# Development and Testing of a Veteran-Centered Lethal Means Safety Suicide Prevention Intervention

> **NIH VA IK2** · VA EASTERN COLORADO HEALTH CARE SYSTEM · 2021 · —

## Abstract

Background: Seventeen Veterans die by suicide on a daily basis, and Veterans often seek care in Emergency
Departments (EDs) prior to a suicide attempt. Lethal means safety (LMS) interventions, which aim to reduce
access to common methods of suicide such as firearms or toxic medications, are considered important
components of suicide prevention programs and are recommended for Veterans with elevated suicide risk.
Significance/Impact: The Veterans Health Administration (VHA) considers suicide prevention a clinical and
research priority. In 2019, VHA began screening all Veterans seeking ED care for elevated suicide risk. The
VA’s National Strategy for Preventing Veteran Suicide highlights “efforts to reduce access to lethal means of
suicide among Veterans with identified suicide risk.” However, no LMS intervention has been developed to
accompany this initiative and prior LMS interventions have not been developed for US Veterans or VHA
settings. The proposed work will address this critical gap in VHA suicide prevention efforts by developing and
testing a Veteran-centered, ED-based LMS intervention for multiple methods of suicide.
Innovation: Several evidence gaps must be addressed in developing such an intervention. No prior LMS
intervention has been shown to be efficacious in promoting medication and firearm safety, and prior
interventions have not accounted for the various, person-specific mechanisms by which individuals change
behaviors. The proposed intervention will incorporate multiple evidence-informed elements specifically chosen
to target different but complimentary behavioral mechanisms highlighted within the Health Belief Model (e.g.,
self-efficacy) as critical to behavior change. Elements include those that equip staff with evidence-based
communication strategies, and provide Veterans with practical, patient-centered support to facilitate LMS
behaviors. To ensure that this intervention meets the needs of at-risk ED patients and is sustainable long-term
if shown to be efficacious, we will engage Veteran and clinical stakeholders to develop the intervention.
Engaging stakeholders in intervention development, an emerging VHA priority, is critical for ensuring feasibility,
acceptability, and credibility. As one Veteran remarked during a focus group, “I appreciate you all askin’ us
what we’re thinkin’, rather than just sayin’, ya know, here’s what it is and here’s what it’s gonna be.”
Specific Aims and Methodology:
Aim 1: Identify contextual factors that may inform development of the intervention. I will conduct semi-
structured qualitative interviews with up to 30 at-risk Veterans who recently received VHA ED care to identify
intrapersonal, interpersonal, and institutional factors that should be considered during intervention refinement
and adaptation in Aim 2.
Aim 2: Leverage the expertise of a diverse sample of stakeholders to refine intervention elements, adapt them
for use among Veterans and within VHA EDs, and develop a final interventio...

## Key facts

- **NIH application ID:** 10184090
- **Project number:** 1IK2HX002861-01A2
- **Recipient organization:** VA EASTERN COLORADO HEALTH CARE SYSTEM
- **Principal Investigator:** Joseph A Simonetti
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10184090

## Citation

> US National Institutes of Health, RePORTER application 10184090, Development and Testing of a Veteran-Centered Lethal Means Safety Suicide Prevention Intervention (1IK2HX002861-01A2). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10184090. Licensed CC0.

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