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Addressing Firearm Suicide Risk Reduction with an Online Patient Decision Aid Tailored to Women Veterans

J Womens Health (Larchmt). 2026 Mar 19:15409996261434153. doi: 10.1177/15409996261434153. Online ahead of print.

ABSTRACT

BACKGROUND: Reducing suicide risk among Veterans is a national priority. Although firearms are the leading method of suicide among women Veterans, involved in nearly half of such deaths, firearm suicide prevention interventions tailored to women Veterans remain understudied.

OBJECTIVE: To assess women Veterans’ perceptions of and satisfaction with an online decision aid to reduce firearm suicide risk in women Veterans: Supporting Suicide prevention through Awareness, Firearm Safety, Education and Resources (eSAFER).

METHODS: This quality improvement project used mixed methods, including online surveys (n = 90) and telephone interviews (n = 35) with women Veterans between September 18 and 30, 2024.

RESULTS: Women Veterans reported high satisfaction with eSAFER, finding important its focus on: statistics specific to women Veterans, prevention, nonlethal safety considerations, empowerment with personalized options, engagement of trusted individuals, and inclusion of resources. Most (94%, n = 81) reported that it encouraged them to engage others with their safety plan. All interviewed participants reported equal or greater comfort using the online version relative to receiving a paper version in clinic or by postal mail, preferring its ease of completion, accessibility, confidentiality, and the ability to keep/share their plan.

CONCLUSIONS: An online decision aid tailored to women Veterans may reduce firearm suicide risk by increasing risk recognition, guiding personalized safety choices, and facilitating completion and support from others. eSAFER is a scalable tool to reach high-risk populations tailored to their needs.

PMID:41856920 | DOI:10.1177/15409996261434153

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