"Lock to Live" for firearm and medication safety: Feasibility and acceptability of a suicide prevention tool in a learning healthcare system

Few patients with suicide risk are counseled on lethal means safety by health providers. This study tested the feasibility of different delivery methods for Lock to Live (L2L), a web-based decision aid of safe storage options for firearms and medications. Patients reporting suicide ideation on the P...

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Bibliographic Details
Published in:Frontiers in digital health 2022-09, Vol.4, p.974153
Main Authors: Boggs, Jennifer M, Quintana, LeeAnn M, Beck, Arne, Clinch, Samuel, Richardson, Laura, Conley, Amy, Richards, Julie E, Betz, Marian E
Format: Article
Language:English
Subjects:
Digital Health
firearms
lethal means
Lock to Live
medication access
web-based
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Summary:Few patients with suicide risk are counseled on lethal means safety by health providers. This study tested the feasibility of different delivery methods for Lock to Live (L2L), a web-based decision aid of safe storage options for firearms and medications. Patients reporting suicide ideation on the PHQ9 depression screener during outpatient health visits were included. Invitation messages to visit L2L were sent combinations of email, text, Electronic Health Record (EHR) message, mailed letter, or provider referral, followed by a survey about storage behavior and acceptability. Provider interviews evaluated logistical considerations and acceptability. The population-based method reached 2,729 patients and the best method (EHR message plus 2 email reminders) had 11% uptake (L2L visitation rate). Provider referral had small reach (14 patients) and 100% uptake (all visited). Provider interviews identified several strategies to promote uptake including: EHR reminders, provider training, quality metrics with accountability, a clearly communicated lethal means screening/counseling policy, and strong organizational leadership support. Despite the low uptake for population-based (11%), far more patients with suicide risk were engaged in the L2L tool through population-based outreach than provider-referral over the same time frame.
ISSN:2673-253X
2673-253X
DOI:10.3389/fdgth.2022.974153