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: 10589763
• 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/10589763
• 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; 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; 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.

退伍军人的自杀率明显高于普通人群，有两个以上- 这些死亡中有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 当枪支储存不安全(例如，上了膛，没有锁定装置)时，明显更高，这似乎 在退伍军人中是一种普遍的做法。致命手段咨询(LMC)，一种促进安全的干预措施 在自杀危机期间，从家里储存和/或临时移走枪支，已经证明 增加安全储存的初步效果。然而，这种干预措施尚未在退伍军人身上进行测试 人口。此外，几个文化和后勤障碍可能会阻碍退伍军人获得同样的权利 与其他人群一样受益，包括退伍军人自我暴露自杀想法的可能性较低，不信任 动机(即认为谈话是含蓄的枪支管制企图)，以及对此表示的偏好 与其他枪支拥有者或退伍军人进行讨论，而不是临床医生。因此，该计划的目的是 建议的职业发展奖-1(CDA-1)是为了调整和扩大现有的LMC干预措施，以供同行- 在拥有枪支的退伍军人中送货。适应将涉及召集一个由资深和非 经验丰富的专家，他们将就干预和干预者培训的各个方面提供意见 需要适应。资深干预者和资深参与者将通过东南部招募 路易斯安那州退伍军人医疗保健系统(SLVHCS)、更广泛的社区和现有的 由老兵知情安全干预和外联网络(VISION)建立的联系--一组 社区和退伍军人利益相关者促进退伍军人自杀预防。资深干预主义者将是 经过培训，进行适应干预，它将与至少15名拥有枪支的退伍军人进行试点。 然后将通过使用自我报告来评估这种干预措施的初步可行性和可接受性 问卷调查和定性访谈。在CDA-1期间，我希望培养老兵的技能- 从事研究和定性方法，这将支持我作为自杀预防的发展 研究员。我将与我的主要导师密切合作，他在这些研究方面拥有广泛的专业知识 并将完成关于这些主题的正式教学课程和网络研讨会。我也希望 通过传统大学提高与随机对照试验(RCT)设计和分析相关的技能 课程、有组织的咨询和指导。拟议的研究将提供重要的经验。 与退伍军人一起实施这些方法。这项拟议研究的数据将用于支持职业生涯 发展奖-2(CDA-2)申请，这将涉及一项随机对照研究，调查同行- 在退伍军人中交付了LMC。因此，这个奖项将为我的长期工作提供非凡的准备 职业目标是成为退伍军人事务部的一名独立临床科学家。