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dc.contributor.authorSimmons, Molly M.en_US
dc.contributor.authorGabrielian, Sonyaen_US
dc.contributor.authorByrne, Thomasen_US
dc.contributor.authorMcCullough, Megan B.en_US
dc.contributor.authorSmith, Jeffery L.en_US
dc.contributor.authorTaylor, Thom J.en_US
dc.contributor.authorO’Toole, Tom P.en_US
dc.contributor.authorKane, Vincenten_US
dc.contributor.authorYakovchenko, Veraen_US
dc.contributor.authorMcInnes, D. Keithen_US
dc.contributor.authorSmelson, David A.en_US
dc.date.accessioned2018-01-29T15:20:58Z
dc.date.available2018-01-29T15:20:58Z
dc.date.issued2017-12
dc.identifier.citationMolly M. Simmons, Sonya Gabrielian, Thomas Byrne, Megan B. McCullough, Jeffery L. Smith, Thom J. Taylor, Tom P. O’Toole, Vincent Kane, Vera Yakovchenko, D. Keith McInnes, David A. Smelson. 2017. "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, Volume 12, Issue 1,
dc.identifier.issn1748-5908
dc.identifier.urihttps://hdl.handle.net/2144/26464
dc.description.abstractBACKGROUND: Homeless veterans often have multiple health care and psychosocial needs, including assistance with access to housing and health care, as well as support for ongoing treatment engagement. The Department of Veterans Affairs (VA) developed specialized Homeless Patient Alignment Care Teams (HPACT) with the goal of offering an integrated, “one-stop program” to address housing and health care needs of homeless veterans. However, while 70% of HPACT’s veteran enrollees have co-occurring mental health and substance use disorders, HPACT does not have a uniform, embedded treatment protocol for this subpopulation. One wraparound intervention designed to address the needs of homeless veterans with co-occurring mental health and substance use disorders which is suitable to be integrated into HPACT clinic sites is the evidence-based practice called Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking-Veterans Edition, or MISSION-Vet. Despite the promise of MISSION-Vet within HPACT clinics, implementation of an evidence-based intervention within a busy program like HPACT can be difficult. The current study is being undertaken to identify an appropriate implementation strategy for MISSION-Vet within HPACT. The study will test the implementation platform called Facilitation and compared to implementation as usual (IU). The aims of this study are as follows: (1) Compare the extent to which IU or Facilitation strategies achieve fidelity to the MISSION-Vet intervention as delivered by HPACT homeless provider staff. (2) Compare the effects of Facilitation and IU strategies on the National HPACT Performance Measures. (3) Compare the effects of IU and Facilitation on the permanent housing status. (4) Identify and describe key stakeholders’ (patients, providers, staff) experiences with, and perspectives on, the barriers to, and facilitators of implementing MISSION. DESIGN: Type III Hybrid modified stepped wedge implementation comparing IU to Facilitation across seven HPACT teams in three sites in the greater Los Angeles VA system. This is a cluster randomized trial. DISCUSSION: Integrating MISSION-Vet within HPACT has the potential to improve the health of thousands of veterans, but it is crucial to implement the intervention appropriately in order for it to succeed. The lessons learned in this protocol could assist with a larger roll-out of MISSION within HPACT. This protocol is registered with clinicaltrials.gov and was assigned the number NCT 02942979.en_US
dc.description.sponsorshipQUE 15-284 - VA Health Services Research and Development Quality Enhancement Research Iniativeen_US
dc.relation.ispartofImplementation Science
dc.rights© 2017 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectMedical and health sciencesen_US
dc.subjectInformation and computing sciencesen_US
dc.subjectHealth policy & servicesen_US
dc.subjectStep wedge designen_US
dc.subjectVeteransen_US
dc.subjectCo-occurring disordersen_US
dc.subjectVulnerable populationsen_US
dc.subjectHomeless Patient Aligned Care Teams (HPACT)en_US
dc.subjectUnited Statesen_US
dc.titleA 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 Programsen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s13012-017-0563-2
pubs.elements-sourcecrossrefen_US
pubs.notesEmbargo: Not knownen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, School of Social Worken_US
pubs.publication-statusPublisheden_US
dc.date.online2017-04-04
dc.identifier.orcid0000-0003-4824-0284 (Byrne, Thomas)


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© 2017 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Except where otherwise noted, this item's license is described as © 2017 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.