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Implementing eScreening for suicide prevention in VA post-9/11 transition programs using a stepped-wedge,
James O E Pittman1,2,3, Laurie Lindamer4,5,6, Niloofar Afari4,5,6
1VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr, San Diego, CA, USA. james.pittman@va.gov.
Implementation Science Communications
|April 30, 2021
Summary
Implementing eScreening for Post-9/11 veterans improves suicide risk detection and referral rates. This study evaluates eScreening and a multicomponent implementation strategy for better mental health care access.
Area of Science:
- Implementation Science
- Health Services Research
- Mental Health Screening
Background:
- Post-9/11 veterans accessing VA healthcare often exhibit suicidal ideation or behavior.
- Current screening methods frequently fail to detect suicide risk upon enrollment.
- Early detection and treatment referral are crucial for decreasing suicide risk.
Purpose of the Study:
- To evaluate the impact of eScreening on the rate and speed of suicide risk screening and referral compared to usual care.
- To assess the effectiveness of a multicomponent implementation strategy (MCIS) on eScreening adoption and sustainability.
- To explore contextual factors influencing eScreening implementation across different sites.
Main Methods:
- An eight-site, 4-year, stepped-wedge, mixed-method, hybrid type-II implementation trial.
- Comparison of eScreening versus usual screening methods in transition and care management (TCM) programs.
- Mixed methods approach using medical record data, staff questionnaires, and qualitative interviews, guided by RE-AIM and PRISM frameworks.
Main Results:
- eScreening is expected to improve rates and speed of screening for PTSD, depression, alcohol use, and suicide.
- Increased referral rates to mental health treatment are anticipated with eScreening implementation.
- The MCIS is being evaluated for its feasibility, acceptability, and impact on eScreening adoption and maintenance.
Conclusions:
- Study findings will identify best practices for suicide prevention screening in Post-9/11 veterans.
- Results will inform the optimal implementation of technology-based screening in clinical settings.
- This research aims to enhance the integration of effective suicide risk screening into VA healthcare.
