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Increasing Help-Seeking Behavior Among Transitioning Veterans At Risk For Suicide With Online Gatekeeper Training: A Pilot Study Of PsychArmor S.A.V.E.

通过在线看门人培训增加有自杀风险的过渡退伍军人的寻求帮助行为：PsychArmor S.A.V.E 的试点研究

基本信息

批准号：
10248352
负责人：
Alan Teo
金额：
--
依托单位：
PORTLAND VA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-10-01 至 2022-03-31
项目状态：
已结题

项目摘要

Background: Suicide is an urgent public health crisis, and transitioning Veterans (those who have recently separated from the military) are a high-risk group for suicide. A key component to advancing suicide prevention efforts among at-risk Veterans is to address low levels of help-seeking and engagement in treatment, including Veterans Health Administration (VHA) care. Veterans are most likely to disclose suicidal thoughts to their close supports—family members, friends, and their peers. However, Veterans and their close supports rarely receive training in how to help a peer at risk of suicide, despite strong interest in such training. Gatekeeper training is a key strategy with potential to help address these challenges. Gatekeeper training teaches “gatekeepers” skills in how to identify a Veteran with suicide risk, inquire about suicidal thoughts, and help make a connection to professional treatment; it may benefit the trainee’s own mental health too. PsychArmor S.A.V.E. is a brief, novel online gatekeeper training that was created in partnership with VA and is designed for Veterans and their close supports. Significance/Impact: This project focuses on VA’s topic clinical priority, suicide prevention. The 2019 VA and Department of Defense Clinical Practice Guidelines also identified gatekeeper training as an important research gap and priority for future research. Finally, our research design addresses three separate goals and objectives contained in VA’s National Strategy for Preventing Veteran Suicide, including involvement of Veterans’ close supports. Innovation: This proposal employs the novel approach of recruiting Veterans and their close supports through online social media advertisements, allowing for broad outreach, suicide prevention targeting Veterans outside the VA network, and the potential to test the effectiveness of gatekeeper training on a large scale. Online gatekeeper trainings are highly scalable public health strategies with the potential to diffuse through online social networks. Specific Aims: Our primary objective is to conduct a pilot randomized controlled trial (RCT) to evaluate the feasibility and acceptability of the online gatekeeper training PsychArmor S.A.V.E. To reach this objective we will achieve these aims: 1) Determine the feasibility of recruiting participants via social media, engaging them to participate in an online gatekeeper training program, and retaining them in an online intervention study; and 2) Determine the acceptability of PsychArmor S.A.V.E. in a pilot RCT, and evaluate measures for use in a future larger-scale RCT. Methodology: This is a two-arm pilot randomized clinical trial involving 200 participants. We will recruit participants through social media advertisements targeting transitioning Veterans and their close supports (family and friends). Participants will be randomized to take the PsychArmor S.A.V.E. gatekeeper training or a “sham” control training and followed for 6 months. Mixed quantitative and qualitative methods will be used to assess outcomes on feasibility and acceptability. Additional data collection and analysis of measures related to suicide prevention, such as gatekeeper behaviors, knowledge, stigma, self-efficacy, and social norms measures will help prepare for a larger-scale RCT. Implementation/Next Steps: By using an extremely scalable intervention and building off existing VA practices and partnerships, this project will be very well-positioned for further evaluation and implementation into VA practice if found to be effective. It is freely available online, making it highly amenable to being rapidly taken to scale. Results of this project will inform future efforts to disseminate and/or revise PsychArmor S.A.V.E.

背景：自杀是一个紧迫的公共卫生危机，过渡退伍军人（那些最近与军队分离的人）是自杀的高危群体。推进自杀预防的关键组成部分风险退伍军人的努力是解决低水平的寻求帮助和参与治疗，包括退伍军人健康管理局（VHA）护理。退伍军人最有可能向他们的亲人透露自杀的想法。家庭成员、朋友和同龄人的支持。然而，退伍军人和他们的密切支持很少得到培训如何帮助有自杀风险的同伴，尽管对这种培训有浓厚的兴趣。守门员训练是一个有可能帮助应对这些挑战的关键战略。把关人培训传授“把关人”技能如何识别有自杀风险的退伍军人，询问自杀想法，并帮助建立联系，专业治疗;它也可能有益于受训者自身的心理健康。PsychArmor S.A.V.E.是一个简短的，一种新颖的在线守门员培训，是与VA合作创建的，专为退伍军人及其密切支持。意义/影响：该项目的重点是VA的主题临床优先事项，自杀预防。2019年VA和国防部临床实践指南也将守门人培训确定为重要的研究差距和未来研究的重点。最后，我们的研究设计解决了三个独立的目标，预防退伍军人自杀的国家战略，包括参与退伍军人的亲密支持。创新：该提案采用了招募退伍军人及其密切支持的新方法，在线社交媒体广告，允许广泛的宣传，针对退伍军人的自杀预防 VA网络，以及大规模测试看门人培训有效性的潜力。在线守门人培训是高度可扩展的公共卫生战略，有可能通过在线传播社交网络。具体目的：我们的主要目的是进行一项初步随机对照试验（RCT），以评估 PsychArmor S.A.V.E.在线守门员培训的可行性和可接受性。为了实现这一目标，我们将实现这些目标：1）确定通过社交媒体招募参与者的可行性，参与在线把关人培训计划，并将其保留在在线干预研究中;以及 2)确定PsychArmor S.A.V.E.的可接受性。在一项试验性RCT中，并评估用于未来更大规模的RCT 方法学：这是一项涉及200名参与者的两组试点随机临床试验。我们将招募参与者通过社交媒体广告针对过渡退伍军人及其密切支持（家人和朋友）。参与者将被随机分配到PsychArmor S.A.V.E.看门人培训或 “假”对照训练，并随访6个月。将使用定量和定性混合方法，评估结果的可行性和可接受性。收集更多数据并分析与下列方面有关的措施：自杀预防，如看门人行为，知识，耻辱，自我效能和社会规范这些措施将有助于为更大规模的RCT做准备。实施/后续步骤：通过使用极具扩展性的干预措施并在现有VA基础上构建实践和伙伴关系，该项目将非常适合进一步评估和实施实践证明，这是有效的。它可以在网上免费获得，这使得它非常容易被迅速按比例绘制。该项目的结果将为今后传播和/或修订心理装甲的工作提供信息 S.A.V. E