METHODS
A codesign approach was used to develop the suicide prevention training module. Vechakul and colleagues define codesign as a cooperative process bringing people and design professionals together to find new and innovative solutions for different problems of everyday life, this can include the innovation of technological products and/or management of complex social issues.Two stakeholder panels were involved in reviewing material developed for Pharm‐SAVES: a community pharmacy stakeholder panel including nine community pharmacy staff (i.e., pharmacists, pharmacy technicians, and a student pharmacist) and the Finger Lakes VA Veterans Research Engagement Board (VREB). The VREB consisted of 10 veterans from all branches, service periods, races, and genders, including officers and enlisted members. In addition to soliciting input from the pharmacy stakeholders and the VREB panel, a website development, educational design, two suicide prevention, and a patient‐provider communication expert, who attended the pharmacy panel meetings, provided input throughout the course of module development.Before meeting with all stakeholders, the research team, comprised of two primary investigators, a postdoctoral research assistant (postdoc) with previous experience in suicide prevention, and two study coordinators, met to discuss results from a previous formative study on pharmacy staff preferences for suicide prevention content. Data from the formative study showed that pharmacy staff preferred training that included: local suicide prevention referral resources, training that takes under 30‐min to complete, and incorporates three to four realistic role play scenarios, including a telephone interaction.Over the course of 8 months, 9 pharmacy stakeholder panel meetings were held in the late afternoon/evenings to accommodate busy pharmacy staff schedules (Table Stakeholder engagement meetings and content outline.
Reviewed the formative study outlining gatekeeper training needs of community pharmacy staffWatched existing videos modeling pharmacist‐ patient interactions of suicidal behaviorElicited specific feedback to determine if the interaction was realistic, an appropriate length, and needed to be adapted for pharmacy setting.Introduced VA SAVE, the suicide prevention gatekeeper training program developed by the VA Center of Excellence for Suicide Prevention (S.A.V.E. (Finalized regular meeting time
Reviewed scripts for the three proposed pharmacy video scenarios: (1) in‐person, (2) via telephone, and (3) drive‐through.VREB Panel Meeting 1
Reviewed proposed website contentReviewed scripts for the three proposed video scenarios, which take place: (1) in‐person, (2) via telephone and (3) at the pharmacy drive‐through.
Reviewed revised in‐person video scriptPresented written content for the training websiteFocused on structure of the websiteWebsite was divided into four key module topics: (1) Why me?, (2) What can I do? (Pharm‐SAVES), (3) How does it work? and (4) Referral resources.
Facilitated by the UNC MEDIA teamEvaluated website layout and design
Three different website mock‐ups with varying layouts and interactive features.VREB Panel Meeting 2
VREB reviewed the final drafts of video scripts and website mock‐up
MEDIA team presented revised website with training contentSolicited real‐time feedback on website modules for additional feedbackDrafted interactive cases
Presented the final version of the full training websiteReviewed the Introduction page and Module 1 ‘Why me?’ contentFeedback on Interactive Cases solicited, discussed the scripts and flow of content
Updated Introduction pageModule 2: ‘What can I do?’ (Pharm‐SAVES)Module 3: ‘How does it work?’Module 4: ResourcesSummary page
Module 2: ‘What can I do?’ (Pharm‐SAVES)Module 3: ‘How does it work?’Module 4: ResourcesSummary pageAdded section with credit for contributors and checked credentials
Study post‐doc presented Pharm‐SAVE websiteSolicited feedback on website content and structureAdvised to make ‘Set a reminder to follow‐up’ a separate step
Reviewed content proposed by suicide prevention expertUpdated acronym to ‘Pharm‐SAVES’ based on feedback from suicide prevention expertsReviewed resource referral toolThe pharmacy stakeholder group was provided with the video scripts before the meetings to provide written feedback and scripts were then reviewed over Zoom in real‐time as a group.The review of scripts was done via Zoom. The study post‐doc attended the meeting and took notes in real‐time which were typed and reviewed with the study team for integration into the revised scripts.The content was outlined by the postdoc and reviewed by the study investigators. A written outline of content was provided to the stakeholders for review prior to the meeting.Meeting minutes were recorded in a Word document in real‐time directly on the meeting agenda by either the study post‐doc or one of the study coordinators. Meeting minutes were reviewed weekly by the study team, where suggestions for website improvements, usability, module language, and content were extracted from meeting minutes. Any suggestions or edits related to website content (either written or video) were extracted and organized in a separate Word document. This Word document outlining website changes was then emailed to the UNC MEDIA team for incorporation into the course website.Due to the sensitive nature of the topic material, stakeholders and project staff were provided with mental health resources. The study post‐doc was also trained in mental health and suicide prevention protocols and was available for debriefing or to provide appropriate referral and local crisis resources.