Expanding Provider Capacity to Prevent Rural Veteran Suicide: Virtual Reality Lethal Means Safety Training
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 36
- 试验地点
- 2
- 主要终点
- Confidence in Lethal Means Safety Counseling
研究概览
简要总结
The goal of this randomized clinical trial is to determine whether a virtual reality (VR) training program can help healthcare providers improve their skills in discussing suicide prevention and safe storage of firearms and medications with Veterans. The study will test whether VR training increases providers' self-efficacy, confidence, and comfort in conducting lethal means safety counseling, and whether it improves their intention to use these counseling practices in their clinical work. Researchers will compare healthcare providers who complete the VR training to those who complete a 2D video training to determine whether the VR approach is more effective. Participants will complete online surveys before and after the training and again three months later. They will be randomly assigned to one of two groups: VR training group: Participants use a VR headset to interact with a virtual Veteran patient in a simulated rural clinic and practice suicide prevention counseling skills; Video training group: Participants use the same headset to watch a ~10-minute 2D video depicting the lethal means safety counseling session. After the training, participants will also provide feedback about their experience, including how realistic and useful they found the training.
详细描述
This study will test whether a virtual reality (VR) training program can improve healthcare providers' ability to talk with Veterans about suicide prevention and safe storage of firearms and medications. Rural Veterans have suicide rates much higher than the national average, and providers in rural areas often do not receive enough training in suicide risk identification or lethal means safety counseling.
This project builds on our prior Veteran Suicide Assessment in Virtual Reality (VET-SAVR) study, which showed that VR can be a feasible and acceptable way to deliver suicide prevention training. In the current study, called the Virtual Reality Lethal Means Safety Training (VR-LMST) project, we will compare an immersive VR training simulation to a 2D video training.
Study Aims
Aim 1: Develop a VR training simulation focused on suicide prevention counseling with rural Veterans.
Aim 2: Test whether VR-LMST improves provider confidence (primary), and comfortability and intention (secondary) to engage in lethal means safety counseling.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
盲法说明
Participants and study personnel are aware of assignment because the intervention content differs (interactive VR simulation vs. 2D video). Both groups use headsets to reduce expectancy differences, but this does not blind allocation. To mitigate bias, we use centralized randomization, standardized instructions, and prespecified analyses; where feasible, data analysts will be masked to group labels.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Age 18 or older
- •healthcare providers serving rural Veterans in Texas (e.g., physicians, physician assistants, nurse practitioners, nurses, pharmacists, social workers, healthcare case managers)
- •English-speaking
- •Able to provide informed consent
排除标准
- •Self-reported pregnancy
- •History of motor or balance disorders
- •Color blindness
- •Neurological or cognitive disorders
- •Cardiovascular issues that may be worsened by VR use
- •Use of cardiac pacemakers, defibrillators, or hearing aids incompatible with VR equipment
- •Significant discomfort in virtual reality environments (e.g., severe motion sickness, vertigo)
研究组 & 干预措施
VR-LMST Intervention
Participants use a Meta Quest 3 headset to complete an interactive virtual reality simulation of a rural clinic visit with a Veteran avatar at risk for suicide. The simulation incorporates skills in suicide risk identification, firearm and medication safety counseling, and collaborative safety planning.
干预措施: Virtual Reality Lethal Means Safety Training (Behavioral)
2D Video Training
Participants use a VR headset to view a 10-minute 2D video depicting a lethal means safety counseling session with a veteran.
干预措施: 2D Video Training (Behavioral)
结局指标
主要结局
Confidence in Lethal Means Safety Counseling
时间窗: Baseline (pre-test), immediately after intervention (post-test), and 3-month follow-up
Measured by the Counseling on Access to Lethal Means (CALM) Core Scale (Sale et al., 2018) Confidence subscale ("How confident are you that …"). Items are rated on a 4-point scale and summed; higher scores indicate greater confidence (range = 5 - 20).
次要结局
- Comfortability in Lethal Means Safety Counseling(Baseline (pre-test), immediately after intervention (post-test), and 3-month follow-up)
- Counseling Intentions(Baseline (pre-test), immediately after intervention (post-test), and 3-month follow-up)
- Spatial Presence(Immediately after intervention (post-test only))
- Engagement(Immediately after intervention (post-test only))
- Ecological Validity / Naturalness(Immediately after intervention (post-test only))
- Negative Effects (Tolerability)(Immediately after intervention (post-test only))