Public Messaging to Increase Treatment Seeking for Veterans at Risk for Suicide

VA Office of Research and Development

Status: Completed

Conditions: Suicide; Mental Health

Treatments: Behavioral: Messaging; Other: Wait list control

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT04784663

SDR 19-354

HX003130-01A2 (Other Grant/Funding Number)

Details and patient eligibility

About

The risk for suicide increases by nearly 50% in the first year that service members transition from the military to civilian life underscoring the need for effective strategies to facilitate help seeking among Veterans vulnerable to self-directed violence. Yet despite a great need for treatment, more than half of returning Veterans at risk for suicide do not initiate mental health services. VA has embarked on the regular use of communication campaigns as part of a public health approach designed to reach the larger Veteran population with messages promoting help seeking. However, what types of messages effectively change beliefs and behaviors for at-risk Veterans resistant to seek treatment is unclear. The main objective of this study is to develop and test the use of public messaging to increase treatment seeking among Veterans at risk for suicide and resistant to seek mental health care following separation from military service. This represents the first study to systematically develop public messaging strategies for populations at risk for suicide.

Full description

The main objective of this study is to develop and test the use of public messaging to increase treatment seeking among Veterans at risk for suicide and resistant to seek mental health care following separation from military service. A four-year mixed methods study that uses a sequential embedded design will be used to collect data from nationwide samples of Veterans at risk for suicide not in mental health treatment who separated from the DoD in the past year. Informed by the Theory of Planned Behavior, individual interviews will first be conducted to guide the design of effective public messages that will be subsequently tested in a two-arm RCT to determine exposure effects among targeted audience vs. control group. Messages will be disseminated to study participants during the trial by a smartphone app. Research staff will collect assessments by telephone at baseline, 1- and 3-months post-randomization. Potential participants (for all study aims) will be identified using data available from the VA/DOD Identity Repository (VADIR) and recruited by invitational mailing and follow-up telephone calls. If the intervention is found effective, the investigators will work with the VA operational partner to include messages in future outreach approaches to prevent Veteran suicide and use findings to improve current communication performance measures.

Enrollment: 355 patients

Sex: All

Ages: 18 to 89 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• U.S. Veteran that separated from military service in the past 12 months (any discharge type);
• >18 years old;
• experiencing suicidal ideation;
• low intent to seek help;
• capable of understanding the goals of the study;
• willing and able to provide verbal consent; and 7) smartphone ownership and willing to download/use study mobile app

Exclusion criteria

• currently (or in the past 12 months) in formal mental health treatment services;
• deemed impaired during eligibility screening; and 3) currently institutionalized

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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355 participants in 2 patient groups, including a placebo group

Message Exposure

Experimental group

Description:

Participants exposed to 4 study videos over a one-month period and complete telephone-based assessments at baseline, 1- and 2-month follow up. Study videos are delivered by study's mobile app downloaded to participants' own Smartphone.

Treatment:

Behavioral: Messaging

Wait List Control

Placebo Comparator group

Description:

While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Telephone-based assessments are completed at baseline, 1- and 2-month follow up. Push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.

Treatment:

Other: Wait list control