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2023 HSR&D/QUERI National Conference Abstract

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4073 — Creating a tool to examine the unmet community suicide prevention needs of rural Hispanic Veterans using a community participatory based approach

Lead/Presenter: Nathaniel Eliazar-Macke,  North Fl/ South Ga VHA
All Authors: Eliazar-Macke ND (North Florida South Georgia Veterans Health System), Uphold CR (North Florida South Georgia Veterans Health System) Orejuela M (North Florida South Georgia Veterans Health System) Lopez J (North Florida South Georgia Veterans Health System) Freytes IM (North Florida South Georgia Veterans Health System)

Objectives:
Over the last decade Hispanic Veterans have had the largest increase in suicide rate amongst all Veterans. Despite these numbers, suicide among Hispanics remains relatively understudied and little is known about how to prevent suicide in this population. We describe the process used to develop a community suicide needs assessment toolkit for counties that have a high density of Hispanic Veterans.

Methods:
We used a community-based participatory action approach to examine the suicide prevention needs of rural Hispanic Veterans in VISN 8. We used a combination of VA and census data to identify rural areas with a higher-than-average density of Hispanic Veterans. We conducted 21 interviews with stakeholders and community partners involved in suicide prevention and who were knowledgeable about Hispanic Veterans in their communities. Qualitative data was analyzed using template analysis, a method of thematically organizing and analyzing data. Using themes from the analysis, we identified important and actionable indicators to be used in a community suicide needs assessment tool. The indicators were refined through an iterative process involving a review of the literature, continued engagement of stakeholders and consulting with suicide prevention experts.

Results:
We developed a suicide prevention toolkit to examine community needs related to suicide prevention efforts for rural Hispanic Veterans. The toolkit consists of a community suicide needs assessment tool and a compendium of resources to address the identified needs. The tool contains 16 evidence-based indicators that are collected from publicly available sources. It assesses metrics that are actionable and have been identified by communities as being important for planning decisions about suicide prevention programs (e.g. linguistic isolation, access to broadband and transportation). The toolkit was designed for use in suicide prevention planning and for persons involved in making programmatic decisions and implementing ongoing public health suicide prevention programs.

Implications:
In light of the changing US demographics and the increasing risk for suicide among Hispanic Veterans, it is critical to develop culturally appropriate suicide assessment and prevention programs. Examining the suicide prevention needs of Hispanic Veterans, we identified factors that stakeholders found as important for suicide prevention planning, but also found that needs were not homogenous across counties due to intra-ethnic and inter-county variability. The ability of the toolkit to evaluate needs on a county-by-county level, as well as its genesis from indicators that stakeholders identified as important to suicide prevention planning supports its future use. Future work should consider performing effectiveness trials in higher-than-average density Hispanic Veteran counties.

Impacts:
Understanding the unique needs of underserved communities, like rural Hispanic Veterans, is vital for planning suicide prevention efforts and including members from the target community throughout the process is essential and has been shown to improve uptake.