Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial
Abstract Background The USA is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a “deadly gap.” In response, the nation has develope...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Implementation Science |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13012-022-01212-9 |
| _version_ | 1818518775720312832 |
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| author | Joseph C. Geraci Erin P. Finley Emily R. Edwards Sheila Frankfurt A. Solomon Kurz Nipa Kamdar Megan E. Vanneman Leonard M. Lopoo Hannah Patnaik Jean Yoon Nicholas Armstrong Ashley L. Greene Gilly Cantor Joseph Wrobleski Erin Young Matthew Goldsmith Richard W. Seim Marianne Goodman |
| author_facet | Joseph C. Geraci Erin P. Finley Emily R. Edwards Sheila Frankfurt A. Solomon Kurz Nipa Kamdar Megan E. Vanneman Leonard M. Lopoo Hannah Patnaik Jean Yoon Nicholas Armstrong Ashley L. Greene Gilly Cantor Joseph Wrobleski Erin Young Matthew Goldsmith Richard W. Seim Marianne Goodman |
| author_sort | Joseph C. Geraci |
| collection | DOAJ |
| description | Abstract Background The USA is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a “deadly gap.” In response, the nation has developed strategies that emphasize a preventive, universal, and public health approach and embrace the value of community interventions. The three-step theory of suicide suggests that community interventions that reduce reintegration difficulties and promote connectedness for Veterans as they transition to civilian life have the greatest likelihood of reducing suicide. Recent research shows that the effectiveness of community interventions can be enhanced when augmented by volunteer and certified sponsors (1-on-1) who actively engage with Veterans, as part of the Veteran Sponsorship Initiative (VSI). Method/design The purpose of this randomized hybrid type 2 effectiveness-implementation trial is to evaluate the implementation of the VSI in six cities in Texas in collaboration with the US Departments of Defense, Labor and Veterans Affairs, Texas government, and local stakeholders. Texas is an optimal location for this large-scale implementation as it has the second largest population of these young Veterans and is home to the largest US military installation, Fort Hood. The first aim is to determine the effectiveness of the VSI, as evidenced by measures of reintegration difficulties, health/psychological distress, VA healthcare utilization, connectedness, and suicidal risk. The second aim is to determine the feasibility and potential utility of a stakeholder-engaged plan for implementing the VSI in Texas with the intent of future expansion in more states. The evaluators will use a stepped wedge design with a sequential roll-out to participating cities over time. Participants (n=630) will be enrolled on military installations six months prior to discharge. Implementation efforts will draw upon a bundled implementation strategy that includes strategies such as ongoing training, implementation facilitation, and audit and feedback. Formative and summative evaluations will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and will include interviews with participants and periodic reflections with key stakeholders to longitudinally identify barriers and facilitators to implementation. Discussion This evaluation will have important implications for the national implementation of community interventions that address the epidemic of Veteran suicide. Aligned with the Evidence Act, it is the first large-scale implementation of an evidence-based practice that conducts a thorough assessment of TSMVs during the “deadly gap.” Trial registration ClinicalTrials.gov ID number: NCT05224440 . Registered on 04 February 2022. |
| first_indexed | 2024-12-11T01:14:53Z |
| format | Article |
| id | doaj.art-a281864f5f2940d78157a96985926232 |
| institution | Directory Open Access Journal |
| issn | 1748-5908 |
| language | English |
| last_indexed | 2024-12-11T01:14:53Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science |
| spelling | doaj.art-a281864f5f2940d78157a969859262322022-12-22T01:25:56ZengBMCImplementation Science1748-59082022-07-0117111410.1186/s13012-022-01212-9Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trialJoseph C. Geraci0Erin P. Finley1Emily R. Edwards2Sheila Frankfurt3A. Solomon Kurz4Nipa Kamdar5Megan E. Vanneman6Leonard M. Lopoo7Hannah Patnaik8Jean Yoon9Nicholas Armstrong10Ashley L. Greene11Gilly Cantor12Joseph Wrobleski13Erin Young14Matthew Goldsmith15Richard W. Seim16Marianne Goodman17Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterCenter of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical CenterTransitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterCenter of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical CenterCenter of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical CenterCenter for Innovations in Quality, Effectiveness and Safety, VAInformatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care SystemDepartment of Public Administration and International Affairs, Syracuse UniversityDepartment of Public Administration and International Affairs, Syracuse UniversityVA Health Economics Resource Center, VA Palo Alto Healthcare SystemInstitute for Veterans and Military Families, Syracuse UniversityTransitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterInstitute for Veterans and Military Families, Syracuse UniversityTransitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterTransitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterTransitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterCenter of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical CenterTransitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical CenterAbstract Background The USA is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a “deadly gap.” In response, the nation has developed strategies that emphasize a preventive, universal, and public health approach and embrace the value of community interventions. The three-step theory of suicide suggests that community interventions that reduce reintegration difficulties and promote connectedness for Veterans as they transition to civilian life have the greatest likelihood of reducing suicide. Recent research shows that the effectiveness of community interventions can be enhanced when augmented by volunteer and certified sponsors (1-on-1) who actively engage with Veterans, as part of the Veteran Sponsorship Initiative (VSI). Method/design The purpose of this randomized hybrid type 2 effectiveness-implementation trial is to evaluate the implementation of the VSI in six cities in Texas in collaboration with the US Departments of Defense, Labor and Veterans Affairs, Texas government, and local stakeholders. Texas is an optimal location for this large-scale implementation as it has the second largest population of these young Veterans and is home to the largest US military installation, Fort Hood. The first aim is to determine the effectiveness of the VSI, as evidenced by measures of reintegration difficulties, health/psychological distress, VA healthcare utilization, connectedness, and suicidal risk. The second aim is to determine the feasibility and potential utility of a stakeholder-engaged plan for implementing the VSI in Texas with the intent of future expansion in more states. The evaluators will use a stepped wedge design with a sequential roll-out to participating cities over time. Participants (n=630) will be enrolled on military installations six months prior to discharge. Implementation efforts will draw upon a bundled implementation strategy that includes strategies such as ongoing training, implementation facilitation, and audit and feedback. Formative and summative evaluations will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and will include interviews with participants and periodic reflections with key stakeholders to longitudinally identify barriers and facilitators to implementation. Discussion This evaluation will have important implications for the national implementation of community interventions that address the epidemic of Veteran suicide. Aligned with the Evidence Act, it is the first large-scale implementation of an evidence-based practice that conducts a thorough assessment of TSMVs during the “deadly gap.” Trial registration ClinicalTrials.gov ID number: NCT05224440 . Registered on 04 February 2022.https://doi.org/10.1186/s13012-022-01212-9Veteran Sponsorship InitiativeReintegration difficultiesSuicide preventionConnectednessVA utilizationCommunity intervention |
| spellingShingle | Joseph C. Geraci Erin P. Finley Emily R. Edwards Sheila Frankfurt A. Solomon Kurz Nipa Kamdar Megan E. Vanneman Leonard M. Lopoo Hannah Patnaik Jean Yoon Nicholas Armstrong Ashley L. Greene Gilly Cantor Joseph Wrobleski Erin Young Matthew Goldsmith Richard W. Seim Marianne Goodman Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial Implementation Science Veteran Sponsorship Initiative Reintegration difficulties Suicide prevention Connectedness VA utilization Community intervention |
| title | Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial |
| title_full | Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial |
| title_fullStr | Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial |
| title_full_unstemmed | Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial |
| title_short | Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness—implementation trial |
| title_sort | partnered implementation of the veteran sponsorship initiative protocol for a randomized hybrid type 2 effectiveness implementation trial |
| topic | Veteran Sponsorship Initiative Reintegration difficulties Suicide prevention Connectedness VA utilization Community intervention |
| url | https://doi.org/10.1186/s13012-022-01212-9 |
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