Development of the Veterans Crisis Line Caring Letters Suicide Prevention Intervention. 2022

Mark A Reger, and Mary Grace Lauver, and Caitlin Manchester, and Traci H Abraham, and Sara J Landes, and Melissa M Garrido, and Cameron Griffin, and Jack A Woods, and Kiersten L Strombotne, and Gregory Hughes
Mental Health Service Line, VA Puget Sound Health Care System, Seattle, Washington, USA.

To describe the design, implementation, and plans to evaluate the Veterans Crisis Line (VCL) Caring Letters intervention. Veterans with VCL contact and VHA service utilization. Caring Letters is an evidence-based post-acute care suicide prevention intervention in which brief messages are mailed to individuals at high risk of suicide repeatedly over time to communicate that people care about them and are concerned for their well-being. An effectiveness-implementation hybrid type 1 trial using the RE-AIM evaluation framework is underway to examine the use of Caring Letters with veterans who contact the VCL. A team of suicide prevention subject matter experts, researchers, and operational partners from the VCL will evaluate the effects of Caring Letters on clinical outcomes and Department of Veterans Affairs - Veterans Health Administration (VHA) clinical utilization rates and examine facilitators and barriers to implementing the Caring Letters campaign. Veterans who contact the VCL are linked with national administrative VHA data. Semi-structured interviews were conducted as part of a qualitative formative evaluation. In the first 12 months of the intervention, Caring Letters have been sent to over 100,000 veterans with VCL contact (over 500,000 letters mailed). A formative qualitative evaluation early in implementation revealed a variety of positive veteran perspectives on the intervention. Partnered program design and evaluation with a high level of stakeholder engagement and participant feedback can result in a rigorous and feasible evaluation plan that improves implementation processes and produces actionable results. The initial results of this evaluation will be used to better inform care in the VHA and, specifically, the VCL.

UI MeSH Term Description Entries
D011177 Postal Service The functions and activities carried out by the U.S. Postal Service, foreign postal services, and private postal services such as Federal Express. Mail,Mail Distribution,Mail-Order,Service, Postal,Distribution, Mail,Distributions, Mail,Mail Distributions,Mail Order,Mail-Orders,Mails,Postal Services,Services, Postal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000092864 Suicide Prevention Specific strategies for averting suicides. These include mental HEALTH PROMOTION and monitoring PSYCHOLOGICAL WELL-BEING and other intervention programs targeting susceptible individuals. Suicide Awareness,Awareness, Suicide,Prevention, Suicide,Suicide Preventions
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014493 United States Department of Veterans Affairs A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position. United States Veterans Administration,Veterans Administration (U.S.),Veterans Affairs (U.S.),United States Veterans' Administration,United States. Dept. of Veterans Affairs,Veterans Administration
D014728 Veterans Former members of the armed services. Veteran

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