3 - (SYM 118) Engaging Primary Care Clinicians and Stakeholders to Inform the Development of a Brief, Motivational Interviewing-based Intervention to Promote Secure Firearm Storage

Firearm injury accounts for 72% of veteran suicide deaths and is a critical area for prevention intervention. Lethal means safety is one of the few empirically- and Veteran-supported approaches for reducing firearm suicide risk. Limiting access to lethal means through improving the security of firearm storage reduces suicide risk by allowing brief episodes of acute distress to resolve prior to being able to act on an urge for suicide.

Primary care settings is a critical setting for lethal means safety counseling for secure firearm storage. In the month prior to suicide death, the majority of Veteran suicide decedents were seen in primary care, and were twice as likely to be seen in primary care settings compared to mental health settings. While primary care is an essential setting in which to extend lethal means safety counseling for suicide prevention, it can be a particularly challenging environment in which to incorporate novel interventions. In order to reduce the likelihood that a novel intervention can be incorporated into workflow, it is essential to engage key stakeholders and partners.

We iteratively engaged 32 primary care stakeholders, including veterans, clinicians, and clinic leaders to inform the development of a brief, motivational interviewing-based lethal means safety counseling intervention to address firearm storage for use in primary care settings. Stakeholders felt highly motivated and committed to providing lethal means safety counseling but suggested more practice and structure for delivering it might increase confidence. They stressed the importance of a lethal means safety intervention being brief to improve feasibility, and stated that sample language, role play scenarios, and a tangible tool could support clinicians in offering lethal means safety counseling

In this presentation, we will highlight how the stakeholder engagement influenced the intervention development process and receptivity of the intervention, as well as synthesize lessons learned and continued challenges about engaging stakeholders integrated suicide prevention research.