均安全报告分数低于其他英语国家，并且因出版商特征而存在差异。我们的结果提供了经验证据，表明提高对自杀报告指南的遵守程度不仅有利于个人的健康，而且还支持出版商的影响力和参与度目标。