Partnered Implementation Evaluation of a National Sponsorship Program for Transitioning Service Members ( PEC 20-170)

Summary

Background: The United States is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a "deadly gap" for them. In response, the nation has developed strategies that emphasize a preventive, universal and public health approach and embrace the value of community interventions. The three-step theory of suicide suggests that community interventions that reduce pain from reintegration difficulties and promote connectedness for Veterans as they transition to civilian life have the greatest likelihood of success. Recent research shows that the effectiveness of community interventions can be enhanced when augmented by volunteer and certified sponsors (1-on-1) who actively engage with Veterans, as part of the Veterans Affairs' Transitioning Servicemember/Veteran (TSMV) Sponsorship Initiative. Method/Design: The purpose of this trial is to determine how to implement the Veteran Sponsorship Initiative in six cities in Texas in collaboration with the US Department of Defense, VA, Texas government, and local stakeholders. Texas is an optimal location for this large-scale implementation as it has the second largest population of Veterans aged 18-to-34-years-old and is home to the largest US military installation, Fort Hood. The first aim is to further determine the effectiveness of the Sponsorship Initiative, as evidenced by measures of proximal variables (reintegration difficulties, health/psychological distress, VA healthcare utilization and connectedness) and distal variables (suicidal ideation and behaviors). The second aim is to determine how best to implement the Veteran Sponsorship Initiative in Texas with the intent of future expansion in more states. TSMVs (n=630) will be recruited from military installations six months prior to discharge and prior to moving to target cities. The evaluators are utilizing implementation strategies, such as building community partnerships and external facilitation. Evaluation will be conducted through interviews with TSMVs and periodic reflections with key stakeholders to identify barriers, facilitators, and adaptations. Outcome evaluations will be conducted with TSMVs completing surveys and data collection from working with stakeholders. Discussion: This evaluation will have important implications for the national implementation of community interventions that address the epidemic of TSMV suicide. Aligned with the Evidence Act, it is the first large-scale implementation of an evidence-based practice that conducts a thorough assessment of TSMVs during the "deadly gap".

Description

Eligibility

Age range

18+ years

Sex

All

Healthy volunteers

Yes

Interventions

• Behavioral
  Veteran Sponsorship Initiative

  Consistent with preventive, universal and public health approaches to suicide, the VA's TSMV Sponsorship Initiative establishes public-private partnerships with federal and community organizations to provide TSMVs with one-on-one, certified and volunteer sponsors in their post-military hometowns. Sponsors are assigned approximately six months prior to discharge and help TSMVs to accomplish reintegration tasks pre-and post-discharge. After certification, sponsors are assigned to and managed by a community integration coordinator (CIC), which is a local organization. CICs recruit sponsors, manage sponsors and match sponsors with TSMVs moving to the local region. After being matched with a TSMV, sponsors then integrate their skills during regular contact with matched TSMVs and monthly video or in-person sessions and help TSMVs identify SMART goals and develop reintegration action plans and ensure TSMVs attend VA healthcare appointments.

Locations (2)