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Moecke DP, Holyk T, Beckett M, Chopra S, Petlitsyna P, Girt M, Kirkham A, Kamurasi I, Turner J, Sneddon D, Friesen M, McDonald I, Denson-Camp N, Crosbie S, Camp PG. Scoping review of telehealth use by Indigenous populations from Australia, Canada, New Zealand, and the United States. J Telemed Telecare 2024; 30:1398-1416. [PMID: 36911983 PMCID: PMC11411853 DOI: 10.1177/1357633x231158835] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Telehealth has the potential to address health disparities experienced by Indigenous people, especially in remote areas. This scoping review aims to map and characterize the existing evidence on telehealth use by Indigenous people and explore the key concepts for effective use, cultural safety, and building therapeutic relationships. METHODS A search for published and gray literature, written in English, and published between 2000 and 2022 was completed in 17 electronic databases. Two reviewers independently screened retrieved records for eligibility. For included articles, data were extracted, categorized, and analyzed. Synthesis of findings was performed narratively. RESULTS A total of 321 studies were included. The most popular type of telehealth used was mHealth (44%), and the most common health focuses of the telehealth interventions were mental health (26%) and diabetes/diabetic retinopathy (13%). Frequently described barriers to effective telehealth use included concerns about privacy/confidentiality and limited internet availability; meanwhile, telehealth-usage facilitators included cultural relevance and community engagement. Although working in collaboration with Indigenous communities was the most frequently reported way to achieve cultural safety, 40% of the studies did not report Indigenous involvement. Finally, difficulty to establish trusting therapeutic relationships was a major concern raised about telehealth, and evidence suggests that having the first visit-in-person is a potential way to address this issue. CONCLUSION This comprehensive review identified critical factors to guide the development of culturally-informed telehealth services to meet the needs of Indigenous people and to achieve equitable access and positive health outcomes.
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Affiliation(s)
- Débora Petry Moecke
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Travis Holyk
- Carrier Sekani Family Services, Prince George, Canada
| | - Madelaine Beckett
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sunaina Chopra
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Mirha Girt
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Ivan Kamurasi
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Justin Turner
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Donovan Sneddon
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Ian McDonald
- University of British Columbia (UBC), Vancouver, Canada
| | | | | | - Pat G Camp
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Caughlan C, Kakuska A, Manthei J, Galvin L, Martinez A, Kelley A, Craig Rushing S. Mind4Health: decolonizing gatekeeper trainings using a culturally relevant text message intervention. Front Public Health 2024; 12:1397640. [PMID: 39286750 PMCID: PMC11403716 DOI: 10.3389/fpubh.2024.1397640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024] Open
Abstract
Background When a person dies by suicide, it takes a reverberating emotional, physical, and economic toll on families and communities. The widespread use of social media among youth and adolescents, disclosures of emotional distress, suicidal ideation, intent to self-harm, and other mental health crises posted on these platforms have increased. One solution to address the need for responsive suicide prevention and mental health services is to implement a culturally-tailored gatekeeper training. The Northwest Portland Area Indian Health Board (NPAIHB) developed Mind4Health, an online gatekeeper training (90 min) and text message intervention for caring adults of American Indian/Alaska Native (AI/AN) youth. Methods The Mind4Health intervention was a multi-phase, single-arm, pre-and post-test study of users enrolled in the intervention that is available via text message (SMS) or via a 90 min online, self-paced training. We produced four datasets in this study: Mobile Commons, pre-survey data, post-survey data, and Healthy Native Youth website's Google Analytics. The analysis included data cleaning, basic frequency counts, percentages, and descriptive statistics. Qualitative data were analyzed using thematic content analysis methods and hand-coding techniques with two independent coders. Results From 2022 to 2024, 280 people enrolled in the Mind4Health SMS training, and 250 completed the 8-week intervention. Many messages in the sequence were multi-part text messages and over 21,500 messages were sent out during the timeframe. Of the 280 subscribers, 52 participated in the pre-survey. Pre-survey data show that 94% of participants were female, and nearly one-fourth lived in Washington state, 92% of participants in the pre-survey were very to moderately comfortable talking with youth about mental health (n = 48). Most participants interact with youth in grades K-12. Post-survey data demonstrate changes in knowledge, beliefs, comfort talking about mental health, and self-efficacy among participants. Mind4Health improved participant's skills to have mental health conversations with youth and refer youth to resources in their community.
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Affiliation(s)
- Colbie Caughlan
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Amanda Kakuska
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Jane Manthei
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Lisa Galvin
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Aurora Martinez
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Allyson Kelley
- Allyson Kelley & Associates PLLC, Sisters, OR, United States
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Woods MA, Hampton D, Okoli CTC, Heath J, Moreland G. Pilot Study Focused on Knowledge, Attitudes, and Health Access Behaviors of Psychiatric-Mental Health Nurses Regarding Suicide Prevention. J Am Psychiatr Nurses Assoc 2024; 30:852-857. [PMID: 38653730 DOI: 10.1177/10783903241247216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE: The purpose of this pilot study was to evaluate the effect of a web-based education module on the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in psychiatric-mental health nurses. METHODS: A quasi-experimental pretest-posttest design was employed. Registered nurses from two academic health center units and a 239-bed Psychiatric Hospital were invited to participate. Scores on knowledge of suicide risk and prevention, attitudes, subjective norms, perceived behavioral control, and intent to seek help upon experiencing suicidal ideations were obtained before and after administering a 25-min web-based training. RESULTS: Twenty-nine participants completed the pre-survey, web-based education module, and post-survey. Significant increases from baseline in the scores on knowledge, attitudes, subjective norms, and intentions related to help-seeking behaviors for nurse suicide prevention were noted. Perceived behavioral control median scores increased but were not statistically significant. More than 40% of the participants reported having experienced suicidal thoughts. CONCLUSIONS: Further study is needed to determine contributors to this higher rate. Understanding the effectiveness of strategies to reduce nurse suicide can provide insights into building better nurse suicide prevention programs.
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Affiliation(s)
- Marc A Woods
- Marc A. Woods, DNP, MSN, RN, NEA-BC, UK Healthcare, Lexington, KY, USA
| | - Debra Hampton
- Debra Hampton, PhD, MSN, RN, NEA-BC, CENP, FACHE, FAONL, University of Kentucky, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T. C. Okoli, PhD, MPH, MSN, PMHNP-BC, APRN, NCTTP, FAAN, Eastern State Hospital and University of Kentucky, Lexington, KY, USA
| | - Janie Heath
- Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, University of Kentucky, Lexington, KY, USA
| | - Gwen Moreland
- Gwen Moreland, DNP, RN, NEA-BC, UK Health care, Lexington, KY, USA
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Hicks LJ, Toombs E, Lund J, Kowatch KR, Hopkins C, Mushquash CJ. Expanding our understanding of digital mental health interventions for Indigenous youth: An updated systematic review. J Telemed Telecare 2024:1357633X241239715. [PMID: 38584397 DOI: 10.1177/1357633x241239715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Past research has examined available literature on electronic mental health interventions for Indigenous youth with mental health concerns. However, as there have recently been increases in both the number of studies examining electronic mental health interventions and the need for such interventions (i.e. during periods of pandemic isolation), the present systematic review aims to provide an updated summary of the available peer-reviewed and grey literature on electronic mental health interventions applicable to Indigenous youth. The purpose of this review is to better understand the processes used for electronic mental health intervention development. Among the 48 studies discussed, smoking cessation and suicide were the most commonly targeted mental health concerns in interventions. Text message and smartphone application (app) interventions were the most frequently used delivery methods. Qualitative, quantitative, and/or mixed outcomes were presented in several studies, while other studies outlined intervention development processes or study protocols, indicating high activity in future electronic mental health intervention research. Among the findings, common facilitators included the use of community-based participatory research approaches, representation of culture, and various methods of motivating participant engagement. Meanwhile, common barriers included the lack of necessary resources and limits on the amount of support that online interventions can provide. Considerations regarding the standards and criteria for the development of future electronic mental health interventions for Indigenous youth are offered and future research directions are discussed.
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Affiliation(s)
- Lydia J Hicks
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Kristy R Kowatch
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Carol Hopkins
- Thunderbird Partnership Foundation, Bothwell, ON, Canada
| | - Christopher J Mushquash
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
- Thunder Bay Regional Health Sciences Centre, ON, Canada
- Thunder Bay Regional Health Research Institute, ON, Canada
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Mpofu JJ, Crosby A, Flynn MA, LaFromboise T, Iskander J, Hall JE, Penman-Aguilar A, Thorpe P. Preventing Suicidal Behavior Among American Indian and Alaska Native Adolescents and Young Adults. Public Health Rep 2023; 138:593-601. [PMID: 35856445 PMCID: PMC10291156 DOI: 10.1177/00333549221108986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
From 2009 to 2018, overall suicide rates in the United States increased by 20.3% and increased by 43.5% among non-Hispanic American Indian and Alaska Native (AI/AN) communities. Combining years 2009 through 2018, suicide rates per 100 000 population among non-Hispanic AI/AN adolescents and young adults aged 15 to 34 years were 2 to 4 times higher than those of adolescents and young adults of other races and ethnicities. An estimated 14% to 27% of non-Hispanic AI/AN adolescents attempted suicide during that time. The elevated rates of suicidal behavior among non-Hispanic AI/AN adolescents and young adults reflect inequities in the conditions that create health. In this topical review, we describe school-based educational efforts that are driven by local AI/AN communities, such as the American Indian Life Skills curriculum, that teach stress and coping skills and show promise in reducing suicidal ideation attempts and fatalities among AI/AN adolescents. Using a social-determinants-of-health lens, we review the availability and quality of employment as an important influencer of suicidal behavior, as well as the role of the workplace as an environment for suicide prevention in AI/AN communities. Working with tribal, state, local, and federal colleagues, the public health community can implement programs known to be effective and create additional comprehensive strategies to reduce inequities and ultimately reduce suicide rates.
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Affiliation(s)
- Jonetta J. Mpofu
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- US Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Alex Crosby
- Morehouse School of Medicine, Department of Community Health and Preventative Medicine, Atlanta, GA, USA
| | - Michael A. Flynn
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | | | - John Iskander
- US Public Health Service Commissioned Corps, Rockville, MD, USA
- Office of Science, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffrey E. Hall
- Office of Minority Health and Health Equity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ana Penman-Aguilar
- Office of Minority Health and Health Equity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Phoebe Thorpe
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Pham TV, Fetter AK, Wiglesworth A, Rey LF, Prairie Chicken ML, Azarani M, Riegelman A, Gone JP. Suicide interventions for American Indian and Alaska Native populations: A systematic review of prevention strategies, logics, and rationales. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Pham TV, Fetter AK, Wiglesworth A, Rey LF, Prairie Chicken ML, Azarani M, Riegelman A, Gone JP. Suicide interventions for American Indian and Alaska Native populations: A systematic review of outcomes. SSM - MENTAL HEALTH 2021. [DOI: 10.1016/j.ssmmh.2021.100029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Campos-Castillo C, Thomas BJ, Reyes F, Laestadius LI. Seeking Help From Trusted Adults in Response to Peers' Social Media Posts About Mental Health Struggles: Qualitative Interview Study Among Latinx Adolescents. JMIR Ment Health 2021; 8:e26176. [PMID: 34524088 PMCID: PMC8482171 DOI: 10.2196/26176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rather than confiding in adults about their mental health struggles, adolescents may use social media to disclose them to peers. Disclosure recipients are tasked with deciding whether to alert an adult and, if so, whom to alert. Few studies have examined how adolescents decide on a trusted adult to help a friend who posts on social media about his/her mental health struggles. Moreover, Latinx adolescents are underrepresented in research on social media use, which creates gaps in understanding how social media may influence their well-being. OBJECTIVE This qualitative study presents findings from semistructured interviews with Latinx adolescents to investigate how they seek out trusted adults when a friend posts on social media about their mental health struggles. Specifically, we sought to determine which adult ties they activated, the resources they believed the adult could provide, and the support they expected the adult to provide. METHODS We recruited participants through a nonprofit organization serving the Latinx community (primarily of Mexican origin) located in Milwaukee, Wisconsin. We conducted 43 semistructured interviews, each lasting 60-90 minutes, with Latinx adolescents (25 females, 18 males) aged 13-17 years. All interviews were conducted in English, at the adolescents' request. Using a grounded theory approach, we identified the nature of the relationship between the trusted adult and either the disclosure recipient or distressed friend, and the resources and support the trusted adult is expected to provide. RESULTS Participants nominated adults who were emotionally or physically proximate to either the disclosure recipient or distressed friend, particularly parents (of the recipient and friend) and school staff. However, some felt that not all parents and school staff were emotionally proximate. Adolescents sought trusted adults with access to two resources: experiential knowledge and authority. Some, particularly males, avoided adults with authority because of the risk of punishment and others thought their immigrant parents did not have relevant experiential knowledge to assist them. Interviewees felt that trusted adults with either resource could provide emotional and instrumental support either directly or indirectly, while those with experiential knowledge could provide informational support. Notably, interviews did not problematize the fact that the disclosure occurred on social media when deliberating about adults. CONCLUSIONS To assist a distressed friend posting on social media, Latinx adolescents look not only for trusted adults who are emotionally and physically proximate but also those who have key resources that facilitate support. Efforts should focus on connecting adolescents with trusted adults and training adults who hold positions of authority or experiential knowledge to offer both direct and indirect support. Additionally, efforts should consider how immigrant experiences shape parent-child relations and address the potential long-term consequences of oversurveillance of Latinx youth, particularly males, by school staff for their access to social support.
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Affiliation(s)
| | - Brian Jason Thomas
- Department of Sociology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Felipe Reyes
- Department of Sociology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Linnea Irina Laestadius
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Stotz S, Hebert LE, Brega AG, Lockhart S, Henderson JN, Roubideaux Y, DeSanto K, Moore KR. Technology-based Health Education Resources for Indigenous Adults: A Scoping Review. J Health Care Poor Underserved 2021; 32:318-346. [PMID: 36111137 PMCID: PMC9473312 DOI: 10.1353/hpu.2021.0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Indigenous peoples experience a disparate burden of chronic diseases and lower access to health education resources compared with other populations. Technology can increase access to health education resources, potentially reducing health inequities in these vulnerable populations. Although many Indigenous communities have limited access to the Internet, this barrier is decreasing as tribes and Indigenous-serving organizations work to improve TechQuity. Using Arksey and O'Malley's framework, we conducted a scoping literature review to identify technology-based health education interventions designed for Indigenous adults. We searched multiple databases, limiting papers to those written in English, describing interventions for participants 18 years of age or older, and published between 1999-2020. The review yielded 229 articles, nine of which met eligibility criteria. Findings suggest a paucity of technology-based health education interventions designed for Indigenous peoples and limited testing of the existing resources. Future health disparity research should focus on development and rigorous testing of such interventions.
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Affiliation(s)
- Sarah Stotz
- Centers for American Indian and Alaska Native Health at the Colorado School of Public Health at The University of Colorado Anschutz Medical Campus
| | - Luciana E Hebert
- Institute for Research and Education Advancing Community Health (IREACH) at the Elson S. Floyd College of Medicine at Washington State University
| | - Angela G Brega
- Centers for American Indian and Alaska Native Health at the Colorado School of Public Health at The University of Colorado Anschutz Medical Campus
| | - Steven Lockhart
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) at the Children's Hospital Colorado at The University of Colorado Anschutz Medical Campus
| | - J Neil Henderson
- Memory Keepers Medical Discovery Team at the Department of Family Medicine and Biobehavioral Health at The University of Minnesota Medical School
| | | | | | - Kelly R Moore
- Centers for American Indian and Alaska Native Health at the Colorado School of Public Health at The University of Colorado Anschutz Medical Campus
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Teo AR, Strange W, Bui R, Dobscha SK, Ono SS. Responses to Concerning Posts on Social Media and Their Implications for Suicide Prevention Training for Military Veterans: Qualitative Study. J Med Internet Res 2020; 22:e22076. [PMID: 33124990 PMCID: PMC7665941 DOI: 10.2196/22076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/08/2020] [Accepted: 09/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A "concerning post" is a display of a user's emotional crisis on a social media platform. A better understanding of concerning posts is relevant to suicide prevention, but little is known about social media users' attitudes and responses to concerning posts. Military veterans in the United States are disproportionately affected by suicide, often use social media, and may have exposure to individuals with elevated suicide risk via concerning posts. OBJECTIVE The objective of the study was (1) to obtain insight into whether and how US military veterans respond to members of their social network on social media (ie, "friends") who are experiencing substantial emotional distress, and (2) to identify potential interventions that could assist in users' response to concerning posts. METHODS We recruited veterans through Facebook and conducted semistructured interviews with 30 participants between June and December 2017. We used a summary template for rapid analysis of each interview, followed by double-coding using a codebook based on topic domains from the interview guide. Members of the research team met regularly to discuss emerging patterns in the data, generate themes, and select representative quotes for inclusion in the manuscript. RESULTS Veterans were reluctant to disclose emotional and health issues on Facebook, but they were open to reaching out to others' concerning posts. There was a complex calculus underlying whether and how veterans responded to a concerning post, which involved considering (1) physical proximity to the person posting, (2) relationship closeness, (3) existing responses to the post, and (4) ability to maintain contact with the person. Veterans desired additional training, backed by community-based veteran organizations, in how to respond to concerning posts from peers. CONCLUSIONS There is a need to incorporate features that will help veterans effectively respond to concerning posts from peers into suicide prevention training and to expand access for veterans to such training.
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Affiliation(s)
- Alan R Teo
- Health Services Research and Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- School of Public Health, Oregon Health and Science University and Portland State University, Portland, OR, United States
| | - Wynn Strange
- Health Services Research and Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
| | - Ricky Bui
- Health Services Research and Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
| | - Steven K Dobscha
- Health Services Research and Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Sarah S Ono
- Health Services Research and Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
- Veterans Rural Health Resource Center-Portland, Veterans Health Administration Office of Rural Health, Portland, OR, United States
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, United States
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