Public Messaging to Increase Treatment Seeking for Veterans at Risk for Suicide

NCT04784663 | Completed Results

• 2 other identifiers: SDR 19-354HX003130-01A2
• Study Type: interventional
• Target: 355
• Locations: 1 country
• Sites: 1

Brief Summary

The risk for suicide increases by nearly 50% in the first year that service members transition from the military to civilian life underscoring the need for effective strategies to facilitate help seeking among Veterans vulnerable to self-directed violence. Yet despite a great need for treatment, more than half of returning Veterans at risk for suicide do not initiate mental health services. VA has embarked on the regular use of communication campaigns as part of a public health approach designed to reach the larger Veteran population with messages promoting help seeking. However, what types of messages effectively change beliefs and behaviors for at-risk Veterans resistant to seek treatment is unclear. The main objective of this study is to develop and test the use of public messaging to increase treatment seeking among Veterans at risk for suicide and resistant to seek mental health care following separation from military service. This represents the first study to systematically develop public messaging strategies for populations at risk for suicide.

Conditions

Mental Health; Suicide

Keywords

communication; Veterans; public health; treatment engagement

Outcome Measures

Primary Outcomes (1)

• Treatment Initiation

  yes to initiating psychological treatment and/or medication/pharmacological treatment in the past month to treat mental health issues.

  baseline through 2-month follow-up

Secondary Outcomes (4)

• Mean Change in Beliefs About Mental Health Treatment

  baseline through 2-month follow up

• Mean Change in Intentions to Seek Treatment

  baseline through 2-month follow up

• Mean Change in Perceived Treatment Barriers

  baseline through 2-month follow up

• Mean Change in Normative Beliefs About Seeking Mental Health Care

  baseline through 2-month follow up

Study Arms (3)

Immediate Message Exposure

EXPERIMENTAL

Participants complete baseline (T1) and are randomly assigned to immediately receive 4 study videos over the first month. The exposure period ends and participants complete telephone-based assessments at 1- and 2-month follow up (T2 and T3 respectively). Study videos are delivered by study's mobile app downloaded to participants' own Smartphone.

Behavioral: Messaging

Wait List Control then message exposure at T2

PLACEBO COMPARATOR

Participants complete baseline and are randomly assigned to the waitlist control. While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Following the 1-month follow up (T2), they receive videos over a one month period. The exposure period ends and participants complete the 2-month follow up (T3) assessment by telephone. Videos and push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.

Behavioral: Messaging; Other: Wait list control

Wait List Control then message exposure at T3

PLACEBO COMPARATOR

Participants complete baseline and are randomly assigned to the waitlist control. While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Following completion of the 2 month follow-up (T3), participants receive videos over a one month period. They are not assessed post-exposure. Videos and push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.

Other: Wait list control

Interventions

Messaging BEHAVIORAL

Four brief video messages focused on facilitating treatment seeking. Intervention delivered to participant by study mobile app downloaded to participants' own smartphone.

Immediate Message Exposure; Wait List Control then message exposure at T2

Wait list control OTHER

one push notification each week thanking individuals for participation, informing them that they will receive messages in the near future or reminding them of the length of the study.

Wait List Control then message exposure at T2; Wait List Control then message exposure at T3

Eligibility Criteria

• Age: 18 Years - 89 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• U.S. Veteran that separated from military service in the past 36 months or less (any discharge type);
• \>18 years old;
• experiencing suicide risk;
• low intent to seek help;
• capable of understanding the goals of the study;
• willing and able to provide verbal consent;
• smartphone ownership and willing to download/use study mobile app

You may not qualify if:

• currently (or in the past 12 months) in formal mental health treatment services;
• deemed impaired during eligibility screening;
• currently institutionalized

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Finger Lakes Healthcare System, Canandaigua, NY

Canandaigua, New York, 14424-1159, United States

Location

MeSH Terms

Conditions

Psychological Well-Being; Suicide; Communication

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior; Self-Injurious Behavior; Behavioral Symptoms

Limitations and Caveats

This study represents initial steps to understand how public messages can be used to promote treatment initiation in at-risk populations. Findings may not be generalizable to real world campaign practice. Continued research is needed to assess exposure effects at the population-level, within other contexts and among other at-risk populations.

Results Point of Contact

• Title: Elizabeth Karras
• Organization: Department of Veterans Affairs

elizabeth.karras-pilato@va.gov

585-393-9350

Study Officials

• Elizabeth Karras, PhD

  VA Finger Lakes Healthcare System, Canandaigua, NY

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: CROSSOVER
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: All participants will complete the consent process and baseline assessment by telephone with an RA and are randomized to receive the intervention at either immediately following baseline (T1), at 1-month (T2) or 2-month follow up (T3). Exposure to intervention occurs over a 1-month period.

Study Record Dates

• First Submitted: March 1, 2021
• First Posted: March 5, 2021
• Study Start: December 1, 2022
• Primary Completion: June 30, 2025
• Study Completion: September 30, 2025
• Last Updated: July 9, 2026
• Results First Posted: July 9, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)