Document text
Principal Investigator: Alan Teo
Organization: PORTLAND VA MEDICAL CENTER
Fiscal Year: 2024
Funding agency: Veterans Affairs
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.
Terms: <Active Follow-up><Address><Advertisement><Advertisements><Agreement><Area><Armed Forces Personnel><Attitude><Behavior><Behavioral><Caring><Characteristics><Clinical><Clinical Practice Guideline><Consensus><Data><Data Analyses><Data Analysis><Data Analytics><Data Collection><Department of Defense><Diffuse><Education for Intervention><Educational Intervention><Educational process of instructing><Eligibility><Eligibility Determination><Enrollment><Evaluation><Family><Family member><Feasibility Studies><Feedback><Feeling suicidal><Friends><Future><Gatekeeping><Goals><Individual><Instruction Intervention><Intervention><Intervention Strategies><Intervention Studies><Interview><Knowledge><Link><Measurement><Measures><Mental Health><Mental Hygiene><Methodology><Methods><Military><Military Personnel><Outcome><Outcome Assessment><Participant><Patient Recruitments><Persons><Pilot Projects><Position><Positioning Attribute><Process><Protocol Screening><Psychological Health><Public Health><Qualitative Methods><R-Series Research Projects><R01 Mechanism><R01 Program><Randomized><Randomized, Controlled Trials><Research><Research Design><Research Grants><Research Project Grants><Research Projects><Risk><Self Efficacy><Structure><Study Type><Suicidal thoughts><Suicide><Suicide precaution><Suicide prevention><Survey Instrument><Surveys><Teaching><Technical Expertise><Training><Training Intervention><Training Programs><Veterans><Veterans Health Administration><Veterans Health Affairs><Work><acceptability and feasibility><active followup><analytical method><arm><clinical care><clinical practice and guidelines><comparator group><comparison group><data interpretation><design><designing><effectiveness testing><enroll><family support><fatal attempt><fatal suicide><follow up><follow-up><followed up><followup><gatekeeper><help seeking><help-seeking behavior><high risk><high risk group><high risk individual><high risk people><high risk population><improved><innovate><innovation><innovative><instructional intervention><intent to die><interest><intervention research><interventional research><interventional strategy><interventional study><interventions research><military population><military veteran><new approaches><novel><novel approaches><novel strategies><novel strategy><on-line social networking><online intervention><online social networking><outreach><participant recruitment><peer><pilot study><prevent><prevent suicidality><prevent suicide><preventing><qualitative reasoning><randomisation><randomization><randomized control trial><randomized, clinical trials><randomly assigned><recruit><reduce suicidality><reduce suicide><reducing suicidality><reducing suicide><skills><social media><social networking site><social networking web site><social networking website><social norm><social stigma><stigma><study design><suicidal behavior><suicidal ideation><suicidal risk><suicidal thinking><suicidality prevention><suicide behavior><suicide ideation><suicide intervention><suicide rate><suicide risk><suicides><systematic review><technical skills><thoughts about suicide><veteran population><web site><web-based social networking><website>