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“Lock to Live”—An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults: Pilot Randomized Controlled Trial
Marian E Betz;
Christopher E. Knoepke;
Scott Simpson;
Bonnie J. Siry;
Ashley Clement;
Tamara Saunders;
Rachel Johnson;
Deborah Azrael;
Edwin D. Boudreaux;
Faris Omeragic;
Leah M Adams;
Sydney Almond;
Elizabeth Juarez-Colunga;
Daniel D. Matlock
ABSTRACT
Background:
Counseling to reduce access to lethal means like 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:
To test the feasibility and acceptability of L2L among suicidal adults in emergency departments.
Methods:
At four emergency departments, 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) and received a one-week follow-up telephone call.
Results:
Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many reported having access to firearms (67%), medications (94%), or both (59%). Participants viewed L2L for a median of 6 minutes (interquartile range: 4-10 minutes). L2L also had very high acceptability; almost all reported 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 exploratory analysis in this pilot trial, more in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant.
Conclusions:
The “Lock to Live” 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 effect on home access to lethal means. Clinical Trial: ClinicalTrials.gov NCT03478501
Citation
Please cite as:
Betz ME, Knoepke CE, Simpson S, Siry BJ, Clement A, Saunders T, Johnson R, Azrael D, Boudreaux ED, Omeragic F, Adams LM, Almond S, Juarez-Colunga E, Matlock DD
An Interactive Web-Based Lethal Means Safety Decision Aid for Suicidal Adults (Lock to Live): Pilot Randomized Controlled Trial