BACKGROUND/RATIONALE:
Veterans are at increased risk for suicide as compared to their civilian peers underscoring the need for effective strategies to facilitate help seeking among Veterans vulnerable to self-directed violence. Since 2010, VA has developed a number of public messaging campaigns as part of their suicide prevention strategy to increase help seeking in times of crisis. However, there is a paucity of research examining the effectiveness of these campaigns to increase help seeking among Veterans who need it most. Without careful study, unintentional (and potentially harmful) messages may be disseminated underscoring the importance of message testing with targeted audiences. Yet how these public messages are interpreted or resonate with Veterans at increased risk for suicide is not currently known.

OBJECTIVE(S):
The main objective of this pilot study is to identify characteristics of effective messages that facilitate help seeking among Veterans at high risk for suicide. The following specific aims will be pursued to achieve this objective: (1) examine Veteran perceptions of existing public messages designed to motivate help seeking behaviors among those at high risk for suicide; (2) identify message features that influence the likelihood for help seeking behaviors by Veterans during periods of crisis; and (3) explore facilitators and barriers of message use to identify dissemination methods that reflect Veterans' preferences to effectively reach those at high risk for suicide.

METHODS:
To achieve these aims, individual interviews with Veteran patients (N=40) will be conducted using an interview guide, which reflects the study's conceptual framework (Elaboration Likelihood Model) focused on the mechanisms of persuasive communication. Participants will be recruited nationwide. An iterative sampling approach will be employed in which, initially, purposive sampling with maximum variation will be used. Eligible participants will be identified using VA administrative data and sample will then be selected to include heterogeneity by age and gender. As data analysis progresses, theoretical sampling will then be employed in which insights gleaned from analyses are used to guide the selection of additional participants. Individuals will be considered for participation based on: Inclusion criteria: 1) adult (18+) U.S. Veteran enrolled in VA health care; 2) evidence of a non-fatal suicide attempt in the past 3 to 6 months in VA medical records (ICD-10 code/s); 3) possess (self-reported) reliable internet access to complete study interview; and 4) capable of understanding the goals of the study; and 5) willing and able to provide consent. Exclusion criteria: 1) deemed cognitively impaired; 2) currently institutionalized; 3) current suicide risk warranting crisis intervention. Women and minorities will be included in the study.

FINDINGS/RESULTS:
None to report at this time.

IMPACT:
The VA devotes considerable resources to produce suicide prevention campaigns every year. Results from this proposed study have the potential to inform current VA suicide prevention practices, enhance the VA's mission to deliver Veteran-centric health services that meet the unique needs of the population, particularly vulnerable Veterans, and will guide next steps in this research trajectory that will include a future proposal testing outcomes associated with the resulting messages.

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External Links for this Project

NIH Reporter

Grant Number: I21HX002665-01
Link: https://reporter.nih.gov/project-details/9611754

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PUBLICATIONS:

Journal Articles

1. Karras E, Arriola N, McCarten JM, Britton PC, Besterman-Dahan K, Stecker TA. Veteran Perspectives of Barriers and Facilitators to Campaigns Promoting Help Seeking During Crisis. Community mental health journal. 2021 Aug 1; 57(6):1045-1051. [view]

DRA: Mental, Cognitive and Behavioral Disorders
DRE: Prevention, TRL - Applied/Translational
Keywords: Suicide
MeSH Terms: none