Updated: February 2022

INNOVATIONS IN NUTRITION PROGRAMS AND SERVICES (INNU) 

REPLICATION TOOLKIT

Replication Model C: Georgia State University: Senior Nutrition 

Program Evidence-Based Suicide Intervention Training 

Also referred to as “Suicide Intervention Training Program Toolkit”

How to Use This Toolkit

Please begin by reviewing the https://www.grants.gov/ posting for HHS-2022-ACL-AOAINNU-0040, which outlines requirements for ALL Replication projects. The information 

contained in this replication toolkit provides specific information and requirements 

regarding Replication Model C. 

This Replication Model Toolkit outlines the required elements within a Replication 

Project C application for HHS-2022-ACL-AOA-INNU-0040 Replication Grants. 

The toolkit specifies proposed application:

• Required elements. 

• Components which may or should be customized. 

• Areas where flexible approaches are permitted. 

Successful applications will outline a proposed project that includes all required 

elements while also demonstrating that customized and flexible items are planned.

If funded, your project team will receive regular technical assistance from the National 

Resource Center on Nutrition and Aging as well as consultation with members of the 

original grant’s project team, as feasible.

All surveys/forms and other materials are intended to be customized by the grantee and 

the grantee should review the materials thoroughly to assure the use of customized

information including dates, contact names, etc. 

If your grant proposal involves any programmatic, policy, organizational, or financial 

system changes, it is your responsibility to make sure the changes are acceptable and 

compatible with your state/local polices and requirements.

Summary of the Project

To replicate this project, applications must propose to implement a standardized and 

manualized suicide intervention program (specifically the ASIST training) to homedelivered meal (HDM) participants via nutrition services volunteers, in alignment with 

the materials developed by the Georgia State University 2018 Innovations in Nutrition 

Services and Programs grant.
Updated: February 2022

This unique and successful project created materials designed specifically for Area 

Agencies on Aging (AAA) and local nutrition programs to help them identify how their 

SNP volunteers can play an important role in identifying and supporting communitybased older adults who have, or are at risk for, suicide or mental health distress. 

The Suicide Intervention Training Program Toolkit includes:

• ASIST (Applied Suicide Intervention Skills Training) Suicide Prevention Training 

Centre | LivingWorks/ASIST 

• More than a Meal: Facts, Stress, & Coping Information for HDM Volunteers during 

COVID-19 (guidance on how to identify signs of stress and mental health trouble or 

suicide risk in seniors receiving HDMs)

• Caring for Wellbeing of Older Adults during COVID-19 (tips for ways to connect with 

seniors while social distancing)

• Enhancing Socialization through Making Meaningful Volunteer Connections during 

COVID-19 (tips on building and strengthening connections with seniors)

• Suicide Intervention Response Inventory (SIRI 2) with scoring

Outcomes from the original project include:

• Nutrition services volunteers and providers developed suicide intervention skills. 

• When suicide intervention skills are employed, those skills remain part of their job 

role and provide life assisting suicide interventions to the older adults they serve.

• The intervention process was conceptualized as:
Updated: February 2022

Replication Requirements, Anticipated Customization and Flexibilities

Table: Replication Model C Requirements, Customization and Flexibilities* 

Category Grant 

Requirements

(Elements that 

must be included)

Required 

Customization 

(Elements that must 

be included and 

adjusted to project)

Project Flexibilities

(Optional elements; not 

exclusive)

Application Section

(Bolded sections are 

required; others are 

recommended)

Population 

Served

• 60 and over

• Targeted 

Populations

Specific targeted 

population 

• Risk of hospital 

readmission

• Food insecurity

• Chronic disease

• Abstract

• Problem 

statement

• Approach

Service 

Delivery 

Older Americans 

Act Nutrition 

Program homedelivered meals 

via volunteers

• Policy and 

procedure on 

volunteer 

training and 

roles

• Agency-wide 

approach to 

screening and 

referrals

• Congregate

• Virtual 

• In-person

• Staff training

(recommended)

Approach

Partnerships LivingWorks.net

and a 

LivingWorks 

trainer

Specific 

organizations that 

provide services 

and/or are referral 

entities

• Implementation 

partners:

o Faith-based 

organizations

o Senior 

Centers

o Housing 

authorities

• Abstract

• Approach

Activities 

and Services 

ASIST trainings: 

LivingWorks.net/

ASIST

• Establish 

policies and 

procedures for 

volunteer 

participant 

interaction

• Referral 

process that 

addresses 

individuals 

needing 

additional 

support

• Surveys

• Site visits

• Presentations

• Referral method

Approach

Evaluation Volunteer 

Suicide 

Intervention 

Response 

Inventory

• Planned 

evaluation 

process

• Frequency and 

method of data 

collection

• Outcomes and 

evaluation
Updated: February 2022

Category Grant 

Requirements

(Elements that 

must be included)

Required 

Customization 

(Elements that must 

be included and 

adjusted to project)

Project Flexibilities

(Optional elements; not 

exclusive)

Application Section

(Bolded sections are 

required; others are 

recommended)

• Quality 

assurance 

• Demographics

• Number and 

types of referrals 

to address 

identified risks

Outcomes • Number and 

percent of 

total 

participants 

who are 

identified at 

elevated 

suicide risk 

or in mental 

health 

distress 

(ESR/MHD) 

• Change in 

volunteer 

attitudes 

and 

response to 

someone in 

crisis 

Dissemination 

(webinars, 

conference 

sessions, etc.)

• Policy/procedure 

impacts on staff 

or systems 

efficiencies 

• Costs and 

benefits 

• Abstract

• Outcomes and 

evaluation

Products Capstone project • Surveys

• Presentations

• Evaluation 

reports

• Abstract

• Approach

Sustainability Continue effective 

policies and 

procedures 

developed during 

the project 

• Funding to 

support 

screening or 

services

• Embed training 

and referral 

processes into 

staff/volunteer 

job descriptions

Sustainability

*Please refer to HHS-2022-ACL-AOA-INNU-0040 Replication Grants for requirements which apply to all 

Replication Projects.

 
Updated: February 2022

Grant-related Resources

Suicide Intervention Skills Training for Volunteers: 

• ASIST (Applied Suicide Intervention Skills Training) 

• Suicide Intervention Response Inventory (SIRI-2) with scoring

Other Resources (in addition to those provided in FAQ #7):

• Caring for Wellbeing of Older Adults during COVID-19 (tips for ways to connect with 

seniors while social distancing)

• Enhancing Socialization through Making Meaningful Volunteer Connections during 

COVID-19 (tips on building and strengthening connections with seniors)

• More than a Meal: Facts, Stress, & Coping Information for HDM Volunteers during 

COVID-19 (guidance on how to identify signs of stress and mental health trouble or 

suicide risk in seniors receiving HDMs)

• The Suicidal Behaviors Questionnaire-Revised (SBQ-R) and many other measures 

are available in the book - Gutierrez, P. M., & Osman, A. (2008). Adolescent Suicide: 

An Integrated Approach to Assessment of Risk and Protective Factors. It is available 

from the Cornell University Press. The ISBN is 10:0-87580-616-3, list price is $46 

(US). By purchasing the book, you are granted the right to reproduce any of the 

measures in it at no extra charge and to administer them as paper-and-pencil 

measures.

 
Updated: February 2022

FAQ for Replication Model C

1. Do the volunteers have to be currently involved in the home-delivered 

meals program?

Projects may recruit new volunteers and should follow all existing policies for 

vetting and onboarding volunteers. Organizations without a current volunteer 

base may want to consider partnering with a volunteer services agency, faithbased organization, or other partner.

2. This Toolkit indicates the ASIST program is “evidence-based.” Does that 

mean the program is eligible for OAA III-D funding?

The ASIST program is not currently on the list of approved programs for OAA 

Title III-D funding. 

3. Can any program that enhances suicide intervention and mental health 

awareness skills of nutrition service volunteers be used?

No. To be awarded this replication grant, applicants must implement the program 

listed in the replication toolkit. 

4. Is there a limitation on the number of ASIST trainings which can be held? 

The number of trainings a project proposes will be determined by the applicant. 

Things to consider include: 

o Number of home-delivered meal participants the project intends to serve. 

o Number of volunteers that will be trained. 

o Attrition rate of volunteers. 

o Whether project staff will also be trained (recommended). 

5. How do we estimate training costs and schedule trainings in order to 

submit an accurate budget and workplan? 

Projects should contact LivingWorks, the developer of the ASIST program, prior 

to submitting a grant application in order to obtain accurate cost estimates. In 

addition, the developer can assist projects with identifying existing ASIST 

trainers. Projects can then determine if any ASIST trainers are available 

(including cost) or if they will choose to have project staff trained to provide the

ASIST trainings. Combining this information should allow applicants to project 

cost and timeframes for ASIST trainings.
Updated: February 2022

6. How often should the SIRI-2 be given to the trained volunteers?

The SIRI-2 is a useful tool for monitoring how closely the volunteers are following 

prescribed approaches outlined in the ASIST program (i.e., fidelity). Applicants 

should determine how often they wish to do the inventory with their volunteers. 

Implementing a pre-training program SIRI-2 and an end of program SIRI-2 is 

recommended at minimum. Additional SIRI-2 measurements may be given as 

the applicant deems appropriate and necessary to monitor fidelity and to perform 

quality assurance.

7. Are there other resources that might be helpful in customizing this toolkit?

Yes. The chart below has information about performance measures that may be 

useful to you as you design your replication.

Outcome Performance measure Notes

Volunteer attitudes 

and skills

Attitudes to Suicide 

Prevention Scale, ASP, 

Herron et al., 2001

Self-report measure of volunteer’s perspectives towards 

intervention developed specifically for health care 

members.

Suicide Identification 

Reporting Tool, SIRT

Survey with quantitative and free responses to assess 

the manner particular skills were employed in an at-risk 

identification.

At-risk identification Number of identified “at risk” 

or “in distress” older persons

Frequency counts collected by provider and site 

coordinators.

Suicide Behavior 

Questionnaire, SBQ-R 

Clinical assessment used to determine level of risk for 

suicidal behavior. The SBQ-R and many other measures

are available in Gutierrez, P. M., & Osman, A. (2008). 

Adolescent Suicide: An Integrated Approach to 

Assessment of Risk and Protective Factors.

Interpersonal Needs 

Questionnaire, INQ, Van 

Orden et al., 2012

Developed specifically for use with Joiner’s Interpersonal 

theory of suicide, the INQ assesses perceived 

burdensomeness and thwarted belongingness, which in 

combination lead to active suicidal desire.

Acquired Capability for 

Suicide Scale—Fearlessness 

About Death, ACSS-FAD, 

Ribeiro et al., 2014

Captures one’s psychological defense against ending 

one’s life, and in conjunction with the INQ, can be used 

as a predictor of suicidal intent or behavior.

Personal Health 

Questionnaire, PHQ-2, 

Kroenke et al., 2001; 2003

This will be used as a sequence for older adults as noted 

in Richardson et al., 2011, with the PHQ-9 only 

administered to those that score above 3 on the PHQ-2.

Generalized Anxiety Disorder 

Scale, GAD-7/GAD-2, Spitzer 

et al., 2006, Kroenke et al., 

2007

This will also be administered as a sequence, using cut 

offs from Wild et al., (2013), where the GAD-7 is only 

given to those older persons that score 2 or higher on the 

GAD-2.

Kessler Psychological 

Distress Scale, K6, Kessler et 

al., 2002

Self-report of how depressive and anxiety symptoms 

have changed. Can be used to distinguish dysthymia 

from emergent distress.

Profile of Chronic Pain: 

Screen, PCP:S, Ruchlman et 

al., 2005

Self-report of older person’s pain and emotional state. 

Includes demographic items. Questions on pain tolerance 

(suicide correlate) will also be included.

Wellness Five Factor Wellness 

Inventory, 5F-Wel, Myers & 

Sweeney, 2005

Measures general wellness, five second-order factors 

(Creative, Coping, Social, Essential, and Physical) and 

17 discrete wellness scales.