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NIH grant 1I01RD000657-01A2: Improving Secure Storage of Firearms to Reduce Suicide Deaths: A Hybrid Type 1Implementation Effectiveness Randomized Controlled Trial of the Family Firearms SafetyTraining (FFAST) Intervention
Institute: {'code': 'VA', 'abbreviation': 'VA', 'name': 'Veterans Affairs', 'admin_org_id': '12500964', 'admin_funding_url': ''}. PI: Bryann DeBeer. Award: $.
Start: 2026-10-01T00:00:00.
Significance to VA: Firearm injuries are the most common lethal means in Veteran suicides (73%; VA,
2024). Storing firearms unlocked and/or loaded is associated with greater risk for suicide via firearm. Time
and distance from firearms are critical, especially when an individual may be experiencing a crisis
exacerbated by an existing mental health condition. New suicide prevention interventions are needed that
reach individuals before the onset of a mental health crisis, and Veterans indicate they desire to include a
concerned significant other (CSO; e.g., family member, friend) in their suicide prevention care. Innovation
and Impact: Aligned with the VA National Strategy for Suicide Prevention goal of to developing programs
that promote Veteran well-being, prevent suicide, and establish contingencies to reduce access to lethal
means in the onset of suicide-related behaviors, the goal of this proposed study is to evaluate The Family
FireArms Secure Storage Training (FFAST). The FFAST intervention is a single-session lethal means
safety intervention, developed through stakeholder engagement, that incorporates the participation of a
CSO to facilitate secure firearm storage prior to a mental health crisis. FFAST consists of four primary
components: 1) CSO Involvement: participants are briefed on the importance and role of the CSO in the
intervention, how they serve as an encouraging support person for the Veteran; 2) Psychoeducation:
throughout the intervention, participants are briefed and engage in discussions on mental health
symptoms, suicide warning signs, Veteran suicide rates and lethal means, and benefits of secure storage;
3) Secure Firearm Storage: educate and explore secure storage options with participants; and 4) Crisis
Situation: participants navigate through a mock crisis scenario to practice their newly developed safety
plan and increase comfort in discussing mental health and suicidal crisis. After being tested in two pilots
(Suicide Prevention Research Impact Network [SPRINT], VA Health Sciences Research and Development
[HSR], & VA Office of Suicide Prevention [OSP], PI: DeBeer), collected data indicate the intervention is
acceptable and feasible, and recruitment and retention procedures have been refined for future
comparative testing and implementation. Specific Aims: Objective 1) Examine the relative effectiveness
of FFAST against both active (i.e., Health and Stress Counseling) and waitlist control condition in
increasing secure firearm storage within Veterans over time, as well as increasing CSOs’ willingness to
address a mental health crisis experienced by the Veteran; and Objective 2) Identify the barriers and
facilitating factors of implementing the FFAST intervention within the VA Caregiver Support Program and
Suicide Prevention 2.0. Methodology: Utilizing a 3-arm dynamic waitlist hybrid type I
implementation/effectiveness randomized controlled trial (RCT) design, Veterans (n = 88) who store
firearms in their home unlocked and/or loaded, and their CSOs (n = 88) will be recruited and randomly
assigned to complete one of the three arms. Outcomes assessed at 1-,3-, and 6-month follow-up will
include prevalence of engagement in secure firearm storage planning, practices (e.g., increases in locked
and/or unloaded firearms or removal from home for safety), and mental health crisis preparedness in
Veterans and their CSOs. In addition, a formative evaluation via key informant qualitative interviews with
VA Caregiver Program and Suicide Prevention 2.0 providers and administrators (N = 20) will be conducted
to facilitate future implementation efforts. Further, in-depth qualitative interviews will be conducted with a
sub-set of Veterans and CSOs to understand their experiences with the intervention and inform
implementation efforts. Path to Translation/Implementation: This trial will be the next step in our overall
aim to prevent veteran suicide through an upstream, evidence-based suicide prevention intervention, and
pave the way for FFAST to be disseminated and implemented widely across the VA.document fetched 2026-10-24 02:46