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Seventeen United States Veterans die by suicide each day. Nearly three-fourths of those Veterans die from firearm injury or poisoning, and many seek care in VA Emergency Departments (ED) prior to suicide attempts. In 2019, the VA began screening all Veterans seeking ED care for increased suicide risk. Interventions that promote firearm and medication safety are recommended for Veterans identified as at-risk. The investigators work will provide important information that will aid the development and testing of such an intervention for Veterans who seek care in VA EDs. The investigators will interview at-risk Veterans who recently sought VA ED care to identify factors relevant to developing the intervention, and work with Veterans and VA healthcare staff to develop and test an intervention.
Veterans will be recruited from the Rocky Mountain Regional VA Medical Center (RMRVAMC) ED who are identified as having elevated suicide risk by VHA's new suicide risk screening initiative. All Veterans visiting VHA EDs are screened using an eight-item version of the Columbia Suicide Severity Rating Scale (C-SSRS) Screener, a valid predictor of future suicidal behavior. The C-SSRS Screener assesses suicide risk using eight items about recent suicidal ideation and intent, preparatory behaviors, and action. Deductive and inductive content analysis of qualitative interviews will occur in parallel with recruitment, and participants will be recruited until thematic saturation is achieved.
Veterans' visits (approx. 90 minutes) will be scheduled at their preferred times at RMRVAMC within two weeks of discharge from the ED. Sociodemographic and military service data will be collected using the Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) Demographics Survey. During this visit, individuals will participate in qualitative interviews to identify contextual factors that may inform development of VA-based lethal means safety interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Veteran study group | The investigators will recruit approximately 20 Veterans who were identified as having elevated suicide risk while being treated in a VA Emergency Department. |
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| Measure | Description | Time Frame |
|---|---|---|
| Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Perspectives on VA-based interventions that aim to reduce access to firearms and medications. | baseline |
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Inclusion Criteria:
Exclusion Criteria:
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Veterans will be eligible who are seen for healthcare in the VA Emergency Department
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| Name | Affiliation | Role |
|---|---|---|
| Joseph A Simonetti, MD MPH | Rocky Mountain Regional VA Medical Center, Aurora, CO | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rocky Mountain Regional VA Medical Center, Aurora, CO | Aurora | Colorado | 80045 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Study Group | 28 Veterans who were recently discharged from a VHA emergency care. Veteran participants were: >18 years of age, had access to firearms and/or medications at home, and were determined to be at elevated suicide risk based on the presence of suicide risk factors, including screening positive for having elevated suicide risk at the time of admission via the Columbia Suicide Severity Rating Scale Screener. Veterans were excluded if they were critically ill (intensive care unit requirements), are severely cognitively impaired, or had severe psychiatric symptoms that would preclude study participation. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Study Group | 28 Veterans who were recently discharged from a VHA emergency care. Veteran participants were: >18 years of age, had access to firearms and/or medications at home, and were determined to be at elevated suicide risk based on the presence of suicide risk factors, including screening positive for having elevated suicide risk at the time of admission via the Columbia Suicide Severity Rating Scale Screener. Veterans were excluded if they were critically ill (intensive care unit requirements), are severely cognitively impaired, or had severe psychiatric symptoms that would preclude study participation. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Perspectives on VA-based interventions that aim to reduce access to firearms and medications. | Posted | Number | participants | baseline |
|
1 day
this was not an intervention study and mortality was not assessed.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Study Group | 28 Veterans who were recently discharged from a VHA emergency care. Veteran participants were: >18 years of age, had access to firearms and/or medications at home, and were determined to be at elevated suicide risk based on the presence of suicide risk factors, including screening positive for having elevated suicide risk at the time of admission via the Columbia Suicide Severity Rating Scale Screener. Veterans were excluded if they were critically ill (intensive care unit requirements), are severely cognitively impaired, or had severe psychiatric symptoms that would preclude study participation. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Joseph Simonetti | Veterans Health Administration | 7207236491 | joseph.simonetti@va.gov |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 9, 2022 | Jul 23, 2024 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jan 5, 2022 | Jan 10, 2024 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D013405 | Suicide |
| D062787 | Drug Overdose |
| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D063487 | Prescription Drug Misuse |
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| years |
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| Sex/Gender, Customized | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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| Units | Counts |
|---|---|
| Participants |
|
|
| 0 |
| 0 |
| 0 |
| 28 |
| 0 |
| 28 |
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| D000076064 |
| Drug Misuse |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |