{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T13:12:27Z","timestamp":1793797947130,"version":"4.6.1"},"reference-count":71,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>A suicide epidemic exists among young U.S. veterans, with risk especially elevated in the first year of transition for the 200,000 servicemembers exiting the military annually. The VA Veteran Sponsorship Initiative (VSI) is a public\u2013private-partnership between federal and community partners that aims to decrease suicides by providing a VA-certified volunteer peer sponsor and connection to community services. Onward Ops is a key community-based national program that enrolls, matches and manages the relationship between servicemembers and sponsors. A prior randomized controlled trial showed that the effectiveness of community interventions can be enhanced when augmented by an Onward Ops sponsor. In preparation for national implementation, we conducted a quasi-experimental, matched-cohort pilot to evaluate the feasibility of an adapted VSI protocol and then assessed effectiveness. The adaptations were executed using the Framework for Reporting Adaptations and Modifications-Enhanced between April 2021 and April 2023. The formative results supported the feasibility of the adaptations to enable proactive enrollment on military installations and expand data infrastructure, partnerships, peer sponsors, and VA clinical services. We then assessed the effectiveness for outcomes not studied in the original VSI trial for active-duty soldiers who enrolled between April and December 2023. After nearest-neighbor matching, the sample included 551 VSI participants and 551 soldiers transitioning as usual. The point-probability contrast or risk differences from the conditional logistic regression model indicated that the VSI caused a statistically significant increase in VA primary care utilization of 0.198 and a statistically significant decrease in suicide attempts of \u22120.019, both assessed 10 months post-military discharge. The study demonstrated the utility of public\u2013private-partnerships, peer-sponsorship programs and enhanced VA services to support servicemembers during transition.<\/jats:p>","DOI":"10.3390\/ijerph23040519","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T16:30:36Z","timestamp":1776443436000},"page":"519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mitigating Suicide Risk During the Military-to-Civilian Transition: The VA Veteran Sponsorship Initiative"],"prefix":"10.3390","volume":"23","author":[{"given":"Joseph C.","family":"Geraci","sequence":"first","affiliation":[{"name":"VA Veterans Integrated Service Network (VISN) 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY 10468, USA"},{"name":"VISN 17 Center of Excellence for Research on Returning War Veterans, Doris Miller VA Medical Center, Central Texas Veterans Health Care System, Waco, TX 76711, USA"},{"name":"Teachers College, Columbia University, New York, NY 10027, USA"},{"name":"Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3232-2189","authenticated-orcid":false,"given":"David E.","family":"Goodrich","sequence":"additional","affiliation":[{"name":"VA Veterans Integrated Service Network (VISN) 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY 10468, USA"},{"name":"Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA"},{"name":"Department of General Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin P.","family":"Finley","sequence":"additional","affiliation":[{"name":"VISN 17 Center of Excellence for Research on Returning War Veterans, Doris Miller VA Medical Center, Central Texas Veterans Health Care System, Waco, TX 76711, USA"},{"name":"Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda L.","family":"Reed","sequence":"additional","affiliation":[{"name":"James J. Peters VA Medical Center, Bronx, New York, NY 10468, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Eastman","sequence":"additional","affiliation":[{"name":"Onward Ops, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Bracco","sequence":"additional","affiliation":[{"name":"Onward Ops, Washington, DC 20037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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Peters VA Medical Center, Bronx, New York, NY 10468, USA"},{"name":"Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Eickhoff","sequence":"additional","affiliation":[{"name":"VA National Center for Healthcare Advancement and Partnership, Washington, DC 20420, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4377-5944","authenticated-orcid":false,"given":"Chien J.","family":"Chen","sequence":"additional","affiliation":[{"name":"VA National Center for Healthcare Advancement and Partnership, Washington, DC 20420, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"MacCarthy","sequence":"additional","affiliation":[{"name":"VISN 17 Center of Excellence for Research on Returning War Veterans, Doris Miller VA Medical Center, Central Texas Veterans Health Care System, Waco, TX 76711, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Roeder","sequence":"additional","affiliation":[{"name":"VISN 17 Center of Excellence for Research on Returning War Veterans, Doris Miller VA Medical Center, Central Texas Veterans Health Care System, Waco, TX 76711, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8407-7130","authenticated-orcid":false,"given":"Chris","family":"Paine","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Feliciano","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigid","family":"Connelly","sequence":"additional","affiliation":[{"name":"VA Veterans Integrated Service Network (VISN) 2 Mental Illness Research, Education and Clinical Center, James J. 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Peters VA Medical Center, Bronx, New York, NY 10468, USA"},{"name":"Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref_1","unstructured":"US Department of Veterans Affairs (2026, January 14). 2024 National Veteran Suicide Prevention Annual Report, Available online: https:\/\/www.mentalhealth.va.gov\/suicide_prevention\/data.asp."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/S2215-0366(16)30304-2","article-title":"Time-varying associations of suicide with deployments, mental health conditions, and stressful life events among current and former US military personnel: A retrospective multivariate analysis","volume":"3","author":"Shen","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_3","unstructured":"Veterans Affairs (2026, January 14). 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