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CDA 15-074 – HSR Study

CDA 15-074
Improving Housing Outcomes for Homeless Veterans
Sonya Emi Gabrielian, MD MPH
VA Greater Los Angeles Healthcare System, West Los Angeles, CA
West Los Angeles, CA
Funding Period: March 2017 - February 2022
Social skills are an important and underappreciated determinant of housing outcomes for homeless Veterans. Yet, social skills interventions are uncommon within VA homeless services.

This study aims to develop and study the implementation and effectiveness of a "skills intervention"--built from existing, effective social skills interventions and focused on housing-related social skills--tailored to the VA Supportive Housing (VASH) program. This intervention will be co-delivered by a peer and a social worker, aiming to improve VASH participants' housing retention and mental health. Using the theoretical framework of the Behavioral Model for Vulnerable Populations, with guidance from the Consolidated Framework for Implementation Research, the Aims are to: 1) develop a intervention that improves housing retention and mental health among homeless Veterans; 2) in a controlled pilot trial, study the feasibility, acceptability, and effectiveness of the intervention on factors strongly associated with improved housing retention and mental health among homeless Veterans; and 3) examine barriers to and facilitators of future implementation of the intervention in routine VASH care.

For Aim 1, we conducted key informant interviews with experts in social skills training (n=12); used the RAND/UCLA appropriateness method to convene a panel (n=11) of experts in homelessness and psychosocial rehabilitation; conducted a focus group (n=7) with local homeless program leadership and frontline clinicians; and have planned a focus group (n=12) with homeless Veterans. Aims 2 and 3 entail a controlled effectiveness-implementation hybrid type 1 pilot trial. For Aim 2, we will implement the intervention at the VA Greater Los Angeles (GLA) Domiciliary with homeless Veterans engaged in VASH. We will assess the intervention's feasibility and acceptability, comparing changes over 6 months in social skills, service use, social interactions, and money management among Veterans who receive the intervention (n=30) vs. a control group (n=20). For Aim 3, we will use surveys and qualitative methods to explore barriers to and facilitators of implementation of the intervention in routine care.

Not yet available.

To accelerate efforts to improve care for homeless Veterans, we must implement novel services that are effective in other VA settings but have not been implemented within homeless services. .

External Links for this Project

NIH Reporter

Grant Number: IK2HX002089-01A2

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Journal Articles

  1. Simmons MM, Gabrielian S, Byrne T, McCullough MB, Smith JL, Taylor TJ, O'Toole TP, Kane V, Yakovchenko V, McInnes DK, Smelson DA. A Hybrid III stepped wedge cluster randomized trial testing an implementation strategy to facilitate the use of an evidence-based practice in VA Homeless Primary Care Treatment Programs. Implementation science : IS. 2017 Apr 4; 12(1):46. [view]
  2. Gabrielian S, Hamilton AB, Gelberg L, Hellemann G, Koosis ER, Johnson A, Young AS. A protocol to develop and study the effectiveness and implementation of social skills training that improves supported housing retention for persons with serious mental illness. Contemporary clinical trials communications. 2019 Jun 1; 14:100344. [view]
  3. Raja PV, Gabrielian S, Doran N. Access to Care for Veterans With Serious Mental Illness During the COVID-19 Pandemic. Psychiatric services (Washington, D.C.). 2021 Nov 1; 72(11):1324-1327. [view]
  4. Montgomery AE, Gabrielian SE, Cusack MC, Austin EL, Kertesz SG, Vazzano JK. Applying the Housing First approach to single-site permanent supportive housing. Journal of Social Distress and the Homeless. 2018 Nov 20; 28(1):24-33. [view]
  5. Hempel S, Bolshakova M, Hochman M, Jimenez E, Thompson G, Motala A, Ganz DA, Gabrielian S, Edwards S, Zenner J, Dennis B, Chang E. Caring for high-need patients. BMC health services research. 2023 Nov 23; 23(1):1289. [view]
  6. Llerena K, Gabrielian S, Green MF. Clinical and cognitive correlates of unsheltered status in homeless persons with psychotic disorders. Schizophrenia Research. 2018 Jul 1; 197:421-427. [view]
  7. Castillo EG, Ijadi-Maghsoodi R, Shadravan S, Moore E, Mensah MO, Docherty M, Aguilera Nunez MG, Barcelo N, Goodsmith N, Halpin LE, Morton I, Mango J, Montero AE, Rahmanian Koushkaki S, Bromley E, Chung B, Jones F, Gabrielian S, Gelberg L, Greenberg JM, Kalofonos I, Kataoka SH, Miranda J, Pincus HA, Zima BT, Wells KB. Community Interventions to Promote Mental Health and Social Equity. Current psychiatry reports. 2019 Mar 29; 21(5):35. [view]
  8. Chinchilla M, Gabrielian S, Horan WP, Glasmeier A, Hellemann G, Wynn JK, Capone-Newton P, Green MF. Comparing Tenant and Neighborhood Characteristics of the VA's Project- vs. Tenant-Based Supportive Housing Program in Los Angeles County. Journal of health care for the poor and underserved. 2019 Jan 1; 30(4):1373-1393. [view]
  9. Kertesz SG, deRussy AJ, Kim YI, Hoge AE, Austin EL, Gordon AJ, Gelberg L, Gabrielian SE, Riggs KR, Blosnich JR, Montgomery AE, Holmes SK, Varley AL, Pollio DE, Gundlapalli AV, Jones AL. Comparison of Patient Experience Between Primary Care Settings Tailored for Homeless Clientele and Mainstream Care Settings. Medical care. 2021 Jun 1; 59(6):495-503. [view]
  10. Chinchilla M, Gabrielian S, Hellemann G, Glasmeier A, Green M. Determinants of Community Integration Among Formerly Homeless Veterans Who Received Supportive Housing. Frontiers in psychiatry. 2019 Jun 26; 10:472. [view]
  11. Gabrielian S, Jones AL, Hoge AE, deRussy AJ, Kim YI, Montgomery AE, Blosnich JR, Gordon AJ, Gelberg L, Austin EL, Pollio D, Holmes SK, Varley AL, Kertesz SG. Enhancing Primary Care Experiences for Homeless Patients with Serious Mental Illness: Results from a National Survey. Journal of primary care & community health. 2021 Jan 1; 12:2150132721993654. [view]
  12. Novacek DM, Wynn JK, Gabrielian S, Glynn SM, Hellemann G, Horan WP, Kern RS, Lee J, Marder SR, Sugar C, Green MF. Examining racial differences in community integration between black and white homeless veterans. Psychiatry Research. 2022 Feb 1; 308:114385. [view]
  13. Chinchilla M, Gabrielian S, Glasmeier A, Green MF. Exploring Community Integration Among Formerly Homeless Veterans in Project-Based Versus Tenant-Based Supportive Housing. Community mental health journal. 2020 Feb 1; 56(2):303-312. [view]
  14. Gabrielian S, Koosis ER, Cohenmehr J, Hellemann G, Tuepker A, Green MF, Vazzano JK, Young AS. Factors associated with recovery from homelessness among veterans in permanent supportive housing. Journal of Community Psychology. 2022 Jul 1; 50(5):2144-2162. [view]
  15. Gabrielian S, Hamilton AB, Gelberg L, Koosis ER, Johnson A, Young AS. Identifying Social Skills That Support Housing Attainment and Retention Among Homeless Persons With Serious Mental Illness. Psychiatric services (Washington, D.C.). 2019 May 1; 70(5):374-380. [view]
  16. Horan WP, Wynn JK, Gabrielian S, Glynn SM, Hellemann GS, Kern RS, Lee J, Marder SR, Sugar CA, Green MF. Motivational and cognitive correlates of community integration in homeless veterans entering a permanent supported housing program. The American Journal of Orthopsychiatry. 2019 Apr 25. [view]
  17. Greenberg JM, Wynn JK, Lee J, Hellemann G, Gabrielian S, Green MF. Resilience in homeless veterans: Clinical and cognitive correlates. Psychiatric Rehabilitation Journal. 2019 Sep 1; 42(3):314-322. [view]
  18. Grattan RE, Tryon VL, Lara N, Gabrielian SE, Melnikow J, Niendam TA. Risk and Resilience Factors for Youth Homelessness in Western Countries: A Systematic Review. Psychiatric services (Washington, D.C.). 2022 Apr 1; 73(4):425-438. [view]
  19. Moore EM, Gabrielian S, Zito MF, Kozikowski SD, Lopez JR, Lesgart M, Green MF. Social Connectivity and Coping Among Vulnerable Veterans During the COVID-19 Pandemic. Journal of health care for the poor and underserved. 2023 Jan 1; 34(3):1051-1059. [view]
  20. Gabrielian S, Young AS, Greenberg JM, Bromley E. Social support and housing transitions among homeless adults with serious mental illness and substance use disorders. Psychiatric Rehabilitation Journal. 2018 Sep 1; 41(3):208-215. [view]
  21. Gabrielian S, Hamilton AB, Gelberg L, Koosis ER, Hoffmann L, Carlson DM, Young AS. Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness. Implementation research and practice. 2024 Mar 6; 5:DOI: 10.1177/26334895241236679. [view]
  22. Montgomery AE, Szymkowiak D, Cusack MC, Austin EL, Vazzano JK, Kertesz SG, Gabrielian S. Veterans' assignment to single-site versus scattered-site permanent supportive housing. The American Journal of Orthopsychiatry. 2019 Jan 17. [view]
  23. Lynch KA, McCoy M, Gabrielian S. Veterans Finding Community and a "Home" Within an Emergency Housing Environment. Journal of primary care & community health. 2023 Jan 1; 14:21501319231180448. [view]
  24. Varley AL, Hoge A, Riggs KR, deRussy A, Jones AL, Austin EL, Gabrielian S, Gelberg L, Gordon AJ, Blosnich JR, Montgomery AE, Kertesz SG. What do Veterans with homeless experience want us to know that we are not asking? A qualitative content analysis of comments from a national survey of healthcare experience. Health & Social Care in The Community. 2022 Nov 1; 30(6):e5027-e5037. [view]

  1. Chinchilla M, Gabrielian SE. Stemming the rise of Latinx homelessness: lessons from Los Angeles County. London, England: Taylor & Francis Online; 2019 Sep 5. Report No.: na. [view]

DRA: Other Conditions
DRE: Prevention, TRL - Applied/Translational
Keywords: none
MeSH Terms: none

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