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Strategic Marketing Plan for Suicide Bereaved Fathers

Last Updated:

4/16/2020

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Preface

About the Authors

Patrick Barton is a Master of Public Administration student with the John Glenn College of Public Affairs. Patrick earned a Bachelor of Science in Business Administration degree from Ohio State’s Fisher College of Business in 2017. He has several years of work experience at the federal, state, and local level. Patrick was born and raised in Columbus, Ohio.

Samantha Grevas is a graduate student at the Ohio State University’s John Glenn College of Public Affairs in the Master of Public Administration program. Samantha received her B.A. in Political Science and History from Ohio State University. After completing her degree in May, Samantha looks forward to finding a fulfilling role in a nonprofit or in higher education which will take her out from behind a desk and into the communities she is serving.

Ari Grubaugh is a graduate student at The Ohio State University in a dual degree program through the College of Social Work and John Glenn College of Public Affairs. Before graduate school, they earned a Bachelor of Arts in Political Science and Sexuality Studies, graduating magna cum laude from The Ohio State University in 2015. Ari’s professional interests include community outreach and engagement, advocacy, and social justice work.

Katie Heckerd is an Associate Director of Administration at The Ohio State University Alumni Association. She has ten years of professional fundraising experience. Katie has a bachelor’s degree from Ohio Northern University ‘10 with a focus in finance and management. She is currently pursuing her Master of Arts in Public Policy and Management at the Ohio State University’s John Glenn College of Public Affairs.

Mary Imre is a dual degree student at The Ohio State University studying public administration and social work. Prior to her graduate studies, Mary earned a Bachelor of Science in Psychology with a minor in Criminology from Ohio State. Mary’s professional interests include nonprofit administration, child and youth advocacy, and wildlife conservation.

Disclosure

This report was created by graduate students through a course in the John Glenn College of Public Affairs at The Ohio State University. The findings, opinions, and recommendations of this report are those of the authors and do not represent the John Glenn College of Public Affairs or The Ohio State University. This report is for LOSS Community Services’ internal use only.

Acknowledgements

Our team would like to extend our thanks to Dr. Erynn Beaton for providing guidance throughout the creation of this plan.

We would also like to offer our gratitude to LOSS Community Services and Executive Director Denise Meine-Graham. LOSSCS offers invaluable services for loss survivors and fills an essential gap in the community. Without the support and collaboration from LOSSCS and Denise, this project would not be possible.

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TABLE OF CONTENTS

INTRODUCTION

ORGANIZATIONAL BACKGROUND PROBLEM STATEMENT PURPOSE FOCUS

SITUATION ANALYSIS

AUDIENCE

SEGMENTATION RECOMMENDED AUDIENCE

OBJECTIVES AND GOALS

BARRIERS, BENEFITS, MOTIVATORS, COMPETITION, AND INFLUENTIAL OTHERS

POSITIONING STATEMENT

STRATEGIC MARKETING MIX

PRODUCT PRICE PLACE PROMOTION

MONITORING AND EVALUATION

BUDGET

IMPLEMENTATION PLAN

APPENDECIES

BEHAVIOR OBJECTIVES KNOWLEDGE OBJECTIVE BELIEF OBJECTIVE GOALS

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Executive Summary LOSS Community Services (LOSSCS) fills an essential service gap in the Central Ohio community through postvention services for suicide loss survivors. As LOSSCS continues to grow as an organization, it faces challenges in reaching certain subpopulations of loss survivors including men. The purpose of this report is to help LOSSCS market and augment existing services to increase the recruitment and retainment of suicide bereaved men - specifically fathers who have lost a child to suicide. This report includes analyses of the recommended population, LOSSCS organizational capacities, and social marketing techniques as outlined in Lee & Kotler (2016). These analyses were used to form recommendations that are intended to better focus on bereaved fathers, among other groups of bereaved men.

To complete our analyses and form recommendations, we did an extensive literature review of topics such as male patterns of grief, gender differences in suicide bereavement, barriers to seeking support, and male perceptions of mental health support. We also completed a qualitative analysis of data shared by Dr. Sally Spencer-Thomas, who surveyed men to better understand how they experienced suicide loss bereavement. Finally, using qualitative analysis techniques, we examined common marketing themes across campaigns specifically geared towards men such as Movember and Man Therapy.

Through our analysis and collaboration with LOSSCS, we arrived at the following broad recommendations, which are expanded upon in later sections:

1. Place: Increase accessibility of LOSSCS services for men by offering virtual support groups, adding masculine decor to the office, and expanding community partnerships to engage with men in places they may frequent.

2. Price: Emphasize low monetary costs of LOSSCS services while increasing participants’ perceptions of nonmonetary benefits using a voluntary pledge.

3. Product: Augment current programs to increase accessibility for men. This includes offering a fitness or active option, offering take-home materials, and encouraging self-determination.

4. Promotion: Create new promotional materials designed to appeal to men, including new messages, messengers, and communication channels.

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Introduction

Organizational Background LOSSCS is a 501(c)(3) nonprofit organization in Columbus, Ohio that serves individuals bereaved by suicide loss. LOSSCS’ services provide support after a suicide occurs to help survivors process grief (“postvention”). These services include a partnership with the local Coroner’s Office so LOSSCS volunteers are immediately available to support those left behind in the aftermath of a suicide, a one-on-one companionship program, support groups for 10-18 participants, and remembrance events where survivors can process grief as a community. Additionally, LOSSCS sends personalized messages to loss survivors on key dates that may trigger grief, such as the anniversary of the loss or the victim’s birthday. LOSSCS also performs prevention activities, such as community outreach and education on how to identify and address warning signs of suicide. While LOSSCS services are available to all adults experiencing suicide grief, most of the participants identify as female. Numerous factors prevent male survivors from taking advantage of these services.

Problem Statement Individuals bereaved by suicide loss experience intense grief that can lead to feelings of rejection and abandonment, anxiety, financial insecurity, and suicidal ideation (Addis & Cohane, 2005; Bailley et al., 1999). Men experiencing unaddressed suicide grief are particularly susceptible to destructive coping mechanisms (Martin & Doka, 2000). Men are three times more likely than women to attempt suicide after the loss of a spouse or partner, and twice as likely to attempt suicide after the loss of an adult sibling (Agerbo, 2005; Jordan, 2017). Despite the risks associated with untreated grief, male suicide loss survivors underutilize support services available to them. Only 31% of the individuals connected with LOSSCS are men, and male participation in support groups is even lower. LOSSCS’ mission is to be an instillation of hope and to empower all suicide loss survivors, regardless of gender. To fulfill this mission and grow as an organization, LOSSCS seeks to increase the number of male suicide loss survivors in Central Ohio that utilize support services.

Purpose The purpose of this marketing plan is to alleviate the consequences associated with untreated suicide grief in male suicide loss survivors. Focus The focus of this plan, determined by a thorough segmentation analysis, is to increase participation in LOSSCS programming among men who have lost a child to suicide.

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Situation Analysis The strengths, weaknesses, opportunities, and threats (SWOT) analysis helps an organization understand the internal strengths and weaknesses that affect the organization’s ability to implement a marketing plan, as well as the external opportunities and threats that must be taken advantage of or prepared for, despite not being within the marketer’s control (Lee & Kotler, 2016). See Appendix A for an expanded discussion of the SWOT analysis.

Strengths Weaknesses

• Mission driven board, staff, and volunteers • Staff experienced in marketing • Male loss survivors on board • Strong network of partnerships in Franklin

County

• Challenges reaching certain populations • Reliance on outside funding • Small staff size • Reliance on key partnerships to operate

Opportunities Threats

• Expand partnerships in network • Develop collaborative programming • Expand distribution of promotional

materials • Increase social media presence

• Suicide stigmatization • Challenges convincing men to access

mental health care • Lack of diversified funding sources • Possible change in coroner • Spread of COVID-19

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Audience

Segmentation For LOSSCS to expand, it should access new audiences beyond those most ready and willing to participate. According to LOSSCS, the following demographic groups underutilize support services:

Unengaged Survivors Demographic Variables

56+ years of age Age

Immigrants Nationality

Men Gender

We selected the gender variable for several reasons:

1. Gender is a large, identifiable segment. 2. This variable is more accessible than the others due to fewer cultural and communication

barriers. 3. The problem incidence is high with men, as few are engaging with LOSSCS. 4. The problem severity is high with men because they are nearly four times more likely than

women to complete suicide (Suicide, 2019). 5. The defenselessness of this segment is high because men are more likely to use

destructive coping methods when experiencing grief compared to women (Martin & Doka, 2000).

The male segment is not strongly receptive; thus, our marketing plan focuses on an approach that will appeal to men.

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Recommended Audience Parents who lose a child may experience higher rates of complicated grief than other groups (Jordan & McIntosh, 2011). Furthermore, LOSSCS data, as presented in Table 1, shows that fathers are the most common group of men to engage with LOSSCS. A full version of Table 1 is available in Appendix B. The high percentage of fathers indicates that they may be more in need of services and more willing to seek help compared to other groups of men. Therefore, the marketing strategy is designed to appeal primarily to bereaved fathers. However, the strategy will be applicable to other groups of men.

Table 1: Relationships of named survivors to deceased as of 1/3/2020

Relationship to Deceased

Count of Men

Percentage of Men by

Relationship Type

Count of Women

Percentage of Women by Relationship

Type

Total Count

Parent 184 34.59% 369 31.84% 553 Child/Step-child 97 18.23% 126 10.87% 223 Sibling/Step-Sibling 67 12.59% 128 11.04% 295 Spouse 44 8.27% 210 18.12% 254 Friend 30 5.64% 71 6.13% 101 Other/Unknown 110 20.68% 255 22.00% 365

Total 532 100% 1,159 100% 1,691

Diagram 1 represents the anticipated reach of our marketing suggestions. We expect the recommendations to resonate most deeply with fathers who are suicide loss survivors, followed by men broadly, anyone facing barriers to attending LOSSCS (primarily psychological), and finally those who are seeking out the type of services LOSSCS provides but are uninformed about the organization.

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Objectives and Goals

Behavior Objective Motivate bereaved fathers to seek support services through LOSSCS. Knowledge Objective Help fathers understand the benefits of seeking suicide loss support. Belief Objective Encourage fathers to believe that seeking suicide loss support services is acceptable and advisable. Goals Increase the number of male LOSSCS service participants who are fathers from 184 to 240, while, at a minimum, holding the number of non-fathers constant. This would be a 30% increase in the number of fathers participating in LOSSCS services, and a 10.5% increase in men overall.

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Audience Analysis

Barriers, Benefits, Motivators, The Competition, and Influential Others Suicide loss survivors face unique barriers to seeking help. Feelings of guilt, responsibility, rejection, and shame can prevent loss survivors from obtaining services (Bailey, Kral, & Dunham, 1999; Corrigan et al., 2018). Male loss survivors face barriers arising from the stigmatization of both men’s mental health and suicide. Rochlen & Hoyer (2005) identified three primary barriers facing men in seeking mental health support: ignorance, beliefs, and values:

1. Ignorance refers to the lack of awareness regarding symptoms of mental health concerns, how to talk about them, and services available.

2. Beliefs act as a barrier because men may not believe that intervention services will help them in the desired way. Dr. Sally Spencer-Thomas (2014) found that men had difficulty talking about emotions and did not believe that there were interventions that met their unique needs. Furthermore, Zinner (2000) found that peers and community members may not believe men need help and are thus reluctant to engage with them.

3. Values can be a barrier in seeking support because the traditional perception of mental health support is contradictory to masculine values of strength and independence. Addis and Cohane (2005) found that men perceived grief support as violating masculine ideals by demonstrating weakness.

While there are a variety of benefits to seeking mental health support, it seems that the barriers men face can be overwhelming. Given these barriers, it is important to present intervention services in a way that fits within the motivators of the intended population. Evidence suggests that, though men face these barriers, they still desire help for grief-related concerns. One man indicated the desire to connect with “another experienced [loss survivor]” (Spencer-Thomas, 2014). See Appendix C for a qualitative analysis of other survey responses. Golden (1996) expanded on the ways by which men prefer to cope with their grief, citing a desire for more “active” strategies rather than passive strategies such as talk therapy. The table below summarizes barriers, benefits, motivators, competition, and influential others relevant to male loss survivors.

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Male Suicide Loss Survivors, in General

Barriers

• Mental health stigma • Masculine values and socialization • Unaware of symptoms • Unaware of services • Stigma surrounding suicide • Societal & familial expectations • Logistical barriers: time & place of service

delivery

Benefits

• Improved mental health • Honoring a loved one • Gaining pro-social coping mechanisms • Gaining a sense of belonging • Connecting with peers with similar

experiences • Reduction of shame and guilt

Motivators

• Desire to connect with peers with shared experiences

• Encouragement from loved ones • Examples set by others • Association of services with masculine

ideals • More “active” service options • Transparency of services • No-cost services

Competition

• Not seeking service • Destructive coping mechanisms (such as

substances & physical aggression) • Expression through anger

Influential Others

• Well-known men such as athletes, celebrities, politicians • Respected community members such as religious leaders, local reporters, law

enforcement • Loved ones such as friends and family members • Media sources

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Positioning Statement We want bereaved fathers to see LOSSCS postvention services as a beneficial part of their grieving process, thus reducing the risk for negative outcomes after suicide loss.

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Strategic Marketing Mix

Place Place is where and when the intended audience will receive LOSSCS services. The audience will evaluate the convenience of an organization’s offerings relative to the convenience of other opportunities in their life (Lee & Kotler, 2016). As a result, place factors can significantly impact an organization’s ability to pursue its mission. The following recommendations will make LOSSCS’s location more appealing to survivors: Be at the point of vulnerability: The ideal moment for LOSSCS to interact with bereaved fathers is when they are about to choose between competing behaviors. Reaching men early in their bereavement is crucial, as they may be “most at risk [for suicide] during the first few months of bereavement” (Rostila, Saarela, & Kawachi (2013). The partnership with gun shops and the concealed carry office are excellent ways to reach survivors. LOSSCS should continue to expand this partnership to new gun shops and shooting ranges. LOSSCS should also expand partnerships with places of worship and funeral homes. LOSSCS would also benefit from forging relationships with local media outlets, including television and radio stations, newspapers, and magazines. By doing this, LOSSCS could teach more reporters to respond to suicide in a respectful way and equip media sources with LOSSCS resources to give to loss survivors. LOSSCS should also consider partnering with groups such as Alcoholics Anonymous, where men may be turning to deal with their destructive coping mechanisms. Overcome psychological barriers associated with place: LOSSCS should consider virtual support groups conducted through a video platform to help alleviate the barriers men face upon walking into the physical office. A virtual setting would be more convenient for loss survivors and help transition them to in-person support. Additionally, a text short code provides an additional contact method. Crisis help lines such as The National Suicide Prevention Hotline and the Crisis Text Line are offering text or chat services to increase the degree of anonymity that a phone conversation does not provide (Dockray, 2019). These methods provide alternative methods of engagement that are inclusive of diverse personalities. Make the location more appealing: LOSSCS already recognizes the importance of securing a stand-alone location. A more centralized location closer to a bus stop could help LOSSCS serve more loss survivors. Additionally, the office’s internal environment can influence survivor behaviors. LOSSCS should strive to offer an office environment that all survivors perceive to be comfortable and secure. Otherwise, psychological barriers may prevent survivors from returning to LOSSCS events. One low-cost, high-impact opportunity for LOSSCS to attract men would be to place sports paraphernalia in the office. Such items could include flags, jerseys, or balls featuring Ohio’s sports teams. Another option would be to place photos of men (with their consent) who participate in LOSSCS services. These items would demonstrate that men have a place at LOSSCS and reduce psychological barriers to participating in support programs.

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Price Price is the cost the audience associates with adopting the desired behavior (Lee & Kotler, 2016). This includes both monetary and nonmonetary costs.

Type of Cost Examples

Monetary

• Transportation expenses (gas/vehicle maintenance, bus fees, rideshare)

• Incidental expenses incurred through the companion program

Nonmonetary: Time, Effort • Impact on work • Impact on leisure time

Nonmonetary: Psychological

• Admitting you need help • Speaking about weaknesses • Changes in self-perception (i.e. seeing

yourself as less masculine)

Nonmonetary: Opportunity Costs • Forgoing other self-improvement experiences/opportunities

Below are recommendations on how to incentivize male participation in LOSSCS programming, and disincentivize non-adoption and attrition: Decreasing monetary costs: LOSSCS does not charge a fee to participate in programming. The availability of free programming overcomes a barrier many individuals face in seeking grief assistance. Conversely, therapy sessions can range from $20-250 per session. Many Americans cannot sustain these costs, especially since therapy can become a life-long exercise for those seriously impacted by grief (“How Much Does Therapy Cost?” n.d.). There is little LOSSCS can do to mitigate the other monetary costs of attending programming, such as transportation costs, at this time. However, as the organization researches a location for its future stand-alone office space, LOSSCS can consider incorporating transportation cost into the decision-making process. Increasing nonmonetary benefits: A common method of increasing the nonmonetary benefits of a program is the signing of a consensual pledge to continue attending services (Lee & Kotler, 2016). A study conducted on the effect of pledges in voter turnout found that signing a pledge increased turnout by 3.7 points for all participants and 5.6 points for those who never voted in the past (Costa, Schaffner & Prevost, 2018). Additionally, the use of a pledge card for bicycle helmet use increased the percent of helmets worn on a college campus by 21% (Ludwig, Bucholz & Clarke, 2005). LOSSCS support groups and companion programs can utilize pledges to encourage male participation. Asking (but not forcing) participants to sign a pledge increases self-respect and leads the individual to value the service more highly. LOSSCS does not currently employ a pledge document for individuals attending support groups, opting to provide participants with a readiness assessment and ground rules. A pledge to continue attending support groups can be an intrinsic motivator to potential support group attendees and ensure they remain dedicated to the process.

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Decreasing non-monetary costs: LOSSCS can decrease social and psychological risks of adopting attending programming with endorsements from credible sources (Lee & Kotler, 2016). These endorsements have the potential to reduce the stigma and embarrassment associated with seeking help (Gemünden, 1985). The Place, Product, and Promotion sections list potential messengers that can act as endorsers of LOSSCS and suggest partnerships with organizations bereaved fathers are known to trust. Product The products LOSSCS currently offers include support groups, companion programs, events, and volunteer opportunities, but these products will need to be augmented to better appeal to men (Lee & Kotler, 2016). The common benefit that LOSSCS provides to loss survivors is the chance to support, and receive support from, other survivors. However, men may experience difficulty giving direct verbal support in a traditional group setting while they are experiencing their own grief (Van Dogen, 1990). To best engage bereaved fathers, and all men, LOSSCS should offer service elements that are less formal than a traditional support group. These programs will make it more comfortable for men to engage with LOSSCS because they circumvent the masculine stigma associated with getting help.

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Desired Behavior For bereaved fathers to seek support through LOSSCS

Core Benefit to Offer

Provide support, or receive support from, others with similar lived experiences

Current Products Support Groups

Companion program

Events Volunteer Opportunities

Augmented Product Possibilities

1. Fitness element: offer running/walking group, dog walking group, recreational sports team, etc.

2. Take-home materials such as books written by male suicide loss survivors to allow men to take materials if they are looking for a more individual or private option. a. These materials make it easy for people, such as spouses, to take

home materials to others who may be considering seeking support b. Add LOSSCS materials into inside cover c. See Appendix D for suggested resources.

3. Male role models with lived experience a. Quotes, videos, or direct interaction with a role model from the

community with similar lived experiences integrated into services. This could be done through male loss survivors acting as a facilitator or event speaker.

b. Recruit male volunteers to act as these role models. 4. Events tailored to men such as a Blue Jackets or Clippers game and

take-home items before or after. 5. Companion program tailored to men where they are more closely

matched with similar men and are given more active meet-up choices such as a round of golf.

6. Adding activities that promote self-determination a. Example: “LOSSCS checklist” where participants can check off

activities for attending LOSSCS services or partaking in pro-social & mental wellness activities such as going for a run. This could help keep men mindful of their behaviors and motivated to continue them, while also giving men a sense of choice and control. See Appendix E for an example.

Future Implications of Recommendations: The above recommendations are intended to increase men’s interest in LOSSCS’ current program options, meaning that all current participants are welcome to partake. If in the evaluation phase LOSSCS finds that the number of men increases, we believe it would be beneficial to introduce services exclusively for men such as a men’s support group that includes a fitness element or men’s event such as a father’s sports night. Ethical Considerations: In any product category, it will be important for LOSSCS to only promise benefits and outcomes that are guaranteed. Our analyses have shown that men prefer concrete, objective, and directly stated benefits of products and expect to gain those benefits upon acquiring the product. While postvention benefits many participants, LOSSCS should continue to avoid phrasing such as “you will experience less anxiety.” LOSSCS should instead stress that participants will meet individuals with similar experiences, which can provide a more relevant and

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nonjudgmental perspective. LOSSCS should also reassure participant confidentiality not only to respect survivors’ privacy, but also to further motivate men to engage (Men’s Mental Health Forum, 2014). Promotion Promotion involves the development of persuasive communications designed to inspire the intended audience to action. Promotion seeks to inform the audience of product benefits and how to access services (Lee & Kotler, 2016). For LOSSCS, promotions will persuade suicide bereaved fathers to participate in services offered by the organization. Promotion considerations should include the message, messenger, the creative strategy of the brand, and communication styles.

Messages: An organization must decide what they want to communicate, “inspired by what you want your audience to do, know, and believe” (Lee & Kotler, 2016, p. 343).

1. To do: Access LOSSCS services 2. To know: All the services offered by LOSSCS and the benefits of such services 3. To believe: That seeking suicide loss support services is acceptable and advisable

Messengers: Messengers are as important as the message itself. Research indicates that “People can be persuaded to behave in ways that they believe credible, influential colleagues or peers want them to behave” (Courtenay, 2004, p. 276). As discussed under Product, useful messengers to get men to access services are role models with similar lived experiences, such as local male athletes, celebrities, politicians, religious leaders, reporters, law enforcement agents, and other important community members. New materials could also include quotes from men who have experience with LOSSCS.

Creative Strategy: Developing a creative strategy is important for establishing a campaign’s identity. The creative strategy involves deciding what the envisioned message is and how it should be delivered to the intended audience. To inform recommendations, our team utilized peer reviewed research on engaging men through marketing campaigns (Wilkins, 2014; O’brien & Forrest, 2008; Rochlen & Hoyer, 2005; Courtenay, 2004) and analyzed current men’s mental health campaigns. Campaigns considered were Movember, Man Therapy, and Heads Up Guys (movember.com; mantherapy.org; headsupguys.org). Common themes included:

• A desire to connect with peers with shared experiences • Destigmatization of support seeking behaviors • Evidence of program’s effectiveness • Action-oriented and direct language • Active service options • Sympathy • Humor

Marketing Ideas: Based on the above themes, our team has developed potential messaging examples that LOSSCS could adapt. Examples include:

• Shoulder to Shoulder • Standing Together • Take control of your mental health; you deserve it • Men Grieve Too • You’ve been there before, support LOSSCS

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The above slogans could be used individually or combined, such as “Standing Together, Shoulder to Shoulder.” And below, is a graphic developed for LOSSCS’ use if the organization is interested:

(Image design by Christa Johnston)

Communication Channels: Communication channels are the media through which messages reach an audience. Innovation in consumer-facing technology has expanded the number of channels available to nonprofit organizations. As a result, LOSSCS has numerous opportunities to communicate to stakeholders and audiences effectively and efficiently.

LOSSCS primarily utilizes printed material, social media, and website communication channels to promote awareness and engage with loss survivors. The printed materials reach survivors directly and indirectly through community partnerships. Additionally, the organization operates accounts on Facebook, Twitter, LinkedIn, Pinterest, and Instagram. However, LOSSCS’ website is the primary source of information for current and potential participants and stakeholders. The website also features a blog through which survivors can share their story and honor the memory of their loved ones.

The following options would allow LOSSCS to expand outreach to loss survivors. These ideas offer LOSSCS the opportunity to use new communication channels to reach male loss survivors or use current channels to achieve the belief, behavior, and knowledge objectives.

1. A public service announcement (PSA) on local radio: A PSA can help LOSSCS achieve the behavior, belief, and knowledge objectives of the marketing plan. Additionally, the PSA can increase awareness of LOSSCS and encourage survivors to connect with the organization. Airing the PSA on 97.1 The Fan, for example, would reach a predominantly male audience. This station already airs PSAs regarding mental health, so a partnership emphasizing survivor support is feasible. Additionally, WOSU, a public station, may be open to airing a PSA as a public service. LOSSCS can also survey current participants to determine which radio stations would best reach the intended audience.

2. Gain earned media through local television stations and newspapers: Earned media occurs when an organization “gets free visibility” through communication channels (Lee & Kotler, 2016). The ‘Place’ section recommends forging relationships with local media outlets, such as the television networks (NBC4, ABC6, 10TV, etc.) and newspapers (Columbus Dispatch, Columbus Underground, etc.). These relationships could lead to a news segment about LOSSCS and loss survivor support on local news broadcasts or a profile in newspapers. Additionally, newspapers typically offer reader submission options (such as Letters to the Editor) that allow people to raise issues of public concern. LOSSCS can utilize these options to share survivor stories and raise awareness about survivor services. These

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stories would be an excellent opportunity to spread awareness and encourage men to seek support services.

3. Partner with gyms and recreation centers to increase the distribution of printed materials: Gyms and recreation centers are an excellent location to reach fathers. Men visit gyms because of their desire to maintain their physical health. This focus on wellness creates an environment in which men may be more receptive to focusing on other aspects of health, such as mental health. Potential locations include the YMCA of Central Ohio (a mission-oriented nonprofit organization), municipal recreation centers, and corporate gyms (Planet Fitness, LA Fitness, etc.). Thus, partnering with gyms to distribute printed materials is a strong opportunity to make first contact with loss survivors.

4. Partner with school administrators to increase the distribution of printed materials: Working with schools to distribute LOSSCS information could be a valuable link to many loss survivors. School administration could distribute LOSSCS materials to parents when a suicide is known to them, which would increase access to fathers. School teachers and staff are also at risk of losing a student to suicide While the student-teacher relationship is different than friends or family, losing a student can still be traumatic. Additionally, the teachers and staff may have lost someone in their broader social network.

5. Use social media to achieve the marketing plan’s belief, behavior, and knowledge objectives: LOSSCS’ social media accounts can be efficient tools to encourage men to seek loss support. The content posted on these accounts can inform the public about loss survivor support and persuade survivors to seek it. Below are content concepts that can achieve these goals:

a. List and discuss symptoms of grief, depression, and other challenges arising from suicide loss.

b. Discuss evidence-based outcomes of services i. Present data describing the benefits of loss support generally ii. Discuss outcomes from LOSSCS’ programs

c. Challenge social and psychological barriers d. Highlight (with consent) the stories of male support participants e. Highlight negative coping mechanisms to help men understand that their behaviors

may be related to grief stemming from suicide loss

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6. Leverage technology to support survivors before they join LOSSCS’ programs. Reachingsurvivors early will encourage them to come to LOSSCS. Technological distributionchannels can increase the number of survivors reached during the decision-makingprocess. Furthermore, these channels increase LOSSCS’ reach by being accessiblethroughout the day. This promotes inclusivity by reaching survivors whose availability maynot align with LOSSCS programs or operating hours.

Furthermore, LOSSCS should ensure that their social media handles appear on all printed materials. This will make it easy for loss survivors to find these accounts after learning about LOSSCS through the printed materials.

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Monitoring and Evaluation

LOSSCS is the primary entity responsible for monitoring the effectiveness of the strategies laid out in this marketing plan. Below are recommendations for LOSSCS to consider in their monitoring efforts.

Purpose We have recommended many strategies for altering the behaviors of bereaved fathers and some are likely to be more effective than others. The evaluation plan should focus on determining which strategies are most lucrative. This will allow LOSSCS to properly allocate resources toward the recommendations resulting in the highest degree of behavior change. If none of the strategies are effective, LOSSCS can seek recommendations outside this marketing plan or pivot to previously effective strategies.

Results Measurement and Methods

Evaluation Questions:

1. Are the recommended social marketing strategies resulting in changes to the number of bereaved fathers utilizing LOSSCS services? Which channels are most effective in reaching bereaved fathers?

2. Which social marketing strategies do bereaved fathers find most beneficial, and which least beneficial?

Timeline Measure(s) Method(s) Evaluation Focus Tool(s)

0-6 Months

• Website and social media traffic

• Attendance at programming

• Data Collection*

• Question 1 • Intake form†

6-12 Months

• Organizational commitments‡

• Contributions from partnerships¶

• Observation Research

• Question 1

+12 Months

• Changes in values and beliefs

• Satisfaction • Program popularity

• Online survey and/or self-administered questionnaire

• Question 2 • Qualitative survey§

*Begin to 1) track the demographic characteristics of attendees at support groups and in the companion program 2) attempt rough estimates for remembrance events by assigning one employee this responsibility per event 3) collect email addresses of survivors to establish a communication channel for future survey distribution.

† Develop an intake form for LOSSCS community members that do not access the organization through the coroner relationship (See Appendix F for an example form). Intake form should capture demographic characteristics and inquire how survivors became aware of LOSSCS. Intake form can be hosted on Google Forms or another free resource and be linked to on the homepage of the LOSSCS website. Encourage anyone who reaches out via phone, email, or in-person to complete intake form, so data is as complete as possible.

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‡ Of new LOSSCS attendees, determine how many programs individuals engage with (i.e. do they attend support groups AND remembrance events or are they drawn to one more than the other).

¶ Analyze intake form responses to determine which organizational partnerships are resulting in the most interest in LOSSCS.

§ Distribute qualitative surveys to new participants geared toward determining what messages/programs/etc. brought them to the organization, what programs kept them most engaged, and how marketing efforts changed their opinions on seeking support. An example survey is available in Appendix G.

Timing and Budget This plan involves both ongoing measurements throughout the campaign as well as a final evaluation of efforts. LOSSCS should make course corrections as needed to allocate resources appropriately. The cost of the evaluation plan will range from minimal to moderate, depending on how LOSSCS chooses to distribute the qualitative survey to participants.

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Budget

LOSSCS will be responsible for the budgetary oversight and resource allocation decisions regarding this plan. We do not anticipate that our recommendations will require a substantial monetary commitment. However, we acknowledge that an increase in participants could require service expansion in the future. LOSSCS should consider diversifying funding to accommodate a growing number of support groups or other services. Considering the current COVID-19 Pandemic, many grant opportunities have been redirected or suspended, affecting short-term funding possibilities. Below is a list of grant sources that LOSSCS can monitor for future funding opportunities.

Grant & Funding Sources:

1. U.S Department of Health and Human Services a. Forecasted opportunity HHS-2020-ACF-OFA-ZJ-1846 provides funding for projects

specific to fathers and could be applicable to our recommended marketing mix. 2. HHS Substance Abuse and Mental Health Services Administration (SAMHSA)

a. Suicide Prevention Resource Center Grants, Grants to Implement the National Strategy for Suicide Prevention, & Grants to Implement Zero Suicide in Health Systems

3. The Charles E. Kulby Foundation a. Fund projects related to providing “services to either those afflicted by depression

and depression-related diseases or their friends and family (The Charles E. Kulby Foundation, 2020). Will fund out of state projects such as LOSSCS if the program exhibits potential as a future adoptable project model for the state of Wisconsin.

4. Ohio Department of Mental Health and Addiction Services (OHMAS) 5. Cardinal Health Foundation 6. CareSource Foundation Grants 7. United Way Neighborhood Partnership Grants 8. Current funding partners: The Columbus Foundation, ADAMH

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Implementation Plan LOSSCS is responsible for the implementation of the marketing recommendations within this plan. Below are recommendations for LOSSCS staff to consider when implementing strategies.

Owing to the capacity concerns of nonprofit organizations, we are recommending a phased implementation approach based on the relative cost of recommendations herein. This will aid in the monitoring and evaluation effort as well, allowing LOSSCS to focus and collect data on phases demonstrating the highest return.

We recommend allocating one year to implementation, with each phase occurring over approximately 3.5 months. A theoretical schedule based on a Fall 2020 beginning is below. LOSSCS may adjust these phases as needed based on monitoring and evaluation efforts.

• Phase 1: August 1, 2020 - November 15, 2020; Introduction of new marketing messages through current LOSSCS channels (e.g. social media and extant partner organizations). Begin 0-6 month monitoring efforts.

• Phase 2: November 16, 2020 - January 31, 2021; Developing new strategic partnerships with organizations identified as potential hotspots for male suicide loss survivors. Distributing marketing materials through these new partner networks and/or including partner names/logos on marketing materials to demonstrate their support. Complete 0-6 month monitoring efforts and begin 6-12 month recommendations.

• Phase 3: February 1, 2021 - May 15, 2021; Implementing programming augmentation recommendations to continue growing male population (if previous phases result in metric increases and positive observation results). Complete 6-12 month monitoring efforts and develop materials needed for 12+ month evaluation recommendations.

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References

Addis, M. E., & Cohane, G. H. (2005). Social scientific paradigms of masculinity and their implications for research and practice in men’s mental health. Journal of Clinical Psychology, 61(6), 633–647. doi: 10.1002/jclp.20099

Bailley, S., Kral, M., & Dunham, K. (1999). Survivors of suicide do grieve differently: empirical

support for a commonsense proposition. Suicide and Life-Threatening Behavior, 29(3), 256-271.

Corrigan, P., Sheehan, L., Al-Khouja, M., Lewy, S., Major, D., Mead, J., Redmon, M., Rubey, C., &

Weber, S. (2018). Insight into the stigma of suicide loss survivors: factor analyses of family stereotypes, prejudices, and discrimination. Suicide Research (Archives), 22, 57-66. DOI: 10.1080/13811118.2016.1275993.

Costa, M., Schaffner, B. F., & Prevost, A. (2018). Walking the walk? Experiments on the effect of

pledging to vote on youth turnout. PLOS ONE, 13(5). doi: 10.1371/journal.pone.0197066. Courtenay, W. (2004). Making health manly: social marketing and men’s health. The Journal of

Men’s Health & Gender, 1(2-3), 275–276. doi: 10.1016/j.jmhg.2004.07.027 Dockray, H. (2019). 10 crisis help lines that offer texting or chat services. Retrieved from:

https://mashable.com/article/text-chat-crisis-lines/ Gemünden, H. G. (1985). Perceived risk and information search. A systematic meta-analysis of

the empirical evidence. International Journal of Research in Marketing, 2(2), 79–100. doi: 10.1016/0167-8116(85)90026-6

Golden, T. (1996). Swallowed by a Snake: The Gift of the Masculine Side of Healing. United

States: Golden Healing Publishing, LLC. Heads Up Guys. (2020). Retrieved from https://headsupguys.org/ How Much Does Therapy Cost? (n.d.) Thervo. Retrieved from

https://thervo.com/costs/how-much-does-therapy-cost. Jordan, J. (2017). Postvention is prevention - The case for suicide postvention. Death Studies,

41(10), 614-621. Retrieved from https://doi.org/10.1080/07481187.2017.1335544. Jordan, J. & McIntosh, J. (2011). Grief after Suicide: Understanding the Consequences and Caring

for the Survivors. United States: Taylor & Francis Group, LLC. Kotler, P., & Lee, N. (2016). Social Marketing: Changing Behaviors for Good (Fifth ed.). Los

Angeles: SAGE.

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Ludwig, T. D., Buchholz, C., & Clarke, S. W. (2005). Using Social Marketing to Increase the Use

of Helmets Among Bicyclists. Journal of American College Health, 54(1), 51–58. doi: 10.3200/jach.54.1.51-58

Man Therapy. (2020). Retrieved from https://www.mantherapy.org/ Martin, T. & Doka, T. (2000). Men don’t Cry...Women do: Transcending Gender Stereotypes of

Grief. United States: Taylor & Francis Group, LLC. Movember. (2020). Retrieved from https://www.movember.com/ Rochlen, A. B., & Hoyer, W. D. (2005). Marketing mental health to men: Theoretical and

practical considerations. Journal of Clinical Psychology, 61(6), 675–684. Ddoi: 10.1002/jclp.20102

Rostila, M., Saarela, J., & Kawachi, I. (2013). Suicide following the death of a sibling: A nationwide

follow-up study in Sweden. British Medical Journal Open, 3, e0026. doi:10.1136/bmjopen-2013-002618. Spencer-Thomas, S. (2018, November 12). Men and Suicide Loss: An Often-Invisible Grief.

Retrieved from https://www.sallyspencerthomas.com/dr-sally-speaks-blog/2018/11/12/men-and-suicide-loss-an-often-invisible-grief.

Suicide. (2019). Retrieved from https://www.nimh.nih.gov/health/statistics/suicide.shtml

https://thervo.com/costs/how-much-does-therapy-cost. The Charles E. Kulby Foundation. (2020). Grant Request Funding Priorities [Webpage].

https://charlesekublyfoundation.org/grants.php. Van Dongen, C. (1990). Agonizing questioning: Experiences of survivors of suicide victims. Nursing

Research; 39(4), 224-229. Wilkins, D. (2014). “How to make mental health services work for men.” Men’s Mental Health

Forum; Leeds Beckett University. Retrieved from https://www.vanderbilt.edu/crmh/Howtomakementalhealthserviceswork.pdf.

Zinner, E. S. (2000). Being a man about it: The marginalization of men in grief. Illness, Crisis & Loss, 8(2), 181-188.

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Appendix A - Extended SWOT Analysis

Strengths

LOSSCS has many strengths that support the mission. LOSSCS’ primary asset is the dedicated staff, board members, and volunteers. Most of those who work or volunteer for LOSSCS are suicide loss survivors themselves, making them personally committed to the success of the organization. This commitment and drive foster a desire to adapt marketing and programming to engage more male loss survivors. Furthermore, both Executive Director Denise Meine-Graham and Board President Karen Austin have extensive marketing experience, which will be useful when LOSSCS implements this social marketing plan. Finally, two of the LOSSCS Board members are male loss survivors who can provide insight into our intended audience.

Another area of strength is LOSSCS’ community partnership network. One partner, the Franklin County Coroner, alerts LOSSCS whenever they become aware of a suicide loss, which allows LOSSCS to send the First Responder Team to meet the loss survivors on scene. Other LOSSCS partnerships include law enforcement, local hospitals, funeral homes, and mental health care providers. Our team can utilize these partnerships to spread marketing materials derived from this plan.

Weaknesses

LOSSCS’ weaknesses are the factors that inhibit the ability to support suicide loss survivors. LOSSCS’ greatest challenge is reaching certain subsets of loss survivors, namely men, the elderly, and immigrants. Other LOSSCS weaknesses are common among nonprofit organizations, such as small staff size and reliance on outside funding to operate. A majority of LOSSCS funding comes from one source - the Alcohol, Drug and Mental Health (ADAMH) Board of Franklin County. This concentration of funding could become a threat if ADAMH decreases the amount provided to LOSSCS. In addition, LOSSCS primarily relies on relationships with external organizations, such as the Franklin County Coroner or Buckeye Firearms, to find survivors. This dependency constricts LOSSCS’ ability to serve survivors and forces them to rely on organizations that have separate missions and priorities.

Opportunities

Opportunities are the external circumstances that the organization can utilize to pursue its mission. LOSSCS’ primary opportunity is to expand its community partnership network. For example, LOSSCS has connected with local gun shops and Buckeye Firearms in the past; they could continue to produce collaborative programming to decrease the number of firearm-related suicides. The organization could also pursue partnerships with more hospitals, funeral homes, and mental health care providers to augment their extant networks. LOSSCS can continue to connect with more faith communities, as the organization has already started to do. Expansion allows for more referrals and a greater distribution of LOSSCS marketing materials.

Threats

Threats are external challenges that mitigate an organization’s ability to pursue its mission. A significant threat to LOSSCS is mental health and suicide stigmatization, particularly among men. Convincing men to seek mental health support is a persistent challenge (Addis & Cohane, 2005). Suicide stigma can influence funding and volunteerism for organizations like LOSSCS. LOSSCS faces further funding risks through their reliance on ADAMH and the persistent possibility of an

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economic recession, which could lead to grant and donation reductions. Additionally, politics could threaten LOSSCS’ partnership with the Coroner’s Office. A new Coroner may sever or deemphasize the partnership, thereby reducing LOSSCS’ capacity to find suicide loss survivors.

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Appendix B – Table 1 Expanded

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Appendix C – Qualitative Analysis

“Do you believe men grieve differently than women? How do men grieve differently?”

Code Frequency Difficulty showing / talking about emotion 29x Victims of gender stereotypes 26x Prefer isolation / to internalize 19x Don’t want to / can’t seem weak 16x Physical / active outlets for grief 5x Depression manifesting as anger and irritation 3x

Select Quotes:

• “Most men have difficulties showing the type of emotion that comes with grief. We hold on to it inside which generally leads most men to have issues later or grief takes longer.”

• “Society accepts a woman's grief more.” • “We don't want to seem weak, I feel bad when I start to cry!”

“Please, tell us more about your grief experience (e.g., How did the suicide death affect you -- your mood, your physical well-being, your relationships, your outlook, your spiritual beliefs, your job, etc. How did the grief experience unfold over time?).”

Code Frequency Significant Emotional Toll 22x Stress on Relationships 10x Guilt 8x Faith For Resiliency 8x Signs of Depression 7x Person Is Fundamentally Changed 7x Suicide Ideation 6x Sought Loss Survivor Support Groups 6x Questioning Faith 5x Post Traumatic Stress Disorder 4x Change Careers 4x Anger At Victim 3x “Mood Change” 2x

Select Quotes:

• “My life is changed forever and I will never be the same.” • “I was completely devastated. I became suicidal myself. I still struggle with suicidal

thoughts” • “Devastated, lost, hopeless”

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“Please tell us more about what was most helpful (or very helpful) about the support you got from these sources.”

Code Frequency Fellow Survivors 34x Support Group 29x Friends and Family 23x Religious Figures/Institutions 13x Therapist or Grief Counselor 11x Funeral Staff 4x Work Relationships 3x Little or Nothing 3x Medicine 2x Recognizing and Accepting Grief 1x Law Enforcement Personnel 1x Remembering Pleasant Memories of the Victim 1x Participating in Survivor Awareness Events 1x

Select Quotes:

• “Anyone who would listen was helpful” • “I had a few friends who would call and check on me...make sure I...didn’t just sit around” • “Nothing”

“Please tell us more about what was not helpful (or least helpful) from sources used in the aftermath of suicide death.”

Code Frequency Police / Coroner / Funeral Home just doing their job / impersonal & indifferent

20x

Fear/lack of knowledge holding friends/family back from taking about the issue

9x

People saying the wrong things “I know how you feel – my dog died” / you will get over it / you can get remarried because you’re young

7x

“snap out of it” / “you should be better by now” / “move on” 5x Religious stigma “satan caused this” “loved one in hell” 4x Lack of support / resources / resources not available 4x Lack of systems in workplace for suicide bereavement 3x Shame / stigma 2x

Select Quotes:

• “Police just acted like, yep, another suicide...and even said, well...he had been planning this.”

• “Poor comments: keep a stiff upper lip, [the suicide is] a plus [because] it will make you more compassionate, I know [how] you feel-my dog died”

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“Tell us about resources you wish had been available to support your grief by suicide.” Code Frequency Any/more Support groups 11x One-on-one professional counselors/therapists with knowledge of issue 11x Personal contact with another survivor 5x Assistance through job 3x First responder 3x Religious figure willing to discuss issue rather than place blame 2x Sobriety support 2x

Select Quotes:

• “I looked for suicide survivor support groups in my area and found nothing within 50 miles” • “I wish my work would of stepped up and offered some assistance or referrals when they

realized I was not the same as I was”

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Appendix D – Suggested Resources

Below is a list of books written by male suicide loss survivors that may resonate with bereaved fathers and other seeking services from LOSSCS. The LOSSCS team has only interacted with one book, Real Men do Cry, which had many interesting insights to a bereaved father’s grief, despite having some outdated language and graphic descriptions. Men & Grief: A Guide for Men Surviving the Death of a Loved One and a Resource for Caregivers and Mental Health Professionals Carol Staudacher, New Harbinger Publications, 1991. Separate chapters address bereavement experienced during boyhood, adolescence, and adulthood, as well as a chapter on the effect of alcohol abuse on grief. While the book does include some discussion of bereavement after suicide, the focus is on the male experience of bereavement more generally. Men Don’t Cry… Women Do: Transcending Gender Stereotypes of Grief Terry L. Martin and Kenneth J. Doka, Routledge Taylor & Francis Group, 2000. Part of Robert Neimeyer’s “Death, Dying, and Bereavement Series,” this book is best suited for mental health professionals and others interested in exploring the theoretical and clinical aspects of gender-typical grief. While not specific to suicide loss, the book addresses the impact of socialization and culture on how individuals experience loss. Real Men Do Cry: A Quarterback’s Inspiring Story of Tackling Depression and Surviving Suicide Loss Eric Hipple, with Dr. Gloria Horsley and Dr. Heidi Horsley, Quality of Life Publishing, 2008. Former NFL quarterback for the Detroit Lions, Eric Hipple, candidly shares his experience of living through his fifteen-year-old son’s suicide, his own lifelong struggle with depression, and the difficult path that led him to ultimately seek treatment. When a Man Faces Grief/A Man You Know Is Grieving: 12 Practical Ideas to Help You Heal from Loss Thomas R. Golden and James Miller, Willowgreen Publishing, 1998. This book focuses on grief in general rather than suicide grief in particular. The authors share their view of the “masculine side” of healing. The book’s format is unique: the first half provides guidance to the grieving man himself; turned upside down, the second half advises his family and friends on how best to help him. The twelve suggestions in each half of the book are practical and straightforward. When Suicide Comes Home: A Father’s Diary and Comments Paul Cox, Bolton Press 2002. A father’s perspective on the first year following his son’s suicide, this book is written in a simple, straightforward style, making it easy reading for early grief. Though written from a father’s perspective, female readers (especially spouses) have said that the book helped them to better understand the male experience of grief.

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Appendix E – Sample Take-Home Checklist

Healing from grief can be challenging - it’s not a “one-size fits all” journey. You may find an activity that helps you more than others or may still be looking for something that works for you. This is why we provide this non-exhaustive checklist of strategies and activities that you can try on your own. You have complete control over what you choose to try and when to try it. This is meant only to give you ideas of activities that could fit your life and personal needs. We would love to hear your suggestions that may not be on this list - those activities may be exactly what someone else is looking for. Physical

� Go for a walk or run � Walk your dog � Try a new class at your gym � Yoga � Play a sport with friends (golf,

basketball, football, volleyball, etc.) � Go for a bike ride � Write your own _________________ � Write your own _________________

Emotional

� Attend a LOSSCS program (support group, remembrance event, etc.)

� Try guided meditation � Journal your thoughts � Schedule a therapy session � Attend a religious service � Schedule 10 minutes for self-care � Write your own _________________ � Write your own _________________

Social � Join the LOSSCS companion program � Ask a friend to join you for coffee or a

meal � Call a friend you would like to catch

up with � Attend a local sporting event or

festival with friends � Volunteer at a local organization � Write your own _________________ � Write your own _________________

Creative

� Paint � Draw or sketch � Listen to your favorite music � Take a cooking class � Try writing prompts � Read a new book � Write your own _________________ � Write your own ________________

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Appendix F – Intake Data Form

LOSS Community Services Disclosure: This form is intended to help LOSSCS track participant data to offer programs that best fit the needs of loss survivors. Your name and contact information will not be used for data analyses and will only be used for LOSSCS program registration and communication purposes. Your non-identifiable information may be used in combination with other participants’ data to create data reports and other materials. You may choose to exclude your data from these reports. Furthermore, you may choose not to answer any questions in Section 3 (Loss Data) if you prefer. 1. Consent I consent to the use of data consistent with the disclosure statement listed above ____ Yes, my non-identifiable participant data may be used ____ No, please do not use my data for any reason 2. Demographic Data Name: __________________________ Email: ___________________________ Address: _______________________________________________________________ Phone Number: ___________________ Age: ______ Gender: ____________________ Race: ______________________ How did you hear about LOSSCS? (Please check all that apply) ___ Referral from friend, family member, or other personal connection ___ LOSSCS direct communication ___ LOSSCS first responder team ___ Social media, please list platform ________________________ ___ Community referral (church, funeral home, hospital) ___ Other, please list _____________________________________ 3. Loss Data What is your relationship with the deceased? ______________________________ How much time has passed since your loss(es)? _____________________________ 4. Emergency Contact Name: ______________________________ Relationship: __________________________ Phone Number: _______________________ Address: _______________________________

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Appendix G – Example Satisfaction Survey

1. What inspired you to first attend LOSSCS services?

2. If your answer above was related to marketing materials you saw, can you elaborate on

which messages/images/etc. most inspired you?

3. If your answer was related to anything other than marketing, why did this inspire you to attend LOSSCS?

4. What was your opinion of support services for suicide loss prior to attending LOSSCS?

5. If your opinion has since changed, what is your opinion now?

6. How often have you used LOSSCS services or attended LOSSCS events?

7. How do LOSSCS services help you achieve your goals related to grief, companionship, etc.?

8. What is your favorite service that LOSSCS offers?

9. Have you considered volunteering with LOSSCS?

10. If you could, what improvements would you make to LOSSCS services?

11. Would you recommend LOSSCS services to a friend struggling with suicide grief? Why or

why not?