Feasibility and Acceptability of Recruitment and Retention in a Remote Trial of Gatekeeper Training for Military Veterans

Abstract

Background SAVE (Signs; Ask; Validate; Encourage) is a brief gatekeeper training designed to teach lay individuals how to identify and assist military veterans at risk for suicide. SAVE can be delivered asynchronously using a web-based video format, but no studies of the effectiveness of SAVE exist. Objective The aim of this project was to determine the feasibility and acceptability of recruitment and retention in a remote trial of SAVE. Methods We conducted a social media campaign using sponsored Facebook posts (ads) to recruit veterans, including those outside the Veterans Affairs network of care, and their loved ones. Participants (N=214) were randomized to SAVE or a sham video training unrelated to suicide prevention and followed for 6 months. We also conducted qualitative interviews with a subgroup (n=15) and used a mixed methods framework to integrate findings. Results At baseline, most participants were a family member or friend of a veteran (146/214, 68.2%), and 47.7% (102/214) knew at least one veteran or service member who had died by suicide. Across both study arms, 73.8% (158/214) responded to at least 3 of 6 follow-up surveys and 72.4% (155/214) completed follow-up at 6 months. Themes from interviews indicated the following three barriers to study participation: generic posts, copy (ad text) referring to “research,” and Facebook as a platform. There were 5 facilitators to participation: audience segmentation focused on veterans’ family members and friends, an urgent call to action to help a veteran, prior exposure to suicide, emphasizing the benefits of receiving training, and using a university as the campaign messenger. Conclusions A social media campaign was a feasible and acceptable approach to recruiting and retaining participants—especially the loved ones of veterans with prior exposure to suicide—for a fully remote trial of SAVE gatekeeper training. Several campaign strategies may be applied to further promote remote study participation in this population. Trial Registration ClinicalTrials.gov NCT04565951; https://clinicaltrials.gov/ct2/show/NCT04565951 Conflicts of Interest None declared.