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Applying a Case Management Model in a VA Homeless Program

2. oktober 2026 opdateret af: VA Office of Research and Development

Implementering og opretholdelse af kritisk tidsintervention (CTI) i sagsbehandlingsprogrammer for hjemløse-erfarne veteraner (PII 21-285)

The VA Grant and Per Diem (GPD) case management aftercare program provides six months of case management for homeless-experienced Veterans undergoing housing transitions. This Partnered Implementation Initiative (PII) proposes to implement and evaluate Critical Time Intervention (CTI)-an evidence-based, structured, and time-limited case management practice-in 32 GPD case management aftercare sites across the nation.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The VA Grant and Per Diem case management (GPD-CM) program provides six months of case management for homeless-experienced Veterans (HEVs) undergoing housing transitions. At present, no specific case management paradigm is required in the GPD-CM program, resulting in practice variation across sites. This Partnered Implementation Initiative (PII) implements Critical Time Intervention (CTI)-an evidence-based, structured, and time-limited case management practice-at 32 VA GPD-CM sites. The investigators will use the Replicating Effective Programs (REP) implementation bundle to support CTI implementation at all 32 sites. Half of these sites will also receive 9 months of external facilitation (enhanced REP) as additional support for CTI implementation. In a type 3 hybrid trial, the investigators will use mixed methods to examine the impacts of REP versus enhanced REP. Using trial data, the investigators will develop a business case analysis and implementation playbook for the investigators' program partners to support continued CTI spread and sustainment in the GPD-CM program.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

192

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • California
      • West Los Angeles, California, Forenede Stater, 90073-1003
        • VA Greater Los Angeles Healthcare System, West Los Angeles, CA

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Grant and Per Diem (GPD) case management aftercare grantees in 7 Veterans Integrated Service Networks (VISN), all of whom provide 6-months of case management to Veterans who have experienced homelessness

Exclusion Criteria:

  • None

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Andet
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Replicating Effective Programs (REP)

A stakeholder-informed training and technical assistance implementation strategy
Adfærdsmæssigt: Critical Time Intervention (CTI)

An evidence-based, structured, and time-limited case management practice

Andre navne:
  • CTI
Andet: Replicating Effective Programs

A stakeholder-informed training and technical assistance implementation strategy

Andre navne:
  • REP
Aktiv komparator: REP + External Facilitation (Enhanced REP)

REP plus site specific weekly facilitation to support critical time intervention (CTI) implementation.
Adfærdsmæssigt: Critical Time Intervention (CTI)

An evidence-based, structured, and time-limited case management practice

Andre navne:
  • CTI
Andet: Replicating Effective Programs

A stakeholder-informed training and technical assistance implementation strategy

Andre navne:
  • REP
Andet: External Facilitation

Site-specific support to help sites develop tailored plans to implement critical time intervention (CTI)

Andre navne:
  • Coaching
Ingen indgriben: Control Group

No critical time intervention (CTI) implementation

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Fidelity to critical time intervention (CTI)
Tidsramme: 12 months after implementation start

% of Sites with adequate fidelity to CTI at 12 months, as measured by the CTI fidelity scale
12 months after implementation start
Sustainment of critical time intervention (CTI)
Tidsramme: 18 months after implementation start

% of Sites with adequate fidelity to CTI at 18 months, as measured by the CTI fidelity scale
18 months after implementation start
Dollars spent delivering critical time intervention (CTI) at each site
Tidsramme: Between 6 and 18 months after implementation start

Case manager salary and benefits
Between 6 and 18 months after implementation start

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Housing stability
Tidsramme: Between 6 and 18 months after implementation start

Days between entry into the GPD case management program and indicator of housing instability
Between 6 and 18 months after implementation start
Cost of critical time intervention (CTI) as Implemented
Tidsramme: Between 6 and 18 months after implementation start

Mean monthly cost of CTI case management per GPD case management Veteran served, compared to the mean monthly cost in the non-CTI GPD case management programs.
Between 6 and 18 months after implementation start
Hospitalization rates
Tidsramme: Between 6 and 18 months after implementation start

Number of days between entry into the GPD case management program and hospitalization, number of hospitalizations, number of bed days
Between 6 and 18 months after implementation start
Cost of Implementation Strategies
Tidsramme: Through study completion, 4 years

Dollars spent on REP versus enhanced REP
Through study completion, 4 years
Return on Investment (ROI) of critical time intervention (CTI)
Tidsramme: 6-, 12-, and 18-months after GPD case management program enrollment

Dollars saved via improved housing stability and decreased hospitalizations among patients engaged in CTI versus control participants
6-, 12-, and 18-months after GPD case management program enrollment
Outpatient service use
Tidsramme: Between 6 and 18 months after implementation start

Number of outpatient appointments
Between 6 and 18 months after implementation start

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

VA Office of Research and Development

Samarbejdspartnere

University of California, Los Angeles
University of Southern California
Center for the Advancement of Critical Time Intervention

Efterforskere

  • Ledende efterforsker: Sonya Emi Gabrielian, MD MPH, VA Greater Los Angeles Healthcare System, West Los Angeles, CA

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2021

Primær færdiggørelse (Faktiske)

30. september 2026

Studieafslutning (Faktiske)

30. september 2026

Datoer for studieregistrering

Først indsendt

10. marts 2022

Først indsendt, der opfyldte QC-kriterier

4. april 2022

Først opslået (Faktiske)

5. april 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

7. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • PIX 22-001
  • PII 21-285 (Andet bevillings-/finansieringsnummer: QUERI)
  • 1I50HX003501-01 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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