Randomized Evaluation of a Caring Letters Suicide Prevention Campaign for Service Members Transitioning to Civilian Life

针对军人过渡到平民生活的关怀信预防自杀运动的随机评估

• 批准号: 10308564
• 负责人: Mark A. Reger
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10308564
• 关键词: Aftercare; Caring; Clinical; Clinical effectiveness; Data; Effectiveness of Interventions; Evaluation; Face; Follow-Up Studies; Frequencies; Goals; Health system; Healthcare; Hospitalization; Incidence; Individual; Inpatients; Intervention; Interview; Joints; Leadership; Letters; Life; Mental Health; Military Personnel; Modeling; Outcome; Outpatients; Pattern; Personal Satisfaction; Population; Population Intervention; Prevention; Prevention program; Program Evaluation; Provider; Public Health; Randomized; Randomized Clinical Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Research Design; Resources; Risk; Schedule; Series; Services; Structure; Suicide; Suicide attempt; Suicide prevention; Telephone; Testing; Time; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; active duty; base; budget impact; clinical implementation; cost; design; effectiveness implementation study; effectiveness testing; high risk; high risk population; hybrid type 1 trial; improved; informant; intervention cost; military service; mortality; peer; preventive intervention; programs; reducing suicide; response; secondary analysis; service member; sex; suicidal risk; suicide rate

ABSTRACT Service members transitioning to civilian life have suicide rates that are 63% higher than other service members, and rates are especially high in the first year after separation from service. Therefore, the President issued an Executive Order that requires the Department of Veteran Affairs (VA) to develop a plan to provide, suicide prevention resources to transitioning service members in the year following separation from service. In response, VA’s Central Office Suicide Prevention Program (SPP) plans to implement a Caring Letters campaign for all 245,000 service members who transition each year. In the Caring Letters intervention, a series of messages are sent to individuals to communicate that they are not forgotten, and that people care about them and are concerned for their well-being. The messages also serve as a reminder that help is available. Multiple randomized clinical trials support the efficacy of Caring Letters for reducing suicide and suicide attempt rates. The Joint Commission has recently promoted Caring Letters. The campaign for transitioning service members faces some unique challenges, however, since there is no established VA provider to serve as the signatory. Therefore, we propose a partnered program evaluation between SPP and the proposed evaluation team to examine the use of Caring Letters in this new population. Specifically, the evaluation will test two models: (1) A modified approach to Caring Letters in which letters are sent from a VA provider the Veteran does not know, and (2) a culturally-sensitive peer-based approach to Caring Letters in which letters are sent from recently transitioned service members matched on sex and military service branch. The campaign will also randomize service members to a standard mailing schedule (8 messages in a year) or a high frequency schedule (14 messages in a year). In Aim 1, we will evaluate the effects of Caring Letters on clinical outcomes and VA clinical utilization rates. In Aim 2, we will examine the effects of the two different Caring Letter signatories and two different mailing schedules on the clinical effectiveness of the intervention. Aim 3 will examine facilitators and barriers to implementing the Caring Letters campaign. In Aim 4, we will conduct budget impact analyses of implementation from the VA perspective. This will be the largest evaluation of a Caring Letters intervention ever conducted, and it will provide direct and actionable data to leadership to evaluate the impacts of this major prevention campaign.

抽象的 过渡到平民生活的服务成员的自杀率比其他服务高63％ 与服务分离后的第一年，成员和费率尤其高。因此，总统 发布了一项行政命令，要求退伍军人事务部（VA）制定一项计划，以提供， 自杀预防资源在与服务分离后的一年过渡到过渡服务成员。在 VA的回应，VA的中央办公室预防计划（SPP）计划实施一封有爱心的信件 每年过渡的所有245,000名服务成员的竞选活动。在关怀的信件干预中，一个系列 消息发送给个人，以交流他们没有被遗忘，人们关心 他们并担心自己的幸福。这些消息还提醒您可以提供帮助。 多次随机临床试验支持关怀信件减少自杀和自杀的效率 尝试费率。联合委员会最近推广了有爱心的信件。过渡的运动 但是，服务成员面临一些独特的挑战，因为没有既定的VA提供商可以服务 作为签字人。因此，我们提出了SPP与拟议的合作计划评估 评估团队检查在这个新人群中使用关怀信件的使用。具体而言，评估将 测试两个模型：（1）一种修改的关怀信件方法，其中从VA提供商发送字母 退伍军人不知道，（2）一种基于文化敏感的同龄人的关怀信件的方法 是从最近过渡的服务成员派出的，在性和兵役部门匹配。这 广告系列还将将服务成员随机为标准邮件时间表（一年中的8条消息）或 高频时间表（一年中的14条消息）。在AIM 1中，我们将评估关怀信的影响 临床结果和VA临床利用率。在AIM 2中，我们将研究两种不同的影响 关于干预临床有效性的关怀信件签署者和两个不同的邮件时间表。 AIM 3将检查促进者和障碍以实施关怀的信件活动。在AIM 4中，我们将 从VA的角度进行预算影响实施的影响分析。这将是最大的评估 曾经进行过的关怀信件干预措施，它将向领导层提供直接和可行的数据 评估这项重大预防运动的影响。