Public messaging to increase treatment seeking among Veterans at risk for suicide during transition from military service

公开信息以增加在退伍期间有自杀风险的退伍军人寻求治疗的机会

• 批准号: 10183487
• 负责人: Elizabeth Karras
• 金额: --
• 依托单位: VETERANS AFFAIRS, UNITED STATES DEPARTMENT OF
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10183487
• 关键词: 18 year old; Audience Research; Behavior; Belief; Cellular Phone; Communication; Consent; Control Groups; Data; Data Collection; Eligibility Determination; Evidence based treatment; Exclusion Criteria; Feeling suicidal; Funding; Future; Goals; Head; Healthcare; Impairment; Individual; Intervention; Interview; Life; Measures; Mental Health; Mental Health Services; Methodology; Methods; Military Personnel; Minority; Observational Study; Ownership; Participant; Performance; Planning Theory; Populations at Risk; Predisposition; Process; Public Health; Randomized; Research; Resistance; Risk; Risk Behaviors; Sampling; Self-Direction; Services; Suicide; Suicide prevention; Target Populations; Telephone; Testing; Time; Veterans; Violence; Waiting Lists; Woman; Work; active duty; arm; behavioral response; cost; design; evidence base; experience; follow-up; help-seeking behavior; high risk; high risk population; improved; inclusion criteria; innovation; iterative design; military service; military veteran; mobile application; outreach; peer; portability; prevent; recruit; repository; screening; service member; service utilization; smartphone Application; suicidal behavior; suicidal risk; suicide rate; treatment services

Background: Despite a great need for treatment, more than half of returning Veterans at risk for suicide do not initiate mental health services. Such findings underscore the urgent need for strategies to increase treatment seeking among recently separated Veterans vulnerable to self-directed violence and resistant to initiating mental health care. The 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. What types of messages effectively change beliefs and behaviors for at-risk Veterans is unclear. Significance/ Impact: 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. Innovation: Completion of the study will result in a portable data-driven intervention that can be deployed at low cost per head by VA to effectively reach and engage the target population in need of mental health services. Specific Aims: Aim 1: Develop public messaging to increase the likelihood for treatment seeking among recently separated Veterans at risk for suicide and resistant to initiate mental health care. Aim 2: Conduct a trial testing the messaging developed in Aim 1 to increase treatment seeking for recently separated Veterans at risk for suicide and resistant to initiate mental health care. Aim 3: Examine facilitators and barriers of message use to identify methods for effectively reaching and engaging Veterans at risk for suicide in the first year following separation from service. Methodology: We propose a four-year mixed methods study that uses a sequential embedded design 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. Inclusion criteria: 1) U.S. Veteran that separated from military service in the past 12 months (any discharge type); 2) >18 years old; 3) experiencing suicidal ideation; 4) low intent to seek help; 5) capable of understanding the goals of the study; 6) willing and able to provide verbal consent; and 7) smartphone ownership and willing to download/use study mobile app (for Aims 2 & 3). Exclusion criteria: 1) currently (or in the past 12 months) in formal mental health treatment services; 2) deemed impaired during eligibility screening; and 3) currently institutionalized. Women and minorities will be included in the study. Next Steps/Implementation: If the intervention is found effective, we will work with our VA operational partner to include messages in future outreach approaches to prevent Veteran suicide and use findings to improve current communication performance measures.

背景：尽管需要治疗，但有超过一半的自杀风险的退伍军人却没有 启动心理健康服务。这样的发现强调了迫切需要增加治疗的策略 在最近分离的退伍军人中寻求容易受到自我指导的暴力和抵抗发起的退伍军人 心理保健。弗吉尼亚州已开始定期使用沟通活动作为公众 健康方法旨在通过促进帮助寻求帮助的信息来吸引更大的退伍军人人口。什么 消息类型有效地改变了高危退伍军人的信念和行为。意义/ 影响：这项研究的主要目的是开发和测试使用公共消息来增加的使用 寻求自杀风险和抵抗力寻求精神卫生保健的退伍军人寻求治疗 与兵役分离。创新：研究完成将导致便携式数据驱动 可以通过VA以低成本来部署的干预措施，以有效地达到目标 需要精神卫生服务的人群。具体目的：目标1：开发公共消息传递以增加 在最近分居的退伍军人之间寻求治疗的可能性 心理保健。目标2：进行试验测试AIM 1中开发的消息传递以增加治疗 寻求最近分离的退伍军人，有自杀的风险和抵抗精神卫生保健。目标3： 检查促进者和消息的障碍，用于识别有效达到和参与的方法 退伍军人在与服务分离后的第一年有自杀的风险。方法论：我们提出了一个 四年混合方法研究使用连续嵌入式设计从全国范围 过去与国防部分离的不在心理健康治疗中的自杀风险的退伍军人样本 年。根据计划行为理论的了解，将首先进行个人访谈以指导 设计有效的公共消息，随后将在两臂RCT中测试以确定暴露 目标受众与对照组之间的影响。邮件将被传播以研究参与者 智能手机应用程序的试用。研究人员将在1-和3-基线时通过电话收集评估 随机后几个月。潜在参与者（所有研究目的）将使用可用的数据来确定 VA/DOD身份存储库（VADIR），并通过邀请邮件和后续电话招募。 纳入标准：1）过去12个月与兵役分开的美国退伍军人（任何排放 类型）; 2）> 18岁； 3）经历自杀念头； 4）寻求帮助的意愿低下； 5）能够 了解研究的目标； 6）愿意并能够提供口头同意； 7）智能手机 所有权并愿意下载/使用学习移动应用程序（AIMS 2和3）。排除标准：1）当前（或 过去12个月）在正式的心理健康治疗服务中； 2）在资格期间被认为受损 筛选； 3）当前制度化。妇女和少数民族将包括在研究中。下一个 步骤/实施：如果发现干预措施有效，我们将与VA运营合作伙伴合作 在将来的外展方法中包括消息，以防止退伍军人自杀并使用调查结果来改善 当前的沟通绩效指标。