Suchergebnisse

Abstract. Background: Communication campaigns offer a portable intervention to effectively reach and engage target populations at risk for suicide including US veterans. Few studies have evaluated such efforts, and still fewer have examined factors that contribute to failed suicide prevention messaging. Aims: We aimed to examine characteristics of suicide prevention messages and persuasive processes that may underlie failed communicative intervention with US veterans. Method: Telephone interviews were completed with veterans ( N = 33) from June to September 2016 using a semi-structured interview guide. Interview transcripts were coded by the authors with NVivo using a constant comparison analytic strategy. Results: Several reasons emerged for why suicide prevention messaging may fail to produce intended responses among veterans. Participants identified message features (e.g., language, images, messenger) and communication strategies that may diminish campaign effects. Limitations: Findings are not generalizable, are limited to participants who used VA healthcare and were not suicidal, and are subject to several biases. Conclusion: This work provides initial insights into barriers to effective message use with veterans.

Purpose: The aim of this investigation was to document the prevalence and correlates of refusing to answer a US federal health survey item about firearms in the household. Design: The cross-sectional analysis was conducted with 2004 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey data from Texas, Oregon, Idaho, California, Kansas, and Utah states whose surveys included items about firearms in the household. Participants: Probability-based samples of adults over the age of 18 (n = 34 488 in 2017 BRFSS; n = 33 136 in 2004 BRFSS). Measures: Dichotomized measure of whether respondents answered versus refused to answer "Are any firearms now kept in or around your home?" Analysis: Weighted multiple logistic regression was used to assess how sociodemographic and health-related characteristics were associated with item refusal. Results: Approximately 1.8% (95% CI: 1.6-2.1) of respondents in 2004 and 3.9% (95% CI: 3.4-4.5) of respondents in 2017 sample refused the firearms item ( P < .01). Men were more likely than women (2004: adjusted odds ratio [aOR] = 1.81, 95% CI: 1.24-2.62; 2017: aOR = 1.60, 95% CI = 1.17-2.18) and Latino/a respondents were less likely than white respondents (2004: aOR = 0.24, 95% CI: 0.10-0.60; 2017: aOR = 0.21, 95% CI: 0.13-0.34) to refuse the firearms question. In 2004, refusal was more likely among older than younger respondents, but in 2017, age was not associated with refusal. Conclusions: Refusal to firearm-related survey items along sociodemographic characteristics warrants further research. Community-informed strategies (eg, focus groups, cognitive testing, in-depth interviews) could improve the context and wording of firearm-related items to maximize response to these items in public health surveys.

BACKGROUND: The objectives of this study were to determine whether short-term exposure to firearm safety messaging significantly improved (1) firearm storage practices, and (2) attitudes of safe firearm storage behaviors among U.S. veterans, a group at elevated risk for firearm suicide. DESIGN: A three-arm, parallel-group RCT was conducted online in the U.S. nationwide from December 2015 to January 2016. SETTING: A national random sample of U.S. veterans (N = 358) was recruited from the GfK KnowledgePanel, a probability-based internet panel representative of U.S. adults. All study activities were administered online over a three-week study period. INTERVENTION: Participants were randomized and exposed three times (once per week) to either (a) firearm safety message only (n = 115); (b) firearm safety and mental health promotion messages (n = 133); or (c) active control group exposed to mental health promotion message only (n = 110). Each message was less than two minutes long. MEASURES: Assessments were completed at baseline (pre-randomization) and at end-of-trial. Changes in awareness of risk for injuries, attitudes/beliefs related to safe storage practices, behavioral intentions, and storage practices were measured using self-reported surveys. Linear mixed effect models with weighted generalized estimating equations were used to test for exposure effects. Analyses were conducted February 2018. RESULTS: Analyses restricted to those with baseline firearm access (n = 195) identified no significant changes for intentions or safe storage practices across exposure groups. At baseline, participants' attitudes and beliefs were generally supportive of safe firearm storage. The Firearm Safety message yielded small increases in agreement with the concept that secure storage is "important during emotional or stressful times" (0.36; 95% CI = 0.08, 0.64). Other significant changes in awareness and beliefs were found, but across all study conditions. CONCLUSION: Results reinforce the critical need for considerable research ...

Abstract. Background: Few studies have considered different messaging strategies that may augment campaign efficacy to generate help-seeking behaviors among populations at increased risk for suicide, mainly US military veterans. Aims: Findings are presented from the pilot evaluation of the It's Your Call campaign implemented by the Department of Veterans Affairs (VA). Three messaging strategies (with varying intensity and mix of messages) were compared to explore which best promote use of the Veterans Crisis Line (VCL) among veteran populations. Method: Daily VCL call data were obtained for 10 US cities during 2011–2012 where the campaign was active, and modeled using Poisson regression to identify changes in utilization patterns associated with the implementation of different messaging strategies. Results: Significant increases in call rates were only evident during the campaign in communities where mixed messages were disseminated. Further, use of mixed messages yielded greater increases in call rates when compared with the other tested strategies. This was an observational study where identification of causal relationships between variables was limited. Conclusion: Findings are encouraging as messaging was associated with help seeking, and they provide insights into strategies that may rapidly promote crisis line use. Results also underscore the need for further research on suicide prevention campaigns and dissemination practices.

Abstract. Background: Crisis support services have historically been offered by phone-based suicide prevention hotlines, but are increasingly becoming available through alternative modalities, including Internet chat and text messaging. Aims: To better understand differences in the use of phone and chat/text services. Method: We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to veterans in crisis. Results: Responders indicated that veterans may access the chat/text service primarily for reasons that included a desire for anonymity and possible inability to use the phone. Responders were divided on whether callers and chatters presented with different issues or risk of suicide; however, they suggested that veterans frequently use chat/text to make their first contact with mental health services. Limitations: We spoke with call responders, not the veterans themselves. Additionally, as this is qualitative research, applicability to other settings may be limited. Conclusion: While new platforms offer promise, participants also indicated that chat services can supplement phone lines, but not replace them.