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. 2022 Sep 5:30:100993.
doi: 10.1016/j.conctc.2022.100993. eCollection 2022 Dec.

Feasibility of recruitment and retention in a remote trial of gatekeeper training for close supports of military veterans: Mixed methods study

Alan R Teo  1   2 , Aaron A Call  1 , Elizabeth R Hooker  1 , Clarissa Fong  3 , Elizabeth Karras  4 , Steven K Dobscha  1   2
Affiliations

Feasibility of recruitment and retention in a remote trial of gatekeeper training for close supports of military veterans: Mixed methods study

Alan R Teo et al. Contemp Clin Trials Commun. .

Abstract

Background: VA S.A.V.E. (Signs; Ask; Validate; Encourage/Expedite) is a gatekeeper training, designed to teach individuals how to identify and assist military veterans at risk for suicide. The aim of this pilot was to determine feasibility, barriers, and facilitators of recruitment and retention in a remote trial of VA S.A.V.E.

Methods: We recruited close supports (family and friends) of veterans through Facebook sponsored ads, automatically randomized them to VA S.A.V.E. or an unrelated video training, and followed them for six months. A subgroup completed interviews, and we used a mixed methods framework to integrate quantitative and qualitative findings.

Results: Of 214 participants, 61% were spouses or partners of veterans and 48% knew at least one veteran who had died by suicide. Of the three a priori feasibility benchmarks, two were achieved (enrollment, on average, of twenty participants per week and less than 50% loss to follow-up at the 6-month study endpoint) and one was not (enrollment of at least 50% of eligible individuals). There were three barriers (generic ads, ad text referring to "research," and Facebook as an ad platform) and five facilitators (audience segmentation focused on veterans' family members and friends, an urgent call to action to help a veteran, prior exposure to suicide, emphasizing the benefit of receiving training, and using a university as the campaign messenger) to study participation.

Conclusion: A fully remote trial of VA S.A.V.E. gatekeeper training was feasible in a population of close supports of veterans. Several strategies may further enhance study participation.

Keywords: Caregiver; Social media; Veterans; Virtual; suicide.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Examples of sponsored ads in the close support (LEFT) and veteran (RIGHT) audience segments.
Fig. 2
Fig. 2
Recruitment data and key campaign milestones (A through G) during the 10-week paid media campaign (March 13, 2021 to May 24, 2021). Results are shown as n. A: Recruitment launched targeting Veteran and Close Support audiences, each with two different ads; B: Campaign paused, C: Recruitment re-launched for Veteran audience only with four new ads; D: Recruitment re-launched for close support audience using original ad; E: Veteran audience ads discontinued; F: Budget adjusted to be split more evenly between Veteran and Close Support ads – both targeting the Close Support audience; G: Recruitment ended.
Fig. 3
Fig. 3
Participant flow through the study.
Fig. 4
Fig. 4
Joint display of: quotations and themes from interviews (TOP); and a heat map showing the number of participants recruited in each state (BOTTOM). Together these data illustrate the influence of geography and institutional awareness on credibility and trust of the campaign.
See this image and copyright information in PMC

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