Improving fidelity of patient-centered suicide prevention care in primary care - this R34 application aims to adapt and conduct pilot work on the learning through interactive feedback and…

The Veterans Health Research Institute of Central New York, Inc. received a $502.5K Project Grant award from the National Institute of Mental Health under the Mental Health Research Grants program (CFDA 93.242) to develop and pilot an enhanced version of the Learning Through Interactive Feedback and Training-Suicide Prevention (LIFT-UP) educational program. The award, effective from August 15, 2025, through August 14, 2028, supports the adaptation of this training initiative to improve providers' patient-centered suicide prevention care delivery in primary care settings. The project will refine LIFT-UP's assessment tool and feedback mechanisms by incorporating patient perspectives on lethal means communication and behavioral change motivators, including normative information and patient outcome awareness data.

The primary deliverables include an optimized LIFT-UP assessment tool and structured feedback system informed by qualitative input from 32 diverse patients (including firearm owners, patients with intimate partner violence histories, and opioid users) and 12 healthcare providers. The refined program aims to enhance providers' capability to conduct lethal means safety conversations in a patient-centered manner, ultimately increasing patient willingness to reduce access to lethal means and improve future disclosure of suicidal ideation. This R34 Exploratory/Developmental Research Grant represents a targeted investment in implementation science designed to bridge the gap between content delivery training and the development of providers' interpersonal skills in suicide prevention counseling.

Improving fidelity of patient-centered suicide prevention care in primary care - this R34 application aims to adapt and conduct pilot work on the learning through interactive feedback and training-suicide prevention (LIFT-up) educational program as a strategy to enhance current implementation strategies. While there are many strategies designed to assist providers in suicide prevention, they often focus heavily on supporting provider's delivery of content, such as lethal means (LM) safety, and ignore developing provider's skill for how to ask in a patient-centered manner. Improving the skill by which providers have LM conversations should in turn increase patient's willingness to decrease access to LM and increase future disclosure. LIFT-up, was developed to support provider's broad suicide prevention skill development through the utilization of an algorithmic assessment tool that rates provider's skill during a virtual simulation with an actor followed by the provision of structured constructive verbal feedback. Utilizing recent research on patient perspectives on LM communication and the theory of planned behavior+risk perception, we aim to further adapt LIFT-up by: 1) incorporating components attending to patient-centered LM communication through the alteration of the assessment tool and 2) addressing provider motivation by adding written expert feedback that shares behavioral strategies to improve, normative information, and patient outcome awareness. Therefore, aim 1'S objective is to continue to refine and optimize the LIFT- up assessment tool and feedback through obtaining perspectives from: 1A) 32 diverse patients (i.e., firearm owners, patients with a history of intimate partner violence, patients who use opiates) on face and concurrent validity of high VS. Total scores and specific LM dimensions using recorded simulations and 1B) 12 healthcare providers on the acceptability, appropriateness, informativeness, and ability to motivate change of the verbal and written feedback. After using the information in aim 2 to make refinements to LIFT-up (1C), aim 2 involves a pilot randomized control trial (with crossover) where 50 primary care staff will be assigned to one of two conditions 1) usual care (UC) or 2) UC plus LIFT-up. We hypothesize that the pilot clinical trial will result in providers rating LIFT-up with high levels of appropriateness and acceptability and that they will demonstrate increased fidelity to patient- centered LM skills, be willing to participate in additional LM trainings, and report higher adoption of LM skills than those who engage in UC alone. Results will inform future work towards a large cluster randomized clinical trial examining the predictive validity of LIFT-up's assessment tool and the effectiveness of LIFT-up in enhancing implementation efforts.