Trial Outcomes & Findings for Public Messaging to Increase Treatment Seeking for Veterans at Risk for Suicide (NCT NCT04784663)
NCT ID: NCT04784663
Last Updated: 2026-07-09
Results Overview
yes to initiating psychological treatment and/or medication/pharmacological treatment in the past month to treat mental health issues.
COMPLETED
NA
355 participants
baseline through 2-month follow-up
2026-07-09
Participant Flow
A national random sample was recruited for the trial from December 2022 through April 2025 using the VA and DoD administrative records of those who recently separated from active components of service branches plus activated National Guard/Reservists. These records were queried monthly to randomly select individuals for recruitment, which involved emailing a flyer with a link to a Qualtrics study screener. Follow-up telephone calls were made to enroll those interested and eligible.
Participant milestones
| Measure |
Immediate Message Exposure
Participants complete baseline (T1), are randomized, and immediately receive 4 study videos over the first month. The exposure period ends and participants complete telephone-based assessments at 1- and 2-month follow up (T2 and T3, respectively). Study videos are delivered by the study's mobile app downloaded to the participants' own SmartPhone.
Messaging: Four brief video messages that feature stories focused on the decision to seek mental health treatment.
|
Wait List Control Then Message Exposure at T2
Participants complete baseline and are randomized to the arm, "wait list control then message exposure at T2." While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Following completion of the 1-month assessment (T2), participants receive videos over 1 month period. The exposure period ends and participants complete the 2-month follow up (T3) by telephone. Videos and push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.
|
Wait List Control Then Exposure at T3
Participants complete baseline and are randomized to the arm, "wait list control then message exposure at T3." While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Following completion of the 2-month assessment (T3), participants receive videos over 1 month period. The exposure period ends. There is no subsequent assessment following exposure.
|
|---|---|---|---|
|
Baseline (T1)
STARTED
|
123
|
116
|
116
|
|
Baseline (T1)
Assigned Intervention
|
123
|
0
|
0
|
|
Baseline (T1)
COMPLETED
|
123
|
116
|
116
|
|
Baseline (T1)
NOT COMPLETED
|
0
|
0
|
0
|
|
1-month Follow-up (T2)
STARTED
|
123
|
116
|
116
|
|
1-month Follow-up (T2)
Assigned Intervention
|
0
|
106
|
0
|
|
1-month Follow-up (T2)
COMPLETED
|
107
|
106
|
111
|
|
1-month Follow-up (T2)
NOT COMPLETED
|
16
|
10
|
5
|
|
2 Month Follow-up (T3)
STARTED
|
107
|
106
|
111
|
|
2 Month Follow-up (T3)
Assigned Intervention
|
0
|
0
|
107
|
|
2 Month Follow-up (T3)
COMPLETED
|
102
|
103
|
107
|
|
2 Month Follow-up (T3)
NOT COMPLETED
|
5
|
3
|
4
|
|
Analysis
STARTED
|
123
|
116
|
116
|
|
Analysis
COMPLETED
|
123
|
116
|
116
|
|
Analysis
NOT COMPLETED
|
0
|
0
|
0
|
Reasons for withdrawal
| Measure |
Immediate Message Exposure
Participants complete baseline (T1), are randomized, and immediately receive 4 study videos over the first month. The exposure period ends and participants complete telephone-based assessments at 1- and 2-month follow up (T2 and T3, respectively). Study videos are delivered by the study's mobile app downloaded to the participants' own SmartPhone.
Messaging: Four brief video messages that feature stories focused on the decision to seek mental health treatment.
|
Wait List Control Then Message Exposure at T2
Participants complete baseline and are randomized to the arm, "wait list control then message exposure at T2." While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Following completion of the 1-month assessment (T2), participants receive videos over 1 month period. The exposure period ends and participants complete the 2-month follow up (T3) by telephone. Videos and push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.
|
Wait List Control Then Exposure at T3
Participants complete baseline and are randomized to the arm, "wait list control then message exposure at T3." While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Following completion of the 2-month assessment (T3), participants receive videos over 1 month period. The exposure period ends. There is no subsequent assessment following exposure.
|
|---|---|---|---|
|
1-month Follow-up (T2)
Lost to Follow-up
|
16
|
10
|
5
|
|
2 Month Follow-up (T3)
Lost to Follow-up
|
5
|
3
|
4
|
Baseline Characteristics
Public Messaging to Increase Treatment Seeking for Veterans at Risk for Suicide
Baseline characteristics by cohort
| Measure |
Immediate Message Exposure
n=123 Participants
Participants complete baseline (T1) and are randomly assigned to immediately receive 4 study videos over the first month. The exposure period ends and participants complete telephone-based assessments at 1- and 2-month follow up (T2 and T3 respectively). Study videos are delivered by study's mobile app downloaded to participants' own Smartphone.
Messaging: Four brief video messages focused on facilitating treatment seeking. Intervention delivered to participant by study mobile app downloaded to participants' own smartphone.
|
Wait List Control Then Message Exposure at T2
n=116 Participants
Participants complete baseline and are randomly assigned to the waitlist control until receive videos at T2 (following 1-month follow up assessment). Participants receive videos over a one month period. The exposure period ends and participants complete the 2-month follow up (T3) assessment by telephone.
While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.
Messaging: Four brief video messages focused on facilitating treatment seeking. Intervention delivered to participant by study mobile app downloaded to participants' own smartphone.
Wait list control: one push notification each week thanking individuals for participation, informing them that they will receive messages in the near future or reminding them of the length of the study.
|
Wait List Control Then Message Exposure at T3
n=116 Participants
Participants complete baseline and are randomly assigned to receive videos following their 2-month assessment at T3. Participants receive videos over a one month period. They are not assessed post-exposure.
While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.
Wait list control: one push notification each week thanking individuals for participation, informing them that they will receive messages in the near future or reminding them of the length of the study.
|
Total
n=355 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Continuous
|
34.9 years
STANDARD_DEVIATION 9.2 • n=20 Participants
|
36.5 years
STANDARD_DEVIATION 10.4 • n=20 Participants
|
37.5 years
STANDARD_DEVIATION 9.5 • n=40 Participants
|
36.4 years
STANDARD_DEVIATION 9.9 • n=5 Participants
|
|
Sex: Female, Male
Female
|
49 Participants
n=20 Participants
|
49 Participants
n=20 Participants
|
50 Participants
n=40 Participants
|
148 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
74 Participants
n=20 Participants
|
67 Participants
n=20 Participants
|
66 Participants
n=40 Participants
|
207 Participants
n=5 Participants
|
|
Race/Ethnicity, Customized
White
|
90 Participants
n=20 Participants
|
79 Participants
n=20 Participants
|
83 Participants
n=40 Participants
|
252 Participants
n=5 Participants
|
|
Race/Ethnicity, Customized
Other than White
|
33 Participants
n=20 Participants
|
37 Participants
n=20 Participants
|
33 Participants
n=40 Participants
|
103 Participants
n=5 Participants
|
|
Marital Status
Never married
|
35 Participants
n=20 Participants
|
32 Participants
n=20 Participants
|
39 Participants
n=40 Participants
|
106 Participants
n=5 Participants
|
|
Marital Status
Married/cohabitating
|
71 Participants
n=20 Participants
|
64 Participants
n=20 Participants
|
57 Participants
n=40 Participants
|
192 Participants
n=5 Participants
|
|
Marital Status
Widowed/Divorced/Separated/Unknown
|
17 Participants
n=20 Participants
|
20 Participants
n=20 Participants
|
20 Participants
n=40 Participants
|
57 Participants
n=5 Participants
|
|
Education
High School/GED
|
38 Participants
n=20 Participants
|
32 Participants
n=20 Participants
|
32 Participants
n=40 Participants
|
102 Participants
n=5 Participants
|
|
Education
Undergraduate Degree
|
58 Participants
n=20 Participants
|
46 Participants
n=20 Participants
|
49 Participants
n=40 Participants
|
153 Participants
n=5 Participants
|
|
Education
Graduate Degree
|
27 Participants
n=20 Participants
|
38 Participants
n=20 Participants
|
35 Participants
n=40 Participants
|
100 Participants
n=5 Participants
|
|
Employment
Unemployed
|
29 Participants
n=20 Participants
|
28 Participants
n=20 Participants
|
23 Participants
n=40 Participants
|
80 Participants
n=5 Participants
|
|
Employment
Student
|
19 Participants
n=20 Participants
|
9 Participants
n=20 Participants
|
14 Participants
n=40 Participants
|
42 Participants
n=5 Participants
|
|
Employment
Employed
|
58 Participants
n=20 Participants
|
60 Participants
n=20 Participants
|
57 Participants
n=40 Participants
|
175 Participants
n=5 Participants
|
|
Employment
Retired
|
14 Participants
n=20 Participants
|
16 Participants
n=20 Participants
|
16 Participants
n=40 Participants
|
46 Participants
n=5 Participants
|
|
Employment
Other
|
3 Participants
n=20 Participants
|
3 Participants
n=20 Participants
|
6 Participants
n=40 Participants
|
12 Participants
n=5 Participants
|
|
Time since military separation
1 year or less
|
118 Participants
n=20 Participants
|
112 Participants
n=20 Participants
|
107 Participants
n=40 Participants
|
337 Participants
n=5 Participants
|
|
Time since military separation
2 years
|
4 Participants
n=20 Participants
|
2 Participants
n=20 Participants
|
6 Participants
n=40 Participants
|
12 Participants
n=5 Participants
|
|
Time since military separation
3 years
|
1 Participants
n=20 Participants
|
2 Participants
n=20 Participants
|
3 Participants
n=40 Participants
|
6 Participants
n=5 Participants
|
|
Rank at Separation
Enlisted
|
81 Participants
n=20 Participants
|
66 Participants
n=20 Participants
|
71 Participants
n=40 Participants
|
218 Participants
n=5 Participants
|
|
Rank at Separation
Officer
|
42 Participants
n=20 Participants
|
50 Participants
n=20 Participants
|
45 Participants
n=40 Participants
|
137 Participants
n=5 Participants
|
|
Health Insurance
Yes
|
106 Participants
n=20 Participants
|
106 Participants
n=20 Participants
|
111 Participants
n=40 Participants
|
323 Participants
n=5 Participants
|
|
Health Insurance
No
|
17 Participants
n=20 Participants
|
10 Participants
n=20 Participants
|
5 Participants
n=40 Participants
|
32 Participants
n=5 Participants
|
PRIMARY outcome
Timeframe: baseline through 2-month follow-upPopulation: The Ns are distinct; Participants exposed at T2 contribute data as control and intervention depending on timing and outcome status (exposure is time-varying for this arm). Participants in this arm contributed data as controls (unexposed) for T1 and T2 until they received the intervention. Participants that had already experienced the outcome prior to crossover continued to contribute data as controls, whereas those who had not yet experienced the outcome were intervention observations for T3.
yes to initiating psychological treatment and/or medication/pharmacological treatment in the past month to treat mental health issues.
Outcome measures
| Measure |
Message Exposure
n=229 Participants
the exposure group = all timepoints/participants in the "immediate exposure arm" (receive intervention following baseline) + T3 data for participants in the "waitlist then exposure at T2 arm" who had not yet initiated treatment prior to crossover.
|
Wait List Control
n=232 Participants
the waitlist control group = all timepoints/participants in the "waitlist then exposure at T3 arm" (received intervention at end-of-trial) + T3 data for participants in the "waitlist then exposure at T2 arm" who initiated treatment prior to crossover.
|
|---|---|---|
|
Treatment Initiation
|
34 Participants
|
19 Participants
|
SECONDARY outcome
Timeframe: baseline through 2-month follow upPopulation: Number analyzed = the overall/final N in each condition. Given the cross-over design, participants in group 2 contribute observations to both conditions depending on timing and outcome status (exposure is time-varying for this arm).
Beliefs about mental health treatment was assessed using the "Perceptions about Services Scale" with individuals endorsing items on a scale from 1 (lowest agreement) to 7 (higher agreement). A mean is calculated across items to create a composite score (higher score = greater positive beliefs about mental health treatment); lowest score = 1; highest score = 7.
Outcome measures
| Measure |
Message Exposure
n=229 Participants
the exposure group = all timepoints/participants in the "immediate exposure arm" (receive intervention following baseline) + T3 data for participants in the "waitlist then exposure at T2 arm" who had not yet initiated treatment prior to crossover.
|
Wait List Control
n=232 Participants
the waitlist control group = all timepoints/participants in the "waitlist then exposure at T3 arm" (received intervention at end-of-trial) + T3 data for participants in the "waitlist then exposure at T2 arm" who initiated treatment prior to crossover.
|
|---|---|---|
|
Mean Change in Beliefs About Mental Health Treatment
T3 (2-month follow up)
|
5.14 score on scale
Standard Deviation 1.50
|
5.16 score on scale
Standard Deviation 1.54
|
|
Mean Change in Beliefs About Mental Health Treatment
T1 (baseline)
|
4.51 score on scale
Standard Deviation 1.88
|
4.44 score on scale
Standard Deviation 1.79
|
SECONDARY outcome
Timeframe: baseline through 2-month follow upPopulation: Number analyzed = the overall/final N in each condition. Given the cross-over design, participants in group 2 contribute observations to both conditions depending on timing and outcome status (exposure is time-varying for this arm).
change in intent to seek mental health treatment in the next month measured using a 7-point likert scale (1 indicating low intent and 7 indicating strong intent) from items in the "Perceptions about Services Scale." A mean is calculated (higher score representing higher intentions) to create a composite score on the scale. lowest score = 1; highest score = 7.
Outcome measures
| Measure |
Message Exposure
n=229 Participants
the exposure group = all timepoints/participants in the "immediate exposure arm" (receive intervention following baseline) + T3 data for participants in the "waitlist then exposure at T2 arm" who had not yet initiated treatment prior to crossover.
|
Wait List Control
n=232 Participants
the waitlist control group = all timepoints/participants in the "waitlist then exposure at T3 arm" (received intervention at end-of-trial) + T3 data for participants in the "waitlist then exposure at T2 arm" who initiated treatment prior to crossover.
|
|---|---|---|
|
Mean Change in Intentions to Seek Treatment
T1 (baseline)
|
4.54 score on scale
Standard Deviation 2.15
|
4.21 score on scale
Standard Deviation 2.15
|
|
Mean Change in Intentions to Seek Treatment
T3 (2-month follow up)
|
4.58 score on scale
Standard Deviation 2.06
|
4.44 score on scale
Standard Deviation 2.07
|
SECONDARY outcome
Timeframe: baseline through 2-month follow upPopulation: Number analyzed = the overall/final N in each condition. Given the cross-over design, participants in group 2 contribute observations to both conditions depending on timing and outcome status (exposure is time-varying for this arm).
Used the "Perceived Stigma and Barriers to Care scale" to assess change in agreement with barriers to mental health care that impede one's own behaviors measured using a response scale from 1 (strongly disagree) to 5 (strongly agree). A mean is calculated across items to create a cumulative score (higher score = more experience with barriers to care).lowest score = 1; highest score = 5.
Outcome measures
| Measure |
Message Exposure
n=229 Participants
the exposure group = all timepoints/participants in the "immediate exposure arm" (receive intervention following baseline) + T3 data for participants in the "waitlist then exposure at T2 arm" who had not yet initiated treatment prior to crossover.
|
Wait List Control
n=232 Participants
the waitlist control group = all timepoints/participants in the "waitlist then exposure at T3 arm" (received intervention at end-of-trial) + T3 data for participants in the "waitlist then exposure at T2 arm" who initiated treatment prior to crossover.
|
|---|---|---|
|
Mean Change in Perceived Treatment Barriers
T1 (baseline)
|
2.34 score on scale
Standard Deviation 1.43
|
2.16 score on scale
Standard Deviation 1.36
|
|
Mean Change in Perceived Treatment Barriers
T3 (2-month follow up)
|
2.05 score on scale
Standard Deviation 1.27
|
1.94 score on scale
Standard Deviation 1.22
|
SECONDARY outcome
Timeframe: baseline through 2-month follow upPopulation: Number analyzed = the overall/final N in each condition. Given the cross-over design, participants in group 2 contribute observations to both conditions depending on timing and outcome status (exposure is time-varying for this arm).
Items assessing subjective norms on seeking mental health care were used from "Perceptions about Services Scale" with scores ranging from 1 (low agreement) to 7 (high agreement). A mean was calculated to create a cumulative score (higher score = greater positive perceptions about seeking mental health care); 1 = lowest score; 7 = highest score.
Outcome measures
| Measure |
Message Exposure
n=229 Participants
the exposure group = all timepoints/participants in the "immediate exposure arm" (receive intervention following baseline) + T3 data for participants in the "waitlist then exposure at T2 arm" who had not yet initiated treatment prior to crossover.
|
Wait List Control
n=232 Participants
the waitlist control group = all timepoints/participants in the "waitlist then exposure at T3 arm" (received intervention at end-of-trial) + T3 data for participants in the "waitlist then exposure at T2 arm" who initiated treatment prior to crossover.
|
|---|---|---|
|
Mean Change in Normative Beliefs About Seeking Mental Health Care
T1 (baseline)
|
5.83 score on scale
Standard Deviation 1.70
|
5.94 score on scale
Standard Deviation 1.71
|
|
Mean Change in Normative Beliefs About Seeking Mental Health Care
T3 (2-month follow up)
|
5.99 score on scale
Standard Deviation 1.44
|
6.03 score on scale
Standard Deviation 1.44
|
Adverse Events
Message Exposure
Wait List Control
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place