# Effectiveness and Implementation of eScreening in Post 9/11 Transition Programs

> **NIH VA I01** · VA SAN DIEGO HEALTHCARE SYSTEM · 2020 · —

## Abstract

Background: Veterans disproportionately account for to 22% of all known suicides in the US. Screening for
suicide risk at the first contact with an organization is a best practice in the national Zero Suicide framework
and vital to enhancing access to appropriate care. Transition Care Management (TCM) programs are
positioned to screen post-9/11 Veterans at the critical moment of enrollment in healthcare. Unfortunately, many
Veterans who present for the first time in VHA with recent suicidal thoughts do not receive same day suicide
risk evaluation (SRE), partly due to cumbersome screening processes. eScreening is a web-based Gold
Standard Promising Practice electronic screening system with real-time scoring and integration into
CPRS/VistA. Our eScreening effectiveness pilot in 1,372 post-9/11 Veterans and our 2-site multicomponent
implementation strategy (MCIS) pilot showed increase speed and rate of SRE and sustainment of eScreening
in two pilot sites. More research is warranted to test both. Significance/Impact: This proposal responds to
HSR&D Priority Areas of: Suicide prevention, Increasing the real-world impact of research, and Implementation
science. Our data will inform best practices in suicide prevention through early identification. This project will
also allow for real-world integration of research into practice and inform implementation efforts for technology.
Innovation: eScreening is a unique program developed with feedback from Veterans. To our knowledge, this
is the first study to integrate VHA developed mobile patient-report screening technology to improve screening
in TCM programs. It is also the first to examine the impact of electronic screening on rates of suicide risk
evaluation and referral to care. Specific Aims: Aim 1. Evaluate the effectiveness of eScreening, compared to
paper and verbal screening, on rate and speed of screening completion (suicide screening & evaluation,
PTSD, depression, alcohol) and referral to mental health care in 8 TCM programs, guided by the RE-AIM
outcomes of PRISM. Aim 2: Evaluate the feasibility, acceptability, and potential impact of the MCIS, guided by
the RE-AIM outcomes of PRISM, adoption, implementation, and maintenance using mixed methods. We will
also document and calculate replication costs across sites. Aim 3. Describe and compare high and low
eScreening reach sites guided by contextual constructs of PRISM using qualitative comparative analysis to
explore factors influencing the reach of eScreening and the use of the eScreening MCIS. Methodology: We
propose an 8 site 4-year, stepped-wedge, mixed-method, Hybrid Type 2, pragmatic trial to compare
eScreening to screening as usual while evaluating potential impact of the MCIS in TMC programs. Aim 1
outcomes will be collected via deidentified chart pull at the start and end of the pre-implementation phase, the
9-month intervention period, and 9-months post intervention. Aim 2 outcomes will be collected quantitatively
from TCM staff questionn...

## Key facts

- **NIH application ID:** 10065205
- **Project number:** 1I01HX003079-01A1
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** James Pittman
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10065205

## Citation

> US National Institutes of Health, RePORTER application 10065205, Effectiveness and Implementation of eScreening in Post 9/11 Transition Programs (1I01HX003079-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10065205. Licensed CC0.

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