Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) (QUE 25-013)
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 7,908
- 试验地点
- 1
- 主要终点
- Reach of MAT (Medications for Addiction Treatment)
研究概览
简要总结
The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program provides subsidized permanent housing with case management to homeless-experienced Veterans (HEVs). Up to 40% of Veterans exit HUD-VASH within two years of attaining housing; substance use disorders (SUDs) are one of the largest causes of returns to homelessness for HEVs. CARE-VASH QUERI proposes to implement and evaluate two evidence-based SUD services - Medications for addiction treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD) - among Veterans in HUD-VASH.
详细描述
The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program provides subsidized, permanent housing and supports to Veterans experiencing homelessness. Substance use disorders (SUDs) are a common primary or contributing factor to negative exits from HUD-VASH. The Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) QUERI will implement two evidence-based practices (EBPs) for SUDs-Medications for Addiction Treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD)-in 12 HUD-VASH sites. We will use the Replicating Effective Programs (REP) implementation bundle to support EBP implementation at all 12 sites. Half the sites (n=6) will also receive 9 months of consumer engagement (REP+CE). In a type 3 hybrid trial, we will use mixed methods to examine the impacts of REP vs. REP+CE. Using our trial data, we will develop a budget impact analysis and implementation playbook for our program partners to spread and sustain MAT and CBT-SUD in HUD-VASH.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Homeless-experienced Veterans (HEVs) enrolled in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program.
排除标准
- 未提供
研究组 & 干预措施
Replicating Effective Programs (REP)
A stakeholder-informed training and technical assistance implementation strategy
干预措施: Medication for Addiction Treatment (MAT) (Drug)
Replicating Effective Programs (REP)
A stakeholder-informed training and technical assistance implementation strategy
干预措施: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) (Behavioral)
REP + Consumer Engagement (CE)
REP plus CE package (educational materials, peer coaching, toolkit) to support MAT and CBT-SUD implementation.
干预措施: Medication for Addiction Treatment (MAT) (Drug)
REP + Consumer Engagement (CE)
REP plus CE package (educational materials, peer coaching, toolkit) to support MAT and CBT-SUD implementation.
干预措施: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) (Behavioral)
结局指标
主要结局
Reach of MAT (Medications for Addiction Treatment)
时间窗: 18 months post-implementation
* (percent of) Veterans who used Medications for Opioid Use Disorder (MOUD) for OUD, ≥1 prescription * (percent of) Veterans who used MOUD for OUD for 180 days since initial prescription (without a break ≥14 days in supply) * (percent of) Veterans who used Medications for Alcohol Use Disorder (MAUD) for AUD, ≥1 prescription * (percent of) Veterans who used MAUD for AUD for 180 days since initial prescription (without a break ≥14 days in supply)
Reach of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)
时间窗: 18 months post-implementation
* (percent of) Veterans with stimulant use disorder who had ≥1 visit for Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) or contingency management * (percent of) Veterans with substance use disorder with ≥1 CBT-SUD visit * (percent of) Veterans with substance use disorder with ≥9 CBT-SUD visits
Adoption of MAT (Medications for Addiction Treatment)
时间窗: 18 months post-implementation
% (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) and mental health prescribers engaged with Veterans who ordered Medications for Opioid Use Disorder (MOUD) / Medications for Alcohol Use Disorder (MAUD) at least once
Adoption of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)
时间窗: 18 months post-implementation
% (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) case managers who delivered ≥1 CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) session
Sustainment of MAT (Medications for Addiction Treatment)
时间窗: 18-27 months post-implementation
* (percent of) Veterans who used Medications for Opioid Use Disorder (MOUD) for OUD, ≥1 prescription * (percent of) Veterans who used MOUD for OUD for 180 days since initial prescription (without a break ≥14 days in supply) * (percent of) Veterans who used Medications for Alcohol Use Disorder (MAUD) for AUD, ≥1 prescription * (percent of) Veterans who used MAUD for AUD for 180 days since initial prescription (without a break ≥14 days in supply) * (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) and mental health prescribers engaged with Veterans who ordered Medications for Opioid Use Disorder (MOUD) / Medications for Alcohol Use Disorder (MAUD) at least once
Sustainment of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders)
时间窗: 18-27 months post-implementation
* (percent of) Veterans with stimulant use disorder who had ≥1 visit for Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) or contingency management * (percent of) Veterans with substance use disorder with ≥1 CBT-SUD visit * (percent of) Veterans with substance use disorder with ≥9 CBT-SUD visits * (percent of) Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) case managers who delivered ≥1 CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) session
次要结局
- Housing retention(1 year after implementation by cohort)
- Provider experience(Baseline and 18 months post-implementation)
- Acute care utilization(1 year after implementation by cohort)
- Cost impact of Medications for Addiction Treatment (MAT) and Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD)(18 months (during the course of implementation))