Lethal Means Counseling, Distribution of Cable Locks, and Safe Firearm Storage Practices Among the Mississippi National Guard: A Factorial Randomized Controlled Trial, 2018–2020

Objectives. To examine whether lethal means counseling and provision of cable locks prompt safe firearm storage relative to control among firearm-owning members of the Mississippi National Guard. Methods. This randomized controlled trial utilized a 2 × 2 factorial design (lethal means counseling vs control, provision of cable locks vs no cable locks). Follow-up assessments took place at 3 and 6 months after baseline. Data were collected (n = 232; 87.5% male; mean age = 35.01 years; 77.2% White) from February 2018 through July 2020. Results. Relative to control, lethal means counseling and provision of cable locks resulted in greater adoption of several safe storage methods over time. Lethal means counseling outperformed control (3 months: 55.0% vs 39.0%; odds ratio [OR] = 1.91). Cable locks outperformed control at 3 and 6 months on number of storage methods (1.41 vs 1.11; d = 0.29 and 1.34 vs 1.16; d = 0.15, respectively) and locking devices (59.8% vs 29.9%; OR = 3.49 and 58.4% vs 35.8%; OR = 2.52, respectively) Conclusions. Lethal means counseling and cable locks can result in sustained changes in firearm storage. Public Health Implications. The military may benefit from lethal means counseling, perhaps administering at point of entry. Trial Registration. Clinical Trials.gov identifier: NCT03375099. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e9. https://doi.org/10.2105/AJPH.2020.306019 )

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Lock to Live—An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults: Pilot Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/16253 ◽

2020 ◽

Vol 22 (1) ◽

pp. e16253 ◽

Cited By ~ 2

Author(s):

Marian E Betz ◽

Christopher E Knoepke ◽

Scott Simpson ◽

Bonnie J Siry ◽

Ashley Clement ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Suicide Prevention ◽

Decision Aid ◽

Controlled Trial ◽

Community Dwelling ◽

Web Based ◽

Randomized Controlled ◽

Lethal Means ◽

Pilot Randomized Controlled Trial

Background Counseling to reduce access to lethal means such as firearms and medications is recommended for suicidal adults but does not routinely occur. We developed the Web-based Lock to Live (L2L) decision aid to help suicidal adults and their families choose options for safer home storage. Objective This study aimed to test the feasibility and acceptability of L2L among suicidal adults in emergency departments (EDs). Methods At 4 EDs, we enrolled participants (English-speaking, community-dwelling, suicidal adults) in a pilot randomized controlled trial. Participants were randomized in a 13:7 ratio to L2L or control (website with general suicide prevention information) groups and received a 1-week follow-up telephone call. Results Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many participants reported having access to firearms (33/49, 67%), medications (46/49, 94%), or both (29/49, 59%). Participants viewed L2L for a median of 6 min (IQR 4-10 min). L2L also had very high acceptability; almost all participants reported that they would recommend it to someone in the same situation, that the options felt realistic, and that L2L was respectful of values about firearms. In an exploratory analysis of this pilot trial, more participants in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant. Conclusions The L2L decision aid appears feasible and acceptable for use among adults with suicide risk and may be a useful adjunct to lethal means counseling and other suicide prevention interventions. Future large-scale studies are needed to determine the effect on home access to lethal means. Trial Registration ClinicalTrials.gov NCT03478501; https://clinicaltrials.gov/ct2/show/NCT03478501

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An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults (Lock to Live): Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.16253 ◽

2019 ◽

Author(s):

Marian E Betz ◽

Christopher E Knoepke ◽

Scott Simpson ◽

Bonnie J Siry ◽

Ashley Clement ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Suicide Prevention ◽

Decision Aid ◽

Controlled Trial ◽

Community Dwelling ◽

Web Based ◽

Randomized Controlled ◽

Lethal Means ◽

Pilot Randomized Controlled Trial

BACKGROUND Counseling to reduce access to lethal means such as firearms and medications is recommended for suicidal adults but does not routinely occur. We developed the Web-based <i>Lock to Live</i> (L2L) decision aid to help suicidal adults and their families choose options for safer home storage. OBJECTIVE This study aimed to test the feasibility and acceptability of L2L among suicidal adults in emergency departments (EDs). METHODS At 4 EDs, we enrolled participants (English-speaking, community-dwelling, suicidal adults) in a pilot randomized controlled trial. Participants were randomized in a 13:7 ratio to L2L or control (website with general suicide prevention information) groups and received a 1-week follow-up telephone call. RESULTS Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many participants reported having access to firearms (33/49, 67%), medications (46/49, 94%), or both (29/49, 59%). Participants viewed L2L for a median of 6 min (IQR 4-10 min). L2L also had very high acceptability; almost all participants reported that they would recommend it to someone in the same situation, that the options felt realistic, and that L2L was respectful of values about firearms. In an exploratory analysis of this pilot trial, more participants in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant. CONCLUSIONS The L2L decision aid appears feasible and acceptable for use among adults with suicide risk and may be a useful adjunct to lethal means counseling and other suicide prevention interventions. Future large-scale studies are needed to determine the effect on home access to lethal means. CLINICALTRIAL ClinicalTrials.gov NCT03478501; https://clinicaltrials.gov/ct2/show/NCT03478501

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Community mothers programme - seven-year follow-up of a randomized controlled trial of non-professional intervention in parenting.. Johnson Z, Molloy B, Scallan E, Fitzpatrick P, Rooney B, Keegan T and Byrne P (2000) Journal of Public Health Medicine, 22: 337-342.

Ambulatory Child Health ◽

10.1046/j.1467-0658.2001.0106b.x ◽

2001 ◽

Vol 7 (1) ◽

pp. 53-60

Author(s):

Richard Reading

Keyword(s):

Public Health ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Public Health Medicine ◽

Randomized Controlled ◽

Professional Intervention

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Health Information and Monitoring of Sexually Transmitted Infections (SIM Study): a Randomized Controlled Trial Protocol for Enhancing Adherence to Syphilis Treatment and Follow-up

10.21203/rs.3.rs-694253/v1 ◽

2021 ◽

Author(s):

Eliana Marcia Ros Wendland ◽

Vanessa M. de Oliveira ◽

Flavia Souza ◽

Gerson Pereira ◽

Antonio Gerbase

Keyword(s):

Public Health ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Public Health Problem ◽

Major Change ◽

Mobile Technologies ◽

Monitoring Methods ◽

Intention To Treat ◽

Randomized Controlled

Abstract Background: Syphilis has recently resurfaced as a significant public health problem. Since the 2000s, isolated syphilis outbreaks have increasingly occurred in North America, Europe, and Australia; in Brazil, there have been progressive increases in both congenital and acquired syphilis. There are several possible explanations, such as misdiagnosis of acquired syphilis, which could increase the number of untreated transmitters in the population; failure to initiate or complete treatment; and nontreatment of sexual partners (leading to reinfection). Mobile technologies have been successfully used to promote behaviour changes and can positively impact treatment and follow-up adherence in patients with infectious diseases. The purpose of this clinical trial is to evaluate treatment and monitoring methods in patients with syphilis, including follow-up by telephone, via a game in a smartphone app and at public health centres.Methods: The SIM study is a single-centre, randomized controlled trial with a 12-month follow-up period. The aim is to identify the most effective method of follow-up regarding patient compliance with treatment. The tests will be performed in a mobile unit in easily accessible locations. The goal is to perform 10,000 rapid tests for syphilis. Patients with a confirmed diagnosis according to VDRL tests will be randomized to one of three arms: telephone, smartphone game, or conventional in-person follow-up. All analyses will follow the intention-to-treat principle.Conclusion: If we find differences in effectiveness, a major change in the conventional approach for this patient population may be needed, potentially affecting current Brazilian health policy strategies.

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