The objective of this HSR&D Career Development Award-2 Proposal is to facilitate Dr. Jason Chen's transition into an independent, VA mental health services research career focused on intervention development for Veterans at high-risk of suicide. The goal of the project is to develop a multicomponent intervention focused on increasing social connectedness among Veterans with recent psychiatric hospitalizations through supported participation in community activities. This intervention will be informed by input from Veteran, VHA clinical (e.g. psychiatrists, administrators), and community (e.g. non-profit organizations, family) stakeholders. Research Plan: Although multiple national efforts have been introduced to address Veteran suicide, suicide rates remain high. Systematic reviews have identified few interventions that effectively decrease suicide risk. One promising area for intervention is social connectedness which has been identified as a strong protective factor. However, few interventions directly target social connectedness among at-risk individuals. Increasing Veteran participation in community activities may be one way to improve social connectedness difficulties. The current project proposes the following research aims: 1) Identify Veterans' current behaviors, needs, and preferences for community engagement following psychiatric hospitalization, 2) Identify VHA staff and community stakeholder perceptions and perceived needs related to Veteran community engagement following psychiatric hospitalization, and 3) Develop and pilot a multicomponent, peer-support facilitated intervention for increasing social connectedness among Veterans at elevated risk of death by suicide. Expected outcomes from these aims include clinical toolkits for VA and community stakeholders, academic manuscripts and presentations, and two HSR&D IIR submissions over the course of the CDA award period. Career Plan: Dr. Chen has assembled a mentorship team who will support his development as a VA mental health services researcher. Team members include: Steven Dobscha, MD (Primary Mentor), Julie Lowery, PhD (Co-Mentor; Implementation Science/Qualitative Methods), Paul Pfeiffer, MD, MS (Co-Mentor; Peer Support Intervention Development), Sarah Ono, PhD (Consultant; Veteran Engagement/Qualitative Methods), and Alan Teo, MD, MS (Consultant; Social Support). Dr. Chen will also have three Operations Partners/Consultants:
Aim ee Johnson, LCSW (Office of Mental Health and Suicide Prevention), Tracy Weistreich, PhD (Office of Community Engagement/Center for Compassionate Intervention), and Jason Zimmerman, CPSC (Peer Support Lead). Dr. Chen and his mentorship team have developed the following training goals which align with his research aims: 1) Develop advanced qualitative health services research skills, 2) Acquire intervention development and evaluation skills for conducting clinical trials, 3) Gain didactic and applied training in implementation science, and 4) Achieve further competence in program development to support effective VA-community collaborations including peer support. Dr. Chen will achieve these training goals through coursework, mentorship/consultant meetings, and applied training during CDA research activities. Following the completion of these training goals, Dr. Chen will be well-prepared to become an independent VA HSR&D mental health services researcher with expertise in utilizing qualitative methodology, clinical trials, implementation science, and program development to enhance current Veteran suicide prevention efforts.
Although multiple national efforts have been introduced to address Veteran suicide, Veteran suicide rates remain high and are elevated compared with the general population. Systematic reviews have identified few interventions that effectively decrease suicide risk. One promising area for intervention is social connectedness, which has been identified as a strong protective factor. However, little research has been done on interventions that directly target social connectedness. Studies also suggest that supported engagement with community activities is associated with positive mental health outcomes, but such strategies have not been studied among Veterans. The current project proposes to develop and pilot a multicomponent, peer- support facilitated intervention for increasing social connectedness through participation in community activities among Veterans at elevated risk of death by suicide.
