# Incentivizing Lethal Means Safety Among Veterans at Risk for Suicide

> **NIH VA I01** · PHILADELPHIA VA MEDICAL CENTER · 2024 · —

## Abstract

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...

## Key facts

- **NIH application ID:** 10749229
- **Project number:** 1I01HX003680-01A1
- **Recipient organization:** PHILADELPHIA VA MEDICAL CENTER
- **Principal Investigator:** Gabriela Kattan Khazanov
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-03-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10749229

## Citation

> US National Institutes of Health, RePORTER application 10749229, Incentivizing Lethal Means Safety Among Veterans at Risk for Suicide (1I01HX003680-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10749229. Licensed CC0.

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