Casey S. Gilmore, PhD, Minneapolis VA Health Care System

Carol C. Yu, PhD, Minneapolis VA Health Care System

Quantifying heterogeneity of suicidal inpatient Veterans using individual causal models: A precision medicine approach to suicide prevention using real-time high-density data

Start Date: 1/1/2024

This study augments the ongoing VA RR&D-funded study, “Effects of Neuromodulation and Cognitive Training for Suicide in Veterans (ENACTS)”, which evaluates a novel transcranial direct current stimulation and executive function training intervention to reduce suicidal thoughts and behaviors (STBs) among suicidal inpatient Veterans. The current study will strengthen ENACTS’ ability to characterize the individual heterogeneity in STB risk and treatment response of suicidal inpatient Veterans by collecting high-density data on STBs and related cognitive, psychological, and physiological factors.

Relevance to SPRINT CORE Mission: This project focuses on the Precision Medicine priority area by utilizing a novel precision medicine analytic approach, Causal Discovery Analysis (CDA), which uses high-density, longitudinal data (e.g., ecological momentary assessments [EMA] and wearables), to create models that identify causal relationships between self-reported and objective risk factors and STBs that are specific to an individual.

Sarah Shue, PhD, Indianapolis VA Medical Center

Developing an exercise promotion intervention for high-risk women Veterans

Start Date: 1/1/2024

This qualitative study will develop a group psychological skills training (PST)-based intervention to promote exercise and decrease suicidal behaviors among high-risk women Veterans. Efforts will lead directly to a future proposal that will pilot test the intervention to assess feasibility and acceptability and develop implementation strategies to inform future larger scale testing and scalability of the intervention.

Relevance to SPRINT CORE Mission: This project focuses on a specific high-priority population, women Veterans. Utilizing PST as a way to enhance exercise engagement while also directly addressing suicidal thoughts and risk behaviors has high public health and scientific significance for the study of suicide prevention in at-risk women Veterans.

Lauren Krishnamurti, PhD, VA Eastern Colorado Healthcare System

Women Veterans’ Experiences with VA’s Enhanced Suicide Prevention Care

Start Date: 1/1/2024

The objective of this study is to collect input from women Veterans on their experiences with and perspectives on VA’s enhanced suicide prevention care. This qualitative study will focus on women Veterans’ interactions with suicide prevention teams/suicide prevention coordinators, their comfort with how this care met their needs, as well as perspectives on improving care for women-identifying Veterans with suicide risk. Results from this study will provide important information needed to enhance current care and ensure future care is inclusive of women Veterans. 

Relevance to SPRINT CORE Mission: This study focuses on a specific high-priority population, women Veterans. To date, no VA study has sought recommendations from women Veterans regarding their interactions and experiences with VA’s enhanced suicide prevention care.

Steven Sayers, PhD, Corporal Michael J Crescenz VA Medical Center

Lily Brown, PhD, University of Pennsylvania

The Coaching Into Care-Suicide Prevention (CIC-SP) intervention: A promising lethal means safety intervention for family members of Veterans at risk for suicide

Start Date: 1/1/2024

This project aims to test a coaching intervention, CIC-SP, that helps family members have discussions with Veterans about suicide and securing lethal means. The intervention uses the informational website, WorriedAboutaVeteran.org, developed by a consortium of clinical researchers in the Department of Veterans Affairs, the New York State Governors Challenge, and others. The goal of this pilot study is to inform a future randomized clinical trial testing the coaching intervention CIC-SP as a way to lower risk of Veteran suicide.

Relevance to SPRINT CORE Mission: This project focuses on the priority areas of lethal means safety and engagement of family members to enhance suicide prevention.

Gabriela Khazanov, PhD

Implementation of Lethal Means Counseling among Veterans with Problematic Substance Use: Evaluation and Adaptation

Start Date: 1/1/2023

The study aims to evaluate the implementation of Lethal Means Counseling (LMC) among Veterans with problematic substance use seeking care in VA outpatient behavioral health, using mixed methods including solicitation of feedback from stakeholders (Veterans, VA providers) on ways to adapt LMC for Veterans with problematic substance use. The overarching goal for this study to support a future proposal to engage additional stakeholders to adapt a version of LMC for those with problematic substance use.

Relevance to SPRINT CORE Mission: This project focuses on the priority areas of lethal means safety due to the nature of the counseling and engaging community relationships while soliciting feedback on ways to adapt LMC for those with problematic substance use.

Jill Lavigne, PhD, MPH

Pharmacy Lethal Means Management (LMM) in the Rural Research Alliance of Community Pharmacies (RURAL-CP) Practice Based Research Network (PBRN)

Start Date: 1/1/2023

This study will conduct implementation work in the 116-store, 7-state Rural Research Alliance of Community Pharmacies Practice Based Research Network (RURAL-CP) to elicit pharmacists’ perspectives about which LMM interventions to apply, how best to adapt them, and which barriers and facilitators need to be addressed with implementation strategies.

The study aims to characterize the acceptability, appropriateness and feasibility of LMM interventions to serve Veterans and their families in the RURAL-CP and identify implementation barriers and facilitators. The overarching goal for the study is use these findings to inform a future pilot Hybrid 2 effectiveness-implementation trial.

Relevance to SPRINT CORE Mission: This project focuses on the priority areas of lethal means safety by researching LMM interventions and their barriers and applications and engaging community relationships while working with community pharmacists during LMM research.

Morgan E. Bartholomew, PhD

Modeling the Pathway Between Autonomic Function, Emotion Regulation, and Suicide Risk in Veterans

Start Date: 1/1/2023

The study aims to characterize predictive relationship between emotional regulation (ER) and suicidal thoughts and behaviors (STB), to determine if heart-rate variability (HRV) is a mechanism that can partially explain the relationship between ER and STB, and to identify impacts that chronicity of PTSD symptom severity has on the proposed relationship between ER, HRV, and STB. This study will be used as proof of concept for a CDA study that will evaluate real-time monitoring of changes in HRV and emotional distress in Veterans at high risk for suicide.

Relevance to SPRINT CORE Mission: This project focuses on the priority area of Veterans who are not engaged with VA care by engaging Veterans not otherwise engaged in care by contributing to the development of a mobile intervention that integrates self-report of emotional states and changes in HRV.

Marianne Goodman, MD

"Project Life Force- Rural Veterans (PLF-RV)", Suicide-Specific Safety Planning Group Intervention over Telehealth for Rural Veterans and Veterans who do not seek VA Care: Pilot Implementation

Start Date: 1/1/2022

This pilot study examines a telehealth intervention version of a previously funded suicide safety planning and lethal means safety resource and its effectiveness in rural Veterans who do not seek VA care. Recruitment is done via community partners and veterans service organizations.

The study aims to assess feasibility of PLF-RV for rural Veterans in Arkansas while also identifying factors that impact implementation of PLF-RV. The overarching goal for PLF-RV is to serve as a prototype for future suicide prevention efforts that utilize community engagement and to inform future larger scale projects.

SPRINT CORE Mission: This project focuses on the priority areas of engaging veterans who are not engaged with VA care, lethal means safety education through the materials of the intervention, examining community relationships to reduce risk through the intervention, and researching social determinants of health and social needs in a high-risk rural Veteran subpopulation.

Candice Presseau, PhD

The Development of a Retreat-Based Suicide Prevention Program for Women Veterans

Start Date: 1/1/2022

This study informs the development of a retreat-based suicide prevention program for women Veterans who are at higher risk for suicide as a selective prevention strategy leading to the eventual development of a retreat-based suicide prevention program manual.

The study will conduct three focus groups with women Veterans to determine preferences of a retreat program as well as any interests, facilitators, or perceived barriers to attending such a program. The study will also conduct semi-structured interviews with experts to further identify information for a retreat-based program for women Veterans.

SPRINT CORE Mission: This project focuses on the priority area of understanding social determinants of health and developing an intervention that will reduce risk for a subpopulation of Veterans (women veterans).

Ahmed Mohamed, PhD

Characteristics of Transitioning Service Members who call the Veteran’s Crisis Line and then engage in non-VHA mental healthcare

Start Date: 1/1/2022

This project examines suicide risk in Veterans transitioning from active service within a year of discharge to better understand specific factors of suicide risk in a sub-population of Veterans who experience rates of suicide at rates almost three times higher than the overall Veteran population.

The study aims to use the novel strategy of integrating private health insurance data with VHA data, active-duty records, and VCL data to better understand suicide risk factors and to create methods that will allow for better integration of data from external sources in future projects.

SPRINT CORE Mission: This project focuses on the priority area of understanding social determinants of health and examining risk factors for a subpopulation of high-risk Veterans (transitioning Veterans) and involves research with Veterans who are not engaged with VA care by also examining private health insurance data.

Dr. Kritee Gujral

Impact of VA-issued telehealth tablets on suicide-related hospitalizations and suicide deaths among at-risk rural and urban veterans

Start Date: 1/1/2022

This study uses VA-issued telehealth tablets to help facilitate care among rural Veterans and examines the impact of these tablets on frequency of death by suicide and frequency of suicide-related hospitalizations.

Additionally, the study aims to conduct subgroup analyses on ReachVet Veterans, identified at the highest risk for suicide, to examine any suicide-prevention related effects on this group. This research will help evaluate the VA’s telehealth initiatives while serving as seed funding for future work to streamline telehealth use at the VA.

SPRINT CORE Mission: This project focuses on the priority area of understanding social determinants of health and examining risk factors for a subpopulation of high-risk Veterans (rural Veterans and ReachVet Veterans).

Kirsten Dillon PhD

Developing a mobile intervention to reduce suicidal cognitions in Veterans

• Start Date:4/1/2021
• This pilot project will use the hostile interpretation bias modification intervention to develop a similar intervention to reduce suicidal cognitions for Veterans with PTSD. The impact of this intervention as well as the hostile interpretation bias intervention on suicide risk and daily functioning will be examined.
• Through the development of a mobile interpretation bias modification intervention entitled Mobile Intervention for Suicidal Thoughts (MIST), researchers aim to reduce cognitions that contribute to elevated suicide risk by developing content to target cognitive factors that contribute to suicide risk and program this content into a mobile application.
• SPRINT CORE Mission: The proposed study focuses on the priority area of developing and implementing interventions to target Social Determinants of Health that contribute to elevated risk among Veterans, and it incorporates the use of technology to address the SDoH priority.

Frances Aunon, PhD

Development of a brief, motivational interviewing intervention manual for lethal means safety counseling for implementation within Primary Care and Primary Care Mental Health Integration

• Start Date:4/31/2021
• This pilot project focuses on facilitating LMS counselling in PC settings to leverage the expertise of the VISN1 MIRECC and Mental Health Clinical Trials Network to develop a brief motivational interviewing (MI) manual.
• Guided by the REP framework, interview guides will be developed to conduct qualitative interviews with PC and PCMHI providers; conduct qualitative interviews with PC and PCMHI key stakeholders; and integrate findings from interviews to develop a brief MI LMS manual.
• SPRINT CORE Mission: This project includes research on use of messaging related to lethal means and includes research addressing firearm-owning culture. The project will likely lead to a CDA application for funding of next-step projects and incorporates implementation science by gather

Jason Chen, PhD

Extending the Safety Net: Reaching Veterans at High Risk for Suicide Who Disengage from Care

• Start Date: 4/1/2021
• This pilot project will focus on Veterans who disengage from care in order to identify and test strategies to retain or re- engage those who may be at high risk for suicide.
• Through identification of Veterans with positive C-SSRS screens, researchers will extract CDW data to identify those without primary care and mental health visits at 6 months and 1-year post-positive screen as our primary outcomes. These intervals were chosen to identify unique and shared risk factors for disengagement during acute and chronic suicide risk periods.
• SPRINT CORE Mission: This project focuses on reaching and/or intervening with Veterans who are not engaged in VA care or who have left VA care and outreach to reach Veterans and re-engaging high-risk Veterans.

Elizabeth Karras, PhD

The use of VA public messaging to minimize risk for suicide among recently transitioned veterans not using VHA care

Start Date: 10/1/2020

This study recruited a nationally representative sample of recently transitioned Army and Marine Corps Veterans to investigate and improve the effectiveness of current VA suicide prevention messages on help seeking.

The study aims to have participants view VA suicide prevention messages and gauge responses to understand distinct subgroups with similar needs and preferences to better influence and improve the reception of future messages.

SPRINT CORE Mission: This project focuses on a specific high-risk population of interest: Veterans recently separated from the military.

Bryann DeBeer, PhD, Rocky Mountain MIRECC

Involving Concerned Significant Others in Firearms Safety: Development and Pilot Test of a New Intervention to Prevent Suicide in Firearm Owners

• Start Date: 10/1/2020
• Timeline: 12 months
• This pilot project will develop a concerned significant other (CSO)-involved firearm safety intervention to increase secure storage among Veterans, far in advance of a suicidal crisis
• The intervention will be refined to understand optimal conditions for implementation using a successive cohort design based on stakeholder feedback
• SPRINT CORE Mission: This project aligns with SPRINT’s mission through engaging the Veteran’s family and/or close support using an intervention targeting Means Safety. SPRINT is also focused on supporting projects in implementation science

Jennifer Funderburk, PhD, Syracuse VA Medical Center

Improving Patient-Centered Suicide Prevention Care for At-Risk Veterans in Non-VHA Primary Care

• Start Date: 10/1/2020
• Timeline: 12 months
• This pilot project will examine the feasibility and acceptability of using the Learning through Interactive Feedback and Training-Suicide Prevention (LIFT-UP) program via video teleconferencing with non-VHA providers serving Veterans in primary care. This pilot will support a larger trial examining LIFT-UP as an implementation strategy of suicide prevention practice
• Provider and Veteran feedback will be obtained to evaluate barriers/facilitators of engaging non-VHA providers and distal patient outcomes
• SPRINT Core Mission: This pilot project examines the application of a promising community and non-VA system intervention for Veterans not connected to VA services, two of SPRINT’s priority topic areas

Allison Warren, PhD, VA Connecticut Health Care System

Suicide Prevention and Related Care among LGBTQ Veterans (SPARC)

• Start Date: 10/1/2020
• Timeline: 18 months
• This pilot project focuses on explicating social psychological patient factors to develop a substantive theory to describe and explain LGBTQ Veterans’ decision to seek, or not seek, support when experiencing suicidal ideation
• Through semi-structured interviews consistent with the Health Equity Implementation Framework, LGBTQ Veterans will be asked about their beliefs, preferences for treatment, culture and community strengths and limitations, and knowledge of support services, including VA and community options
• SPRINT Core Mission: This project focuses on a specific high-risk subpopulation of interest: LGBTQ Veterans. Information from this project will provide knowledge necessary to design accessible intervention and implementation strategies for effective suicide prevention within this subpopulation

Kathleen Carlson, PhD, VA Portland Health Care System

Using Large-scale Social Determinants Data to Identify Veterans at Heightened Risk of Suicide: A Data Linkage Pilot Project

• Start Date: 8/1/2020
• Timeline: 12 months
• This pilot project will link VA data to private, non-VA data to identify social determinants of suicide for Veterans who do, and Veterans who do not, use VHA healthcare
• The primary outcome will be death by suicide; Veterans’ social factors will focus on variables strongly associated with suicide and amenable to intervention, including financial stress, unemployment, legal issues, housing in/stability, transportation, and social isolation
• SPRINT Core Mission: This project aligns with multiple SPRINT priority areas by linking non-VA data, examining Veterans not engaged in VA services, as well as understanding upstream, social risk factors for suicide