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PPO 16-126 – HSR&D Study

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PPO 16-126
A pilot intervention to help homeless and at-risk veterans manage their money
Jack Tsai PhD
VA Connecticut Healthcare System West Haven Campus, West Haven, CT
West Haven, CT
Funding Period: May 2017 - April 2018

BACKGROUND/RATIONALE:
Preventing and ending homelessness among Veterans is a national VA priority. While considerable efforts have been made towards providing housing for Veterans , more work is needed on helping Veterans gain skills for independent living to sustain and keep their housing. Research has shown that money mismanagement is a significant risk factor for Veteran homelessness. This pilot project evaluated a money management program designed for homeless Veterans in the VA's largest supported housing program.

OBJECTIVE(S):
The objective of the proposed project was to pilot a new money management intervention for homeless and at-risk homeless Veterans called the Recovery Oriented Money Management Program (ROMMP). ROMMP is a new eight-week intervention developed for homeless and at-risk Veterans to help them manage money. ROMMP consists of three components: financial education groups, computerized budget assistance, and individual coaching. The three aims of the project were 1) to test feasibility of ROMMP; 2) assess money management and clinical outcomes from ROMMP; and 3) refine and further develop ROMMP.

METHODS:
Feasibility of ROMMP will be assessed by tracking group attendance, utilization of computerized budget assistance, and engagement in individual coaching. Money management, housing, substance use, and quality of life will be assessed at baseline, 3 weeks, 8 weeks, and 12 weeks. Qualitative interviews will be conducted with Veterans in each cohort to obtain Veteran input in the development of ROMMP.

FINDINGS/RESULTS:
A total of sixty-three Veterans across five cohorts of Veterans were enrolled in ROMMP. Veterans attended a mean of 2.8 group sessions and a mean of 3.0 individual financial coaching sessions. Thirty-nine Veterans (61.9%) agreed to participate in the research portion of ROMMP. Participants had a mean age of 54.2 years (sd= 13.2), mean of 13.0 years of education (sd= 1.5), 86% male, 56% non-white, 89% with history of homelessness with a total income of $1,831.7 (sd= 1689.8). In addition, 45% of participants reported serious mental health symptoms and 62% reported problems with substance abuse. Mixed linear regression showed a trend towards decrease in the Conrad M3 mismanagement score from 9.8 (sd= 1.1) at baseline to 7.0 (3.1) at 12 weeks, F(3,22)= 2.41, p= .09. On average, Veterans "mostly agree" they were satisfied with the ROMMP program (mean= 5.0 out of 6-point scale, sd= .6) and they "slightly agree" the program made an impact of their money management (mean= 4.2 out of 6-point scale, sd= .6). Qualitative data was collected after every cohort to continuously refine ROMMP to be more accessible and Veteran-centric. Qualitative findings indicated that Veterans viewed ROMMP as "fresh and new" and helped Veterans gain a "better understanding of what was going in and coming out" in terms of their savings and spending.

IMPACT:
These pilot results demonstrate ROMMP to be an acceptable and feasible money management intervention that could be scaled and potentially replicated at other VAs. Through this project, the ROMMP intervention has been refined to be more Veteran-centric with the ultimate goal of implementing the program at other VA facilities to prevent and end Veteran homelessness. A larger controlled study of ROMMP would allow rigorous testing of the model and would be helpful in establishing program effectiveness.

PUBLICATIONS:
None at this time.


DRA: Mental, Cognitive and Behavioral Disorders, Health Systems
DRE: Technology Development and Assessment, TRL - Development
Keywords: Homeless, Social Support, Socioeconomic Factors, Substance Use and Abuse
MeSH Terms: none