Home Safety Intervention
- Conditions
- SuicideFirearm InjuryOverdose
- Interventions
- Behavioral: household safety intervention
- Registration Number
- NCT06216327
- Lead Sponsor
- VA Office of Research and Development
- Brief Summary
Access to lethal methods of self-harm such as firearms and medications increases risk for suicide. As such, VA/DoD guidelines for the care of individuals with elevated suicide risk include recommendations that clinicians deliver interventions to reduce access to lethal methods of suicide among patients who are identified as having elevated suicide risk. However, no interventions have been developed or tested among Veterans with elevated suicide risk. The aim of this study is to pilot test a lethal means safety intervention developed specifically for Veterans who seek care in VHA clinical settings and are identified as having elevated suicide risk.
- Detailed Description
The investigators will pilot the LMS intervention among up to 50 Veterans to assess feasibility and acceptability.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 30
-
Encounter at VHA ED or urgent care setting, outpatient mental health, women's health, or primary care
->17 years
-
Discharged home from the encounter (rather than hospital admission)
-
Positive Columbia Screener
-
Patient-reported access to self-owned firearms and/or medications
- Unable to consent due to cognitive impairment, severity of illness (including psychiatric symptoms), intoxication with drugs and/or alcohol
- Unreliable telephone access
- Unreliable video access (because remote intervention)
- Those currently experiencing unsheltered homelessness
- No mailing address
- Active opioid or stimulant use disorder
- Active alcohol use disorder with daily alcohol consumption
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description intervention arm household safety intervention There is a single intervention arm with no comparator for this pilot study
- Primary Outcome Measures
Name Time Method Feasibility of study recruitment through study completion, an average of one year Ability to recruit 30 Veterans in one year
Comfort with intervention discussion day of intervention delivery - day 0; and at 4 weeks "How comfortable did you feel engaging in the discussion? " Likert responses: Very uncomfortable Uncomfortable Neither Comfortable Very comfortable
Respectfulness of the intervention day of intervention delivery - day 0; and at 4 weeks "To what extent was this intervention respectful of your values as a firearm owner? Likert responses: Very disrespectful Disrespectful Neither Respectful Very respectful
participant intervention satisfaction at 4 weeks Qualitative evaluation of participant's experiences
Intervention helpfulness in medication decisions day of intervention delivery - day 0; and at 4 weeks "How helpful was your interaction in making decisions about medication storage and safety?" Likert responses: Not at all Slightly helpful Moderately helpful Very helpful Extremely helpful
Intervention helpfulness in firearm decisions day of intervention delivery - day 0; and at 4 weeks "How helpful was your interaction in making decisions about firearm storage?" Likert responses: Not at all Slightly helpful Moderately helpful Very helpful Extremely helpful
Feasibility of study follow up approximately 30 days \>70% follow up
- Secondary Outcome Measures
Name Time Method Institutional Trust Day of intervention delivery (day 0) and at 4 weeks On a scale from 0 to 10, where 10 indicates complete trust and 0 indicates complete distrust (so 5 would indicate that you neither trust, nor distrust), please indicate your level of trust in the VA healthcare system?
Firearm storage storage Stage of Change Day of intervention delivery at visit #1 (day 0); optional visit #2 (1-29 days); optional visit #3 (2-29 days); and at 4 weeks One thing some people consider doing to reduce risk of suicide or injury for themselves and others in their household is to securely store all firearms. On a scale from 0 to 10, where 0 is not at all, and 10 is completely, how would you rate your readiness to \[make a change\] like that? (range 0-10)
Medication adherence at 4 weeks "To what extent have you had difficulty remembering to take your medications in the past month?" Likert responses: Never Rarely Sometimes Very Often Always
Change in firearm storage practices Day of intervention delivery (day 0) and at 4 weeks Changes in whether household firearms are present, and whether present firearms are stored securely. Answers:
Yes, all of them are locked Yes, some of them are locked None of them are locked I'm not sureBeliefs about importance of secure medication storage always Day of intervention delivery (day 0) and at 4 weeks "On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important." It is always important to securely store medications even if someone is not at risk for suicide in the home. Answer range: 0-10
Beliefs about importance of secure firearm storage when someone is suicidal Day of intervention delivery (day 0) and at 4 weeks "On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important." It is important to securely store firearms when I or someone in my household has had recent thoughts of suicide. Answer range: 0-10
Firearm removal stage of change Day of intervention delivery at visit #1 (day 0); optional visit #2 (1-29 days); optional visit #3 (2-29 days); and at 4 weeks One of the safest things someone can do while they?re going through a difficult time is to store their firearms outside of the home with someone they trust. On a scale from 0 to 10, where 0 is not at all, and 10 is completely, how would you rate your readiness to \[make a change\] like that? Answer range: 0-10
Medication return envelope at 8 weeks Verification of returned medication safety envelope (yes/no)
Beliefs about importance of unloaded firearm storage always Day of intervention delivery (day 0) and at 4 weeks "On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important." It is always important to securely store firearms unloaded even if someone is not at risk for suicide in the home. Answer range: 0-10
Number of firearms in household Day of intervention delivery (day 0) and at 4 weeks Number of firearms in household: Answer range: 0 to 10,000
Keeping firearms for protection Day of intervention delivery (day 0) and at 4 weeks On a scale of 0 to 10, to what extent do you keep your firearms to protect yourself or your loved ones from other people? Someone who answers 0 does not consider themselves to keep firearms for protection, while someone who answers 10 considers that their firearms are absolutely required for protection. Answer range: 0-10
Beliefs about importance of secure firearm storage always Day of intervention delivery (day 0) and at 4 weeks "On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important." It is always important to store firearms securely in a locked space, or with a locking device, even if someone is not at risk for suicide in the home. Answer range: 0-10
Change in ammunition storage practices Day of intervention delivery (day 0) and at 4 weeks Changes in whether household ammunition is present, and whether present ammunition is stored securely. Answer options: Yes, all of the ammunition is locked Yes, some of the ammunition is locked None of the ammunition is locked I'm not sure No ammunition is in my home
Beliefs about importance of secure medication storage when someone is suicidal Day of intervention delivery (day 0) and at 4 weeks "On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important." It is important to securely store medications when I or someone in my household has had recent thoughts of suicide. Answer range: 0-10
Medication storage storage Stage of Change Day of intervention delivery at visit #1 (day 0); optional visit #2 (1-29 days); optional visit #3 (2-29 days); and at 4 weeks One thing some people consider doing to reduce risk of suicide or injury for themselves and others in their household is to securely store all medications. On a scale from 0 to 10, where 0 is not at all, and 10 is completely, how would you rate your readiness to \[make a change\]? (range 0-10)
Change in medication storage practices Day of intervention delivery (day 0) and at 4 weeks Changes in whether household medication is present, and whether present medication is stored securely. Answer options:
Yes, all of the medications in my home are locked up Yes, some of the medications in my home are locked up None of the medications in my home are locked up I'm not sureChange in access to firearm storage combination Day of intervention delivery (day 0) and at 4 weeks Changes in who has access to household locking combinations.
Answer options:
You Your spouse or partner Children under the age of 18 years Children 18 years of age or older A friend A neighbor Other:__________Naloxone prescription at 8 weeks Verification of naloxone prescription within the electronic health record (yes/no)
Trial Locations
- Locations (1)
Rocky Mountain Regional VA Medical Center, Aurora, CO
🇺🇸Aurora, Colorado, United States