Background. Firearm injury accounts for 70% of Veteran suicides, making safer storage of firearms among Veterans at risk for suicide a top VA & HSR&D priority. Although VA providers encourage Veterans to store their firearms more safely during lethal means safety counseling (LMSC), only about half of individuals follow through on these recommendations. Additionally, little is known about methods for verifying firearm storage practices, which are critical for evaluating LMSC interventions. Research shows that offering financial and social incentives increases behavior change, and the Philadelphia VAMC has led a successful national program providing incentive-based interventions to Veterans with substance use disorders. The use of financial and social incentives to increase safe storage of firearms, however, has not yet been assessed. Significance/Impact. This proposal aims to leverage financial and social incentives to increase Veterans’ safe storage of firearms following LMSC, thereby contributing to VA’s suicide prevention efforts. VA’s existing infrastructure supporting the delivery of both LMSC and incentive-based interventions makes it an ideal setting for this work. Operational partners, including the Office of Mental Health and Suicide Prevention, the Rocky Mountain VA, and the Veterans Rural Health Resource Center support this proposal. Innovation. Financial and social incentives increase behavior change and our pilot work suggests that Veterans and VA clinicians are interested in using incentives to encourage safer storage of firearms. This proposal is the first to examine the use of incentives to change firearm storage behavior. It is also the first to evaluate methods for verifying firearm storage practices, which will provide critical information to researchers developing lethal means safety interventions and clinical providers delivering these interventions. Specific Aims. 1) Consult with stakeholders to determine the most acceptable and feasible intervention protocol that offers Veterans at risk for suicide financial and/or social incentives to store their firearms safely. 2) Pilot test the add-on, incentive-based intervention among Veterans receiving LMSC in VA behavioral health. Methodology. Aims will include participants from the VAMCs in Philadelphia and New Orleans, and will be conducted remotely to facilitate recruitment. Veteran participants will be seen in outpatient behavioral health and have access to firearms; equal numbers will be drawn from urban and rural settings and about a quarter will identify as women and racial/ethnic minorities. Aim 1 will include two steps. First, we will conduct qualitative interviews with ~20 Veterans with recent suicidal ideation, as well as ~10 VA clinicians/administrators. Interviews will evaluate the acceptability and feasibility of potential incentives, methods of verifying firearm storage practices, and other intervention components. Second, we will develop an advisory board made up of 8...