In 2016, 45,000 U.S. individuals died by suicide, twice as many as died by homicide. Military personnel are disproportionately affected, especially in the National Guard (NG) where suicide rates (27.6/100,000) are the highest of all the Armed Forces and twice those of similar-aged individuals in the U.S. population. The proposed translation project will conduct a Hybrid Type I Effectiveness-Implementation Trial testing group-based Crisis Line Facilitation (CLF) vs. passive implementation (PI) to enhance NG Crisis Line Facilitation (MVCL) use. In Phase 1, we will conduct a cluster RCT, enrolling 300 Michigan soldiers from 12 NG units during drill weekends, with units randomized to receive either group-based CLF or PI (i.e., handouts). In Phase 2, qualitative data on barriers and facilitators to MVCL use and CLF implementation in the NG will be collected from key stakeholders, NG leadership, and NG service members. Based on these data and using the translation framework Enhanced-Replicating Effective Programs (E-REP), we will develop a customized implementation toolkit (i.e., program components, training materials, fidelity and process evaluation tools, technical support) and examine implementation (enhanced by an external facilitator), including evaluating RE-AIM outcomes.
