Feasibility and Acceptability of Caring Cards: A Peer‐to‐Peer Recovery‐Oriented Suicide Prevention Intervention for US Veterans

Caring Cards is a novel adaptation of caring contacts, where Veterans with a history of suicidality (card makers) create cards for Veterans with active suicidality (recipients). Aims included (1) establishing Caring Cards' feasibility and acceptability, including an optional meetup group, and (2) evaluating pre-/postchanges in thwarted belongingness, perceived burdensomeness, social connectedness, and suicide ideation. Participants included 30 card makers and 50 recipients receiving care at a Veterans Affairs Center. Groups of 5-10 card makers met weekly for 3-6 months to create cards; recipients received cards monthly for 6 months. Outcomes were collected at baseline and follow-up (one month postparticipation completion). Card makers demonstrated marginal feasibility (69.4% average attendance). Card maker attrition was greater than expected (60%). These rates may have been impacted by COVID-19. Card maker follow-up was feasible (70%). There was 0% attrition for recipients; however, follow-up was marginally feasible (68%). The optional meetup group was not feasible (36.4% attendance). All participants found the intervention acceptable (> 75% average satisfaction). There were no significant pre-/postdifferences across card maker outcomes. Recipients reported significant reductions in thwarted belongingness (d = 0.27) and perceived rejection (d = 0.41). Results highlight the promise of Caring Cards as a low-cost, highly scalable intervention.