Applying a Case Management Model in a VA Homeless Program
ホームレス経験のある退役軍人のためのケース管理プログラムにおけるクリティカル タイム インターベンション (CTI) の実装と維持 (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.
調査の概要
状態
条件
詳細な説明
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.
研究の種類
入学 (実際)
段階
- フェーズ 1
連絡先と場所
研究場所
-
-
California
-
West Los Angeles、California、アメリカ、90073-1003
- VA Greater Los Angeles Healthcare System, West Los Angeles, CA
-
-
参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
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
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：他の
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：Replicating Effective Programs (REP)
A stakeholder-informed training and technical assistance implementation strategy |
An evidence-based, structured, and time-limited case management practice
他の名前：
A stakeholder-informed training and technical assistance implementation strategy
他の名前：
|
|
アクティブコンパレータ：REP + External Facilitation (Enhanced REP)
REP plus site specific weekly facilitation to support critical time intervention (CTI) implementation. |
An evidence-based, structured, and time-limited case management practice
他の名前：
A stakeholder-informed training and technical assistance implementation strategy
他の名前：
Site-specific support to help sites develop tailored plans to implement critical time intervention (CTI)
他の名前：
|
|
介入なし：Control Group
No critical time intervention (CTI) implementation |
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Fidelity to critical time intervention (CTI)
時間枠：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)
時間枠：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
時間枠：Between 6 and 18 months after implementation start
|
Case manager salary and benefits |
Between 6 and 18 months after implementation start
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Housing stability
時間枠：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
時間枠：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
時間枠：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
時間枠：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)
時間枠：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
時間枠：Between 6 and 18 months after implementation start
|
Number of outpatient appointments |
Between 6 and 18 months after implementation start
|
協力者と研究者
協力者
捜査官
- 主任研究者：Sonya Emi Gabrielian, MD MPH、VA Greater Los Angeles Healthcare System, West Los Angeles, CA
出版物と役立つリンク
一般刊行物
- Gabrielian S, Finley EP, Ganz DA, Barnard JM, Jackson NJ, Montgomery AE, Nelson RE, Cordasco KM. Comparing two implementation strategies for implementing and sustaining a case management practice serving homeless-experienced veterans: a protocol for a type 3 hybrid cluster-randomized trial. Implement Sci. 2022 Oct 3;17(1):67. doi: 10.1186/s13012-022-01236-1.
- Cummings C, Rawal M, Tan G, Finley E, Cordasco KM, Herman D, Edwards L, Gabrielian S. Assessing fidelity to Critical Time Intervention (CTI) for homeless-experienced persons. BMC Health Serv Res. 2026 Jun 16. doi: 10.1186/s12913-026-14939-8. Online ahead of print.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- PIX 22-001
- PII 21-285 (その他の助成金/資金番号：QUERI)
- 1I50HX003501-01 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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