Acceptability and Feasibility of a Peer-to-Peer Firearm-Specific Means Safety Intervention

点对点枪支专用手段安全干预的可接受性和可行性

• 批准号: 10369508
• 负责人: Claire Houtsma
• 金额: --
• 依托单位: SOUTHEAST LOUISIANA VETERANS HEALTH CARE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10369508
• 关键词: Adolescent; Award; Belief; Cessation of life; Clinical; Clinical Trials Design; Communities; Consultations; Counseling; Coupled; Data; Development; Devices; Disclosure; Effectiveness; Excision; Feedback; Feeling suicidal; Firearms; Funding; General Population; Goals; Grant; Health Personnel; Healthcare Systems; Home; Individual; Instruction; Intervention; Interview; Investigation; K-Series Research Career Programs; Knowledge; Logistics; Louisiana; Mentors; Mentorship; Methodology; Methods; Military Personnel; Ownership; Participant; Patient Self-Report; Population; Preparation; Probability; Qualitative Methods; Questionnaires; Randomized Controlled Trials; Registries; Research; Research Personnel; Risk; Safety; Science; Scientist; Structure; Suicide prevention; Testing; Time; Training; United States Department of Veterans Affairs; Universities; Veterans; Work; Writing; acceptability and feasibility; arm; base; career; career development; community setting; experience; follow-up; gun control laws; meetings; military veteran; motivational enhancement therapy; outreach; peer; post intervention; preference; recruit; reducing suicide; skills; suicidal; suicidal morbidity; suicidal risk; suicide rate; trial design; virtual

The suicide rate among Veterans is significantly higher than that of the general population, with more than two- thirds of these deaths resulting from firearms. Importantly, research suggests that risk for suicide death is significantly higher when firearms are stored unsafely (e.g., loaded, without a locking device), which appears to be a common practice among Veterans. Lethal means counseling (LMC), an intervention promoting safe storage and/or temporary removal of firearms from the home during times of suicidal crisis, has demonstrated initial effectiveness for increasing safe storage. However, this intervention has yet to be tested in a Veteran population. Furthermore, several cultural and logistical barriers may impede Veterans from obtaining the same benefit as other populations, including low probability of Veterans self-disclosing suicidal thoughts, mistrust of motive (i.e., belief that the conversation is a veiled attempt at gun control), and preference indicated for such discussions to occur with fellow firearm owners or Veterans, as opposed to clinicians. Thus, the purpose of the proposed Career Development Award-1 (CDA-1) is to adapt and expand an existing LMC intervention for peer- delivery among firearm owning Veterans. Adaptation will involve convening a panel of Veteran and non- Veteran experts who will provide input on aspects of the intervention and interventionist training that may require adaptation. Veteran interventionists and Veteran participants will be recruited through the Southeast Louisiana Veterans Health Care System (SLVHCS), the broader community, and an existing network of contacts established by the Veteran Informed Safety Intervention and Outreach Network (VISION) – a group of community and Veteran stakeholders promoting Veteran suicide prevention. Veteran interventionists will be trained in conducting the adapted intervention and it will be piloted with at least15 firearm owning Veterans. This intervention will then be evaluated for initial feasibility and acceptability through use of self-report questionnaires and qualitative interviews. Throughout the CDA-1 period, I hope to develop skills in Veteran- engaged research and qualitative methodology, which will bolster my development as a suicide prevention researcher. I will work closely with my primary mentor, who has extensive expertise in these research approaches, and will complete formal didactic coursework and cyber-seminars on these topics. I also hope to sharpen skills related to randomized controlled trial (RCT) design and analysis through traditional university coursework, structured consultation, and mentorship. The proposed study will provide vital experience implementing these approaches with Veterans. Data from the proposed study will be used to support a Career Development Award-2 (CDA-2) application, which would involve a RCT investigating the efficacy of peer- delivered LMC among Veterans. Thus, this award would provide extraordinary preparation for my long-term career goal to become an independent clinical scientist in the Department of Veterans Affairs.

退伍军人的自杀率显着高于一般人口的自杀率，超过两个以上 这些死亡中的三分之一是由枪支造成的。重要的是，研究表明自杀死亡的风险是 当不安全存储枪支（例如，加载，没有锁定装置）时，显着更高 成为退伍军人的普遍做法。致命是指咨询（LMC），这是一种促进安全的干预措施 在自杀危机时期，储存和/或暂时从家中撤离枪支，已证明 提高安全存储的初始有效性。但是，这种干预尚未在退伍军人中进行测试 人口。此外，几个文化和逻辑障碍可能会阻碍退伍军人获得相同的障碍 作为其他人群的好处，包括退伍军人自我披露自杀念头的可能性低，不信任 动机（即，相信对话是对枪支管制的掩盖尝试），并且对此表示了偏爱 与枪支所有者或退伍军人进行的讨论，而不是临床医生。那，目的 拟议的职业发展奖1（CDA-1）是为了适应和扩展现有的LMC干预措施 在拥有退伍军人的枪支之间交付。适应将涉及召集一组老兵和非 - 资深专家将提供有关干预和干预主义培训方面的意见 需要适应。资深干预主义者和资深参与者将通过东南招募 路易斯安那州退伍军人卫生保健系统（SLVHC），更广泛的社区以及现有的网络 由老将知情的安全干预和外展网络（Vision）建立的联系人 - 一组 社区和资深利益相关者促进预防退伍军人自杀。资深干预主义者将 经过培训，可以进行改编的干预措施，并将由至少15名枪支拥有退伍军人进行驾驶。 然后，将通过使用自我报告来评估此干预措施的最初可行性和可接受性 问卷和定性访谈。在整个CDA-1时期，我希望能够发展经验丰富的技能 参与研究和定性方法，这将加强我作为预防自杀的发展 研究员。我将与我的主要导师紧密合作，后者在这些研究中拥有广泛的专业知识 接近，并将在这些主题上完成正式的教学课程和网络序列。我也希望 通过传统大学培养与随机对照试验（RCT）设计和分析有关的技能 课程工作，结构化咨询和精神训练。拟议的研究将提供重要的经验 用退伍军人实施这些方法。拟议研究的数据将用于支持职业 Development Award-2（CDA-2）应用程序，该应用程序将涉及RCT调查同行效率 在退伍军人中交付了LMC。这是这个奖项将为我的长期提供非凡的准备 成为退伍军人事务部独立临床科学家的职业目标。