Trial Outcomes & Findings for Home Safety Intervention (NCT NCT06216327)

The study used adaptive pilot testing in three phases. Phase 1 (Oct 2024-Mar 2025) recruited Veterans from the Rocky Mountain Regional VA. Phase 2 (Mar-Apr 2025) expanded to VHA VISN 19. No unique challenges were found, however interviews with participants suggested the intervention was too long. In Phase 3 (Apr-Jun 2025), focus shifted to firearm storage, reducing intervention time and increasing acceptability.

40 veterans consented to participate in the study. 3 discontinued enrollment prior to their baseline visit (2 unable to contact after consent, 1 due to time).

Race was collected for all 37 participants who attended their baseline (0 day) visit.

Ability to recruit 40 Veterans in one year. Count represents number of participants recruited within one year.

\>80% of participants attend their 4 week follow up. Count represents number of participants who completed their 4 week follow up visit.

\>80% with score greater than 23 (Client Satisfaction Questionnaire 8). 8 items, each with 4 answer options (1-4) on a Likert Scale. Likert options are different for each item. Score range is 8 to 32. Higher scores indicate higher satisfaction.

Count of participants who deemed the intervention acceptable via a qualitative evaluation of participant's experiences during the intervention. Assessed using the Narrative Evaluation of Intervention Interview (NEII): A 16-item semi-structured qualitative interview that helps participants evaluate the process and outcome of interventions.

Count represent the number of participants who reported feeling "Comfortable" or "Very comfortable". "How comfortable did you feel engaging in the discussion?" Likert responses: * Very uncomfortable * Uncomfortable * Neither * Comfortable * Very comfortable

Count represent the number of participants who reported that their interaction was "Very helpful" or "Extremely helpful". "How helpful was your interaction in making decisions about medication storage and safety?" Likert responses: * Not at all * Slightly helpful * Moderately helpful * Very helpful * Extremely helpful

Count represent the number of participants who reported that their interaction was "Very helpful" or "Extremely helpful". "How helpful was your interaction in making decisions about firearm storage?" Likert responses: * Not at all * Slightly helpful * Moderately helpful * Very helpful * Extremely helpful

Count represents the number of participants who reported that their interaction was "Respectful" or "Very respectful". "To what extent was this intervention respectful of your values as a firearm owner? Likert responses: * Very disrespectful * Disrespectful * Neither * Respectful * Very respectful

"On a scale from 0 to 10, where 10 indicates complete trust and 0 indicates complete distrust (so 5 would indicate that you neither trust, nor distrust), Please indicate your level of trust in the VA healthcare system?" Answer range: 0-10

"On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important. It is important to securely store medications when I or someone in my household has had recent thoughts of suicide." Answer range: 0-10

"On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important. It is always important to securely store medications even if someone is not at risk for suicide in the home." Answer range: 0-10

"On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important. It is important to securely store firearms when I or someone in my household has had recent thoughts of suicide." Answer range: 0-10

"On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important. It is always important to store firearms securely in a locked space, or with a locking device, even if someone is not at risk for suicide in the home." Answer range: 0-10

"On a scale of 0 to 10, I want to ask you about whether you find the following safety measures to be important. Someone who answers 0 does not consider them to be important at all, while someone who answers 10 considers them to be extremely important. It is always important to securely store firearms unloaded even if someone is not at risk for suicide in the home." Answer range: 0-10

"One thing some people consider doing to reduce risk of suicide or injury for themselves and others in their household is to securely store all firearms. On a scale from 0 to 10, where 0 is not at all, and 10 is completely, how would you rate your readiness to \[make a change\] like that?" Answer range: 0-10

"One thing some people consider doing to reduce risk of suicide or injury for themselves and others in their household is to securely store all medications. On a scale from 0 to 10, where 0 is not at all, and 10 is completely, how would you rate your readiness to \[make a change\]?" Answer range: 0-10

Number of firearms in household: Answer range: 0 to 10,000

Count represents number of participants who said 'very often' or 'always'. "To what extent have you had difficulty remembering to take your medications in the past month?" Likert responses: * Never * Rarely * Sometimes * Very Often * Always

Changes in whether household firearms are present in a participant's home from day of intervention delivery (day 0) to 4 weeks. Count represents the number of participants who reported having at least 1 firearm in their home.

Changes in whether household firearms are stored securely. Count represents number of participants who had 'all' firearms locked. "Are any firearms in or around your home currently stored locked?" Answers: * Yes, all of them are locked * Yes, some of them are locked * None of them are locked * I'm not sure * Decline to respond

Changes in whether present medication are all stored securely. Count represents the number of participants who stored 'all' of their medications locked. "Are the medications in your home currently stored locked? (Examples include using a locked cabinet or box)" Answer options: * Yes, all of the medications in my home are locked up * Yes, some of the medications in my home are locked up * None of the medications in my home are locked up * I'm not sure

"On a scale of 0 to 10, to what extent do you keep your firearms to protect yourself or your loved ones from other people? Someone who answers 0 does not consider themselves to keep firearms for protection, while someone who answers 10 considers that their firearms are absolutely required for protection." Answer range: 0-10

"One of the safest things someone can do while they're going through a difficult time is to store their firearms outside of the home with someone they trust. On a scale from 0 to 10, where 0 is not at all, and 10 is completely, how would you rate your readiness to \[make a change\] like that?" Answer range: 0-10

Count of people who said they do not have access to the key/combination for their locked firearm. "For the firearms in your home that are locked, who has access to the keys or number combinations that would be needed to access them?" Answer options: * You * Your spouse or partner * Children under the age of 18 years * Children 18 years of age or older * A friend * A neighbor * Other:\_\_\_\_\_\_\_\_\_\_

Changes from day of intervention delivery (day 0) to 4 weeks in whether household ammunition is present. The presence of ammunition in the home was only asked to participants who stated there were firearms in the home and that they were the owner of at least 1 of the firearms in the home. Count represents number of participants who reported having ammunition in the home.

Count of participants who reported having 'all' ammunition in the home securely locked. This measure was only asked to participants who reported that there were firearms in the home, that they were the owner of at least 1 of the firearms in the home, and that there was ammunition in the home. "Is ammunition in or around your home currently stored in a locked place, such as a locked cabinet?" Answer options: * Yes, all of the ammunition is locked * Yes, some of the ammunition is locked * None of the ammunition is locked * I'm not sure * No ammunition is in my home

Count of participants who have a naloxone prescription (yes/no). Verified through each participant's electronic health record.

Verification of returned medication safety envelope (yes/no). Count represents number of participants who utilized their medication return envelope.