The goal of this clinical trial is to study stressed or distressed veterans and service members. Researchers will compare Caring Contacts plus best available resources to best available resources alone to see if reduces distress and prevents thoughts of suicide.
The objective of this study is to evaluate whether Caring Contacts via text message are beneficial to veterans and service members experiencing stress or distress. In the past, Caring Contacts interventions have focused on individuals who are already suicidal and not a more general population. In addition, a core objective of this study is to understand the mechanisms of action of Caring Contacts and thus has included an ecological momentary assessment (EMA) component that will allow us to determine when and how Caring Contacts is making an impact. Study aims are to Evaluate if stressed or distressed veterans receiving Caring Contacts are at greater or less risk of suicidal ideation or behavior as evidenced by: Decreased mean and reduction in variability of indicators of suicide risk (motivation to live, passive ideation, active ideation, suicide intent, and urges to harm self) acquired during Ecological Momentary Assessment periods. Reduced risk of suicidal ideation (HASS-I) and cognitions (SCS-R) during follow-up. Examine diverse veterans' experiences with Caring Contacts (i.e., access, satisfaction, preferences, potential mechanisms) Evaluate if veterans receiving Caring Contacts will show a decrease in distress (i.e., isolation, depression, substance use, loneliness, defeat, hopelessness, and psychological pain) Identify potential mechanisms of action for Caring Contacts by exploring the relationship between potential mechanisms (i.e., mattering, connectedness, social responsibility, and entrapment), distress, and suicide risk observed during ecological momentary assessment periods to identify potential mechanisms of action of Caring Contacts on decreasing distress and suicide risk
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
521
Caring Contacts are brief, periodic messages sent over 1 year that express unconditional care and concern
Participants will be offered information about best available resources and will receive an email summarizing the resources with links and contact information. These resources are tailored to best serve the participant based on information they share during the online survey or during conversations with study staff.
University of Washington
Seattle, Washington, United States
Suicide risk Visual Analog Scales (VAS)
Suicide risk indicators rated on Visual Analog Scales (VAS; 0-10) acquired during Ecological Momentary Assessment periods. Core constructs of suicide risk selected and worded to maximize face validity: motivation to live, passive ideation, active ideation, and urges for suicide. Higher scores indicate higher suicidal risk (motivation to live is reverse coded).
Time frame: 3 EMA assessments/day for 14 days at baseline; then either 3 EMA assessments/day for 7 days at 12 months OR 3 EMA assessments/day for 7 days/month for 12 months (depending on EMA condition)
Suicidal Ideation
Harkavy-Asnis Suicide Scale (HASS-I), adapted version for study procedures. Min=0, max=60, higher scores indicate higher suicidal ideation.
Time frame: Baseline and 12 month follow-up
Suicide Cognitions
Suicide Cognitions Scale - Revised, Min=16, max=80, higher scores indicate more suicidal cognitions.
Time frame: Baseline and 12 month follow-up
Experience of receiving Caring Contacts
Participants will be asked to describe their experiences with Caring Contacts via an online survey and a qualitative interview with a subset of participants
Time frame: 12 month follow-up
Depression
Patient Health Questionnaire-9 (PHQ-9), Min=0, max=30, higher scores indicate higher degree of depression severity.
Time frame: Baseline and 12 month-up
Substance Abuse
Short Inventory of Problems - Alcohol and Drugs (SIP-AD)
Time frame: Baseline and 12 month follow-up
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Loneliness
NIH Loneliness Scale, Min=5, max=25, higher scores indicate increased loneliness.
Time frame: Baseline and 12 month follow-up
Defeat
The Defeat Scale, Min=0, max=64, higher scores indicate greater defeat.
Time frame: Baseline and 12 month follow-up
Hopelessness
Beck's Hopelessness Scale (BHS), Min=0, max=20, higher scores indicate greater hopelessness.
Time frame: Baseline and 12 month follow-up
Psychological Pain
Unbearable Psychache Scale-3 (UPS-3), Min=3, max=15, higher scores indicate greater psychological pain.
Time frame: Baseline and 12 month follow-up