xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT06011759</url>
    </required_header>
    <id_info>
      <org_study_id>QUX 23-001</org_study_id>
      <nct_id>NCT06011759</nct_id>
    </id_info>
    <brief_title>Maintaining Implementation Through Dynamic Adaptations (MIDAS) Suicide Prevention 2.0 Clinical Telehealth</brief_title>
    <acronym>MIDAS SPCT</acronym>
    <official_title>Maintaining Implementation Through Dynamic Adaptations (MIDAS) - Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) (QUE 20-025)</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>VA Office of Research and Development</agency>
        <agency_class>U.S. Fed</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>VA Office of Research and Development</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
      <is_us_export>No</is_us_export>
    </oversight_info>
    <brief_summary>
      <textblock>
        Scientific advances are constantly leading to better treatments. However, it is quite&#xD;
        challenging for healthcare systems, including VA, to ask very busy providers to change the&#xD;
        way they practice. The MIDAS QUERI program helps providers improve the way they treat VA&#xD;
        patients. This project will focus on increasing referrals to the Suicide Prevention 2.0&#xD;
        Clinical Telehealth (SP 2.0) initiative through the delivery of Academic Detailing and LEAP&#xD;
        (a team-based quality improvement program). SP 2.0 provides accessible, evidence-based&#xD;
        suicide prevention treatment to all Veterans with a history of suicidal self-directed&#xD;
        violence or preparatory behaviors in the past 12 months.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Sustained integration of evidence-based practices (EBPs) is a challenge within many&#xD;
        healthcare systems, especially in settings that have already strived but failed to achieve&#xD;
        longer-term goals. The Veterans Affairs (VA) Maintaining Implementation through Dynamic&#xD;
        Adaptations (MIDAS) Quality Enhancement Research Initiative (QUERI) program was funded as a&#xD;
        series of trials to test multi-component implementation strategies to sustain optimal use of&#xD;
        EBPs. The current project focuses on increasing referrals to the Suicide Prevention 2.0&#xD;
        Clinical Telehealth (SP 2.0) initiative.&#xD;
  &#xD;
        The investigators have recruited 4 sites for this non-randomized intervention project. Sites&#xD;
        have agreed to participate in pre-implementation interviews to gather information regarding&#xD;
        barriers and facilitators to use of the SP 2.0 initiative. Sites will then be provided with&#xD;
        tailored feedback regarding interview findings and potential use of Academic Detailing and&#xD;
        LEAP to address these. Sites may then select to receive either Academic Detailing and/or LEAP&#xD;
        which will be provided by MIDAS QUERI. Sites will be compared to control sites which will be&#xD;
        matched based on similar baseline referral rates. Primary outcome will be rate of SP 2.0&#xD;
        referral adjusted for pre-intervention rate.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Active, not recruiting</overall_status>
    <start_date type="Actual">November 1, 2022</start_date>
    <completion_date type="Anticipated">September 30, 2025</completion_date>
    <primary_completion_date type="Anticipated">October 31, 2024</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>N/A</allocation>
      <intervention_model>Single Group Assignment</intervention_model>
      <intervention_model_description>A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.</intervention_model_description>
      <primary_purpose>Health Services Research</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Referral to SP 2.0 Clinic</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>Change in percentage of referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Receipt of Cognitive Behavioral Therapy for Suicide Prevention at SP 2.0 clinic</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>The change in prevalence of any receipt of Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP). Receipt of any CBT-SP will be measured by extracting from the medical record note templates completed by CBT-SP therapists.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Completion of Cognitive Behavioral Therapy for Suicide Prevention at SP 2.0 clinic</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>The change in prevalence of completion of Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP). Completion of any CBT-SP will be measured by extracting from the medical record note templates completed by CBT-SP therapists.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Receipt of Problem Solving Therapy for Suicide Prevention</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>The change in prevalence of any receipt of Problem Solving Therapy for Suicide Prevention (PST-SP). Receipt of any PST-SP will be measured by extracting from the medical record note templates completed by PST-SP therapists.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Completion of Problem Solving Therapy for Suicide Prevention</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>The change in prevalence of completion of Problem Solving Therapy for Suicide Prevention (PST-SP). Completion of any PST-SP will be measured by extracting from the medical record note templates completed by PST-SP therapists.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Receipt of Dialectical Behavior Therapy</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>The change in prevalence of any receipt of Dialectical Behavior Therapy for Suicide Prevention (DBT-SP). Receipt of any DBT-SP will be measured by extracting from the medical record note templates completed by DBT-SP therapists.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Completion of Dialectical Behavior Therapy</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>The change in prevalence of completion of Dialectical Behavior Therapy for Suicide Prevention (DBT-SP). Completion of any DBT-SP will be measured by extracting from the medical record note templates completed by DBT-SP therapists.</description>
    </secondary_outcome>
    <other_outcome>
      <measure>Change in Employee Engagement in Quality Improvement</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>3-item pilot measure of the extent to which employees engage in quality improvement activities. Scores are 1-5 with higher ratings indicating more engagement in QI.</description>
    </other_outcome>
    <other_outcome>
      <measure>Change in Employee Burnout</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>3-item measure comprising I feel burned out from my work (Exhaustion), I worry that this job is hardening me emotionally (Depersonalization), and I have accomplished many worthwhile things in this job (Reduced Achievement; reverse score). &quot;High Burnout&quot; measures the percent of staff who are feeling burned out on all three burnout symptoms at a frequency of &quot;once a week&quot; to &quot;every day.&quot; Scored: 0-100%, where LOWER score is more favorable. Exhaustion (physical burnout) Depersonalization (emotional burnout), Reduced Achievement (cognitive burnout).</description>
    </other_outcome>
    <other_outcome>
      <measure>Change in Workgroup Cohesion &amp; Engagement</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>7-item measure from the VA's newly developed Patient Safety Culture. Values 1 to 5 where higher values indicate more positive scores.</description>
    </other_outcome>
    <other_outcome>
      <measure>Change in quality improvement skills application</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>16-item measure of change in quality improvement skills application. Values 1 to 4 where higher values indicate more frequent use of quality improvement skills.</description>
    </other_outcome>
    <other_outcome>
      <measure>Change in provider satisfaction with academic detailing</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>7-item measure of satisfaction with Academic Detailing. Values 1 to 5 where higher values indicate higher satisfaction.</description>
    </other_outcome>
    <other_outcome>
      <measure>Change in provider satisfaction with LEAP</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>6-item measure of satisfaction with LEAP. Values 1 to 5 where higher values indicate higher satisfaction.</description>
    </other_outcome>
    <other_outcome>
      <measure>Change in Best Places to Work Score</measure>
      <time_frame>Baseline to 12-months post-baseline</time_frame>
      <description>3-item scale. &quot;Best Places to Work&quot; is a summary measure of the group's satisfaction with the job, organization, and likelihood to recommend VA as a good place to work. This is a measure normally administered within the All-employee Survey (AES). This score is functionally similar to those reported for Federal agencies by the Partnership for Public Service (http://bestplacestowork.org). Overall Satisfaction (% Positive), Organization Satisfaction (% Positive), and Recommend My Organization (% Positive). Score as Percent positive = &quot;Very Satisfied/Satisfied&quot; or &quot;Strongly Agree/Agree.&quot;</description>
    </other_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Actual">4</enrollment>
    <condition>Suicidal Self-directed Violence</condition>
    <condition>Suicidal Preparatory Behavior</condition>
    <arm_group>
      <arm_group_label>Intervention</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Control</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Control sites will be selected to match intervention sites on baseline referral rates.</description>
    </arm_group>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Academic Detailing (AD)</intervention_name>
      <description>The National Resource Center for Academic Detailing (NaRCAD) describes AD as &quot;an innovative, one-on-one outreach education technique that helps clinicians provide evidence-based care to their patients. Using an accurate, up-to-date synthesis of the best clinical evidence in an engaging format, academic detailers ignite clinician behavior change, ultimately improving patient health. A successful AD visit is highly interactive, always a dialogue, and assesses a clinician's individual needs, beliefs, attitudes, issues, and concerns in order to promote better [practice].&quot;</description>
      <arm_group_label>Intervention</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>LEAP</intervention_name>
      <description>Learn. Engage. Act. Process (LEAP) program is a structured 6-month core curriculum plus 6 monthly collaborative sessions. The LEAP quality improvement program engages frontline teams in sustained incremental improvements of EBPs over a six-month period, allowing space for busy clinicians to learn and immediately apply fundamental QI skills. LEAP encompasses: 1) a structured, accessible curriculum based on the Institute for Healthcare Improvement's (IHI) Model for Improvement and Plan-Do-Study-Act cycles of change; 2) team-based, hands-on learning, and 3) coaching support and a QI network to enhance learning and accountability.</description>
      <arm_group_label>Intervention</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Usual care</intervention_name>
      <description>Experimental control sites receiving usual care</description>
      <arm_group_label>Control</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
          Note- the investigators are recruiting clinics/medical centers - not individual patients.&#xD;
          Prior to implementation, the investigators will work with sites to ensure they have met the&#xD;
          preconditions necessary to begin sustained optimization of the EBP:&#xD;
  &#xD;
            -  1) a team leader or champion&#xD;
  &#xD;
            -  2) an identified department with service leadership buy-in and control over the&#xD;
               processes/practices impacted by the implementation&#xD;
  &#xD;
            -  3) readily accessible data to measure process and impact of the implementation and use&#xD;
               of the EBP&#xD;
  &#xD;
            -  4) availability of required resources&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  N/A&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>N/A</minimum_age>
      <maximum_age>N/A</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Paul N Pfeiffer, MD MS</last_name>
      <role>Principal Investigator</role>
      <affiliation>VA Ann Arbor Healthcare System, Ann Arbor, MI</affiliation>
    </overall_official>
    <overall_official>
      <last_name>Jacob E Kurlander, MD MS MS</last_name>
      <role>Principal Investigator</role>
      <affiliation>VA Ann Arbor Healthcare System, Ann Arbor, MI</affiliation>
    </overall_official>
    <overall_official>
      <last_name>Jeremy B. Sussman, MD MS</last_name>
      <role>Principal Investigator</role>
      <affiliation>VA Ann Arbor Healthcare System, Ann Arbor, MI</affiliation>
    </overall_official>
    <location>
      <facility>
        <name>VA Ann Arbor Healthcare System, Ann Arbor, MI</name>
        <address>
          <city>Ann Arbor</city>
          <state>Michigan</state>
          <zip>48105-2303</zip>
          <country>United States</country>
        </address>
      </facility>
    </location>
    <location_countries>
      <country>United States</country>
    </location_countries>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>August 16, 2023</study_first_submitted>
    <study_first_submitted_qc>August 24, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 25, 2023</study_first_posted>
    <last_update_submitted>August 24, 2023</last_update_submitted>
    <last_update_submitted_qc>August 24, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 25, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Sponsor</responsible_party_type>
    </responsible_party>
    <keyword>implementation science</keyword>
    <keyword>implementation strategy</keyword>
    <keyword>suicide prevention</keyword>
    <keyword>academic detailing</keyword>
    <keyword>quality improvement</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Suicide</mesh_term>
      <mesh_term>Suicide Prevention</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>Yes</sharing_ipd>
      <ipd_description>Site-level data that underlie results reported, after de-identification will be available.</ipd_description>
      <ipd_info_type>Study Protocol</ipd_info_type>
      <ipd_info_type>Analytic Code</ipd_info_type>
      <ipd_time_frame>For 36 months after article is published.</ipd_time_frame>
      <ipd_access_criteria>Upon request by researchers who provide a methodologically sound proposal. Further details will be available.</ipd_access_criteria>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT06011759
  org study id: QUX 23-001
  nct id: NCT06011759
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  is us export: No
  Scientific advances are constantly leading to better treatments. However, it is quite
        challenging for healthcare systems, including VA, to ask very busy providers to change the
        way they practice. The MIDAS QUERI program helps providers improve the way they treat VA
        patients. This project will focus on increasing referrals to the Suicide Prevention 2.0
        Clinical Telehealth (SP 2.0) initiative through the delivery of Academic Detailing and LEAP
        (a team-based quality improvement program). SP 2.0 provides accessible, evidence-based
        suicide prevention treatment to all Veterans with a history of suicidal self-directed
        violence or preparatory behaviors in the past 12 months.
  Sustained integration of evidence-based practices (EBPs) is a challenge within many
        healthcare systems, especially in settings that have already strived but failed to achieve
        longer-term goals. The Veterans Affairs (VA) Maintaining Implementation through Dynamic
        Adaptations (MIDAS) Quality Enhancement Research Initiative (QUERI) program was funded as a
        series of trials to test multi-component implementation strategies to sustain optimal use of
        EBPs. The current project focuses on increasing referrals to the Suicide Prevention 2.0
        Clinical Telehealth (SP 2.0) initiative.
  
        The investigators have recruited 4 sites for this non-randomized intervention project. Sites
        have agreed to participate in pre-implementation interviews to gather information regarding
        barriers and facilitators to use of the SP 2.0 initiative. Sites will then be provided with
        tailored feedback regarding interview findings and potential use of Academic Detailing and
        LEAP to address these. Sites may then select to receive either Academic Detailing and/or LEAP
        which will be provided by MIDAS QUERI. Sites will be compared to control sites which will be
        matched based on similar baseline referral rates. Primary outcome will be rate of SP 2.0
        referral adjusted for pre-intervention rate.
  allocation: N/A
  intervention model: Single Group Assignment
  intervention model description: A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.
  primary purpose: Health Services Research
  masking: None (Open Label)
  measure: Referral to SP 2.0 Clinic
  time frame: Baseline to 12-months post-baseline
  description: Change in percentage of referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative.
  measure: Receipt of Cognitive Behavioral Therapy for Suicide Prevention at SP 2.0 clinic
  time frame: Baseline to 12-months post-baseline
  description: The change in prevalence of any receipt of Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP). Receipt of any CBT-SP will be measured by extracting from the medical record note templates completed by CBT-SP therapists.
  measure: Completion of Cognitive Behavioral Therapy for Suicide Prevention at SP 2.0 clinic
  time frame: Baseline to 12-months post-baseline
  description: The change in prevalence of completion of Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP). Completion of any CBT-SP will be measured by extracting from the medical record note templates completed by CBT-SP therapists.
  measure: Receipt of Problem Solving Therapy for Suicide Prevention
  time frame: Baseline to 12-months post-baseline
  description: The change in prevalence of any receipt of Problem Solving Therapy for Suicide Prevention (PST-SP). Receipt of any PST-SP will be measured by extracting from the medical record note templates completed by PST-SP therapists.
  measure: Completion of Problem Solving Therapy for Suicide Prevention
  time frame: Baseline to 12-months post-baseline
  description: The change in prevalence of completion of Problem Solving Therapy for Suicide Prevention (PST-SP). Completion of any PST-SP will be measured by extracting from the medical record note templates completed by PST-SP therapists.
  measure: Receipt of Dialectical Behavior Therapy
  time frame: Baseline to 12-months post-baseline
  description: The change in prevalence of any receipt of Dialectical Behavior Therapy for Suicide Prevention (DBT-SP). Receipt of any DBT-SP will be measured by extracting from the medical record note templates completed by DBT-SP therapists.
  measure: Completion of Dialectical Behavior Therapy
  time frame: Baseline to 12-months post-baseline
  description: The change in prevalence of completion of Dialectical Behavior Therapy for Suicide Prevention (DBT-SP). Completion of any DBT-SP will be measured by extracting from the medical record note templates completed by DBT-SP therapists.
  measure: Change in Employee Engagement in Quality Improvement
  time frame: Baseline to 12-months post-baseline
  description: 3-item pilot measure of the extent to which employees engage in quality improvement activities. Scores are 1-5 with higher ratings indicating more engagement in QI.
  measure: Change in Employee Burnout
  time frame: Baseline to 12-months post-baseline
  description: 3-item measure comprising I feel burned out from my work (Exhaustion), I worry that this job is hardening me emotionally (Depersonalization), and I have accomplished many worthwhile things in this job (Reduced Achievement; reverse score). "High Burnout" measures the percent of staff who are feeling burned out on all three burnout symptoms at a frequency of "once a week" to "every day." Scored: 0-100%, where LOWER score is more favorable. Exhaustion (physical burnout) Depersonalization (emotional burnout), Reduced Achievement (cognitive burnout).
  measure: Change in Workgroup Cohesion & Engagement
  time frame: Baseline to 12-months post-baseline
  description: 7-item measure from the VA's newly developed Patient Safety Culture. Values 1 to 5 where higher values indicate more positive scores.
  measure: Change in quality improvement skills application
  time frame: Baseline to 12-months post-baseline
  description: 16-item measure of change in quality improvement skills application. Values 1 to 4 where higher values indicate more frequent use of quality improvement skills.
  measure: Change in provider satisfaction with academic detailing
  time frame: Baseline to 12-months post-baseline
  description: 7-item measure of satisfaction with Academic Detailing. Values 1 to 5 where higher values indicate higher satisfaction.
  measure: Change in provider satisfaction with LEAP
  time frame: Baseline to 12-months post-baseline
  description: 6-item measure of satisfaction with LEAP. Values 1 to 5 where higher values indicate higher satisfaction.
  measure: Change in Best Places to Work Score
  time frame: Baseline to 12-months post-baseline
  description: 3-item scale. "Best Places to Work" is a summary measure of the group's satisfaction with the job, organization, and likelihood to recommend VA as a good place to work. This is a measure normally administered within the All-employee Survey (AES). This score is functionally similar to those reported for Federal agencies by the Partnership for Public Service (http://bestplacestowork.org). Overall Satisfaction (% Positive), Organization Satisfaction (% Positive), and Recommend My Organization (% Positive). Score as Percent positive = "Very Satisfied/Satisfied" or "Strongly Agree/Agree."
  arm group label: Intervention
  arm group type: Experimental
  description: A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.
  arm group label: Control
  arm group type: Experimental
  description: Control sites will be selected to match intervention sites on baseline referral rates.
  intervention type: Behavioral
  intervention name: Academic Detailing (AD)
  description: The National Resource Center for Academic Detailing (NaRCAD) describes AD as "an innovative, one-on-one outreach education technique that helps clinicians provide evidence-based care to their patients. Using an accurate, up-to-date synthesis of the best clinical evidence in an engaging format, academic detailers ignite clinician behavior change, ultimately improving patient health. A successful AD visit is highly interactive, always a dialogue, and assesses a clinician's individual needs, beliefs, attitudes, issues, and concerns in order to promote better [practice]."
  arm group label: Intervention
  intervention type: Behavioral
  intervention name: LEAP
  description: Learn. Engage. Act. Process (LEAP) program is a structured 6-month core curriculum plus 6 monthly collaborative sessions. The LEAP quality improvement program engages frontline teams in sustained incremental improvements of EBPs over a six-month period, allowing space for busy clinicians to learn and immediately apply fundamental QI skills. LEAP encompasses: 1) a structured, accessible curriculum based on the Institute for Healthcare Improvement's (IHI) Model for Improvement and Plan-Do-Study-Act cycles of change; 2) team-based, hands-on learning, and 3) coaching support and a QI network to enhance learning and accountability.
  arm group label: Intervention
  intervention type: Behavioral
  intervention name: Usual care
  description: Experimental control sites receiving usual care
  arm group label: Control
  criteria: 
  gender: All
  minimum age: N/A
  maximum age: N/A
  healthy volunteers: No
  last name: Paul N Pfeiffer, MD MS
  role: Principal Investigator
  affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
  last name: Jacob E Kurlander, MD MS MS
  role: Principal Investigator
  affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
  last name: Jeremy B. Sussman, MD MS
  role: Principal Investigator
  affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
  facility: 
  country: United States
  responsible party type: Sponsor
  mesh term: Suicide
  mesh term: Suicide Prevention
  sharing ipd: Yes
  ipd description: Site-level data that underlie results reported, after de-identification will be available.
  ipd info type: Study Protocol
  ipd info type: Analytic Code
  ipd time frame: For 36 months after article is published.
  ipd access criteria: Upon request by researchers who provide a methodologically sound proposal. Further details will be available.