COIN Investigators & Staff
24 August 2021
COIN Investigators
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Joseph A Simonetti, MD
- Title: Assistant Professor, Clinical Investigator, Program for Injury Prevention, Education & Research; Division of Hospital Medicine, University of Colorado
- Contact: Joseph.Simonetti@va.gov
- Location: Denver
- University of Colorado webpage
- Joseph Simonetti, MD, MPH is a hospital medicine physician and health services researcher, with a focus on firearm injury prevention. He is a faculty member in the Program for Injury Prevention, Education & Research at the Colorado School of Public Health and an assistant professor of medicine in the Division of Hospital Medicine at the University of Colorado Anschutz Medical Campus. Dr. Simonetti is also a clinical investigator in the Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention and the Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care at the Veterans Health Administration.
- Dr. Simonetti was awarded a VA HSR&D Career Development Award to develop and pilot test a Veteran-centered lethal means safety suicide prevention intervention. He has served as an invited member to multiple national workgroups to provide guidance on research and policy efforts on firearm injury and suicide prevention.
Recent Publications
The following research fields have been used to summarize Dr. Sayre's publication (the number in parentheis is the times that research field has appeared):
- Clinical Research (14)
- Behavioral and Social Science (9)
- Prevention (8)
- Suicide (6)
- Suicide Prevention (5)
- Mental Health (5)
- Health Services (4)
- Cardiovascular (2)
- Brain Disorders (1)
- Pediatric (1)
- Violence Research (1)
2021
Clark KD, Newell S, Kenyon EA, Karras E, Simonetti JA, Gerrity M, Dobscha SK. Firearms storage safety discussions in VA primary care: Staff perspectives. Gen Hosp Psychiatry. 2021 Jul 22;72:96-101. doi: 10.1016/j.genhosppsych.2021.07.007. Epub ahead of print.
PMID: 34416678
Hoyt T, Holliday R, Simonetti JA, Monteith LL. Firearm Lethal Means Safety with Military Personnel and Veterans: Overcoming Barriers using a Collaborative Approach. Prof Psychol Res Pr. 2021 Aug;52(4):387-395. doi: 10.1037/pro0000372. Epub 2021 May 20. PMCID: PMC8375272.
PMID: 34421193
Hoops K, Fahimi J, Khoeur L, Studenmund C, Barber C, Barnhorst A, Betz ME, Crifasi CK, Davis JA, Dewispelaere W, Fisher L, Howard PK, Ketterer A, Marcolini E, Nestadt PS, Rozel J, Simonetti JA, Spitzer S, Victoroff M, Williams BH, Howley L, Ranney ML. Consensus-Driven Priorities for Firearm Injury Education Among Medical Professionals. Acad Med. 2021 Jul 6. doi: 10.1097/ACM.0000000000004226. Epub ahead of print.
PMID: 34232149
Newell S, Kenyon E, Clark KD, Elliott V, Rynerson A, Gerrity MS, Karras E, Simonetti JA, Dobscha SK. Veterans Are Agreeable to Discussions About Firearms Safety in Primary Care. J Am Board Fam Med. 2021 Mar-Apr;34(2):338-345. doi: 10.3122/jabfm.2021.02.200261.
PMID: 33833002
Dobscha SK, Clark KD, Newell S, Kenyon EA, Karras E, Simonetti JA, Gerrity M. Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives. J Gen Intern Med. 2021 Jan 26. doi: 10.1007/s11606-020-06412-x. Epub ahead of print.
PMID: 33501537
Whittington MD, Ho PM, Kirsh SR, Kenney RR, Todd-Stenberg J, Au DH, Simonetti J. Cost savings associated with electronic specialty consultations. Am J Manag Care. 2021 Jan 1;27(1):e16-e23. doi: 10.37765/ajmc.2021.88579.
PMID: 33471464
2020
Simonetti JA, Clinton WL, Taylor L, Mori A, Fihn SD, Helfrich CD, Nelson K. The impact of survey nonresponse on estimates of healthcare employee burnout. Healthc (Amst). 2020 Sep;8(3):100451. doi: 10.1016/j.hjdsi.2020.100451. Epub 2020 Aug 2.
PMID: 32919589
Simonetti JA. Active Shooter Safety Drills and US Students-Should We Take a Step Back?. JAMA Pediatr. 2020 Aug 31. doi: 10.1001/jamapediatrics.2020.2592. Online ahead of print.
PMID: 32870260
Simonetti JA, Dorsey Holliman B, Holliday R, Brenner LA, Monteith LL. Correction: Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study. PLoS One. 2020 Apr 2;15(4):e0231493. doi: 10.1371/journal.pone.0231493. eCollection 2020.PMID:
PMID: 32240267
Monteith LL, Holliday R, Dorsey Holliman BA, Brenner LA, Simonetti JA. Understanding female veterans' experiences and perspectives of firearms. J Clin Psychol. 2020 Sep;76(9):1736-1753. doi: 10.1002/jclp.22952. Epub 2020 Mar 30.
PMID: 32227687
Simonetti JA, Piegari R, Maynard C, Brenner LA, Mori A, Post EP, Nelson K, Trivedi R. Characteristics and Injury Mechanisms of Veteran Primary Care Suicide Decedents with and without Diagnosed Mental Illness. J Gen Intern Med. 2020 Mar 26. doi: 10.1007/s11606-020-05787-1. Online ahead of print.
PMID: 32219647
Simonetti JA, Dorsey Holliman B, Holiday R, Brenner LA, Monteith LL. Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study. PLoS One. 2020 Mar 10;15(3):e0230135. doi: 10.1371/journal.pone.0230135. eCollection 2020.
PMID: 32155211
Trivedi RB, Post EP, Piegari R, Simonetti J, Boyko EJ, Asch SM, Mori A, Arnow BA, Fihn SD, Nelson KM, Maynard C. Mortality Among Veterans with Major Mental Illnesses Seen in Primary Care: Results of a National Study of Veteran Deaths. J Gen Intern Med. 2020 Jan;35(1):112-118. doi: 10.1007/s11606-019-05307-w. Epub 2019 Oct 30. PMCID: PMC6957595.
PMID: 31667746
Grants & Funding
Current/Recent Grants
- Development and Testing of a Veteran-Centered Lethal Means Safety Suicide Prevention Intervention
- Grant number: 1IK2HX002861
- Funding amount: $0.00
- Start/End date: 7/1/2021 - 6/30/2025
- Abstract:
Seventeen Veterans die by suicide on a daily basis, and Veterans often seek care in Emergency Departments (EDs) prior to a suicide attempt. Lethal means safety (LMS) interventions, which aim to reduce access to common methods of suicide such as firearms or toxic medications, are considered important components of suicide prevention programs and are recommended for Veterans with elevated suicide risk. Significance/Impact: The Veterans Health Administration (VHA) considers suicide prevention a clinical and research priority. In 2019, VHA began screening all Veterans seeking ED care for elevated suicide risk. The VA’s National Strategy for Preventing Veteran Suicide highlights “efforts to reduce access to lethal means of suicide among Veterans with identified suicide risk.” However, no LMS intervention has been developed to accompany this initiative and prior LMS interventions have not been developed for US Veterans or VHA settings. The proposed work will address this critical gap in VHA suicide prevention efforts by developing and testing a Veteran-centered, ED-based LMS intervention for multiple methods of suicide. Innovation: Several evidence gaps must be addressed in developing such an intervention. No prior LMS intervention has been shown to be efficacious in promoting medication and firearm safety, and prior interventions have not accounted for the various, person-specific mechanisms by which individuals change behaviors. The proposed intervention will incorporate multiple evidence-informed elements specifically chosen to target different but complimentary behavioral mechanisms highlighted within the Health Belief Model (e.g., self-efficacy) as critical to behavior change. Elements include those that equip staff with evidence-based communication strategies, and provide Veterans with practical, patient-centered support to facilitate LMS behaviors. To ensure that this intervention meets the needs of at-risk ED patients and is sustainable long-term if shown to be efficacious, we will engage Veteran and clinical stakeholders to develop the intervention. Engaging stakeholders in intervention development, an emerging VHA priority, is critical for ensuring feasibility, acceptability, and credibility. As one Veteran remarked during a focus group, “I appreciate you all askin’ us what we’re thinkin’, rather than just sayin’, ya know, here’s what it is and here’s what it’s gonna be.” Specific Aims and Methodology: Aim 1: Identify contextual factors that may inform development of the intervention. I will conduct semi- structured qualitative interviews with up to 30 at-risk Veterans who recently received VHA ED care to identify intrapersonal, interpersonal, and institutional factors that should be considered during intervention refinement and adaptation in Aim 2. Aim 2: Leverage the expertise of a diverse sample of stakeholders to refine intervention elements, adapt them for use among Veterans and within VHA EDs, and develop a final intervention protocol and related materials. Building on prior studies and knowledge gained from Aim 1, I will employ a stakeholder-engaged process to refine, adapt, and finalize the LMS intervention protocol and materials. I will use two evidence-based methods to engage stakeholders and build consensus (Nominal Group Technique, online modified-Delphi process). Aim 3: Pilot the ED-based LMS intervention among 40 Veterans to assess feasibility and acceptability. I will assess feasibility of recruitment, staff fidelity to the intervention, and Veteran engagement, including after ED discharge, and acceptability of the intervention among participants, intervention staff, and ED staff. Next Steps/Implementation: Results from this pilot study will support an IIR application to test the efficacy of this intervention in promoting LMS behaviors among at-risk Veterans. If found to be efficacious, consistent with VHA’s public health approach to suicide prevention and my long-term career goals, my future work will aim to adapt and disseminate the intervention across various VHA (e.g., primary care) and community settings. - Public Health Relevance Statement:
Seventeen United States Veterans die by suicide each day. Nearly three-fourths of those Veterans die from firearm injury or poisoning, and many seek care in VA Emergency Departments (ED) prior to suicide attempts. In 2019, the VA began screening all Veterans seeking ED care for increased suicide risk. Interventions that promote firearm and medication safety are recommended for Veterans identified as at-risk. Our work will develop and test such an intervention for Veterans who seek care in VA EDs. We will interview at-risk Veterans who recently sought VA ED care to identify factors relevant to developing the intervention, and work with Veterans and VA healthcare staff to develop and test the intervention. Our safety intervention for Veterans with increased suicide risk is consistent with the VA 2018-2028 National Suicide Prevention Strategy, priority in preventing Veteran suicides, and focus on delivering Veteran-centered care. - NIH website: https://reporter.nih.gov/project-details/10184090
