Enhancing Community Integration for Homeless Veterans

加强无家可归退伍军人的社区融合

• 批准号: 10275485
• 负责人: Michael F. Green
• 金额: --
• 依托单位: VA GREATER LOS ANGELES HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-10-01 至 2025-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10275485
• 关键词: Area; Award; Clinical; Clinical assessments; Cognition; Cognitive; Communities; Community Integration; Dissemination and Implementation; Family; Fellowship Program; Friends; Goals; Grant; Health; Health Services; Homelessness; Housing; Intervention; Intervention Studies; Link; Los Angeles; Measures; Methods; Mission; Motivation; Outcome; Pathway interactions; Pharmaceutical Preparations; Population; Predictive Factor; Procedures; Process; Psyche structure; Recovery; Research; Research Personnel; Research Project Grants; Risk; Sampling; Services; Technology; Translational Research; Veterans; Work; base; data management; experience; improved; innovation; neglect; novel; programs; psychosocial; recruit; skills; social; social contact; social integration; statistics; therapeutic target

Homelessness in Veterans is a widespread problem, and a priority at the national level. Despite substantial progress in providing housing for Veterans, a fundamental problem remains: Permanent housing is a necessary, but not sufficient, condition for successful community integration. Community integration (e.g., social integration with friends and family; capacity for work and productive activities) is essential for long-term mental and physical outcomes. Providing housing is only the first step in facilitating recovery among homeless Veterans; once housed, they need different types of assistance to integrate into communities. For these reasons we are proposing an RR&D Center at the VA Greater Los Angeles (GLA) with a mission to understand and to improve community integration in homeless and recently-housed Veterans. The Center will build on an existing Research Enhancement and Award Program (REAP) at GLA and will expand it substantially. The Center will establish an interdisciplinary community of researchers, educators, and clinicians to generate intervention and translational research to improve community integration for these Veterans. This Center will fill a critical gap -- rather than focusing on factors that confer risk for homelessness in Veterans, this team of investigators will apply their skills to the neglected problem of community integration for homeless and recently-housed Veterans. It will also attract and develop clinical researchers and trainees who focus on this critical problem, with components such as a Pilot Grant program and a Postdoctoral Fellowship program. It is fitting that this RR&D Center will be based at GLA, which has the largest homeless program of any VA in the nation, and is current providing housing for > 9,000 Veterans who have experienced homelessness. The overarching goal of this Center is to understand and improve community integration for homeless and recently-housed Veterans. To achieve these goals, the Center will be organized around three research focus areas (FAs) that rely on four service Cores. The FAs include: · FA1: To develop and validate innovative assessments of factors that predict community integration, including cognition (social and nonsocial) and motivation, as well as community integration. · FA2: To identify determinants that predict improvements in community integration. · FA3: To develop and adapt interventions to enhance community integration for homeless and recently- housed Veterans.! These FAs form a sequential translational pathway. The sequence involves three key steps: First, develop innovative methods to assess key variables that are linked to community integration in homeless Veterans. This is a critical need – for example, key aspects of community integration in homeless Veterans cannot be adequately captured with existing measures. Second, use those methods to identify the determinants of community integration. The identification should be with sufficient precision at the level of specific cognitive or motivational sub-processes. Third, use that information to guide choice of and develop interventions for recovery-related therapeutic targets. The intervention approaches can range from psychosocial procedures to medications to novel methods such as neurostimulation. The trials can range from early-stage proof-of- concept studies in which novel treatments are evaluated in terms of feasibility in relatively small samples to later-stage adaptations of existing interventions that have been validated in other populations, but not validated in homeless populations. Findings from this Center, including validated interventions, would be then passed to VA health services investigators for implementation and dissemination. The Center will support four service Cores. These include: the Recruitment Core, the Clinical Assessment Core, the Data Management and Statistics Core, and the Technology Core. All four of these Cores will provide critical services to each of the three FAs.

退伍军人无家可归是一个普遍存在的问题，也是国家一级的优先事项。尽管作出了重大的 在为退伍军人提供住房方面取得进展，一个根本问题仍然存在：永久住房是一个 这是成功融入社会的必要条件，但不是充分条件。社区融合（例如， 与朋友和家庭的社会融合;工作和生产活动的能力）是长期 精神和身体的结果。提供住房只是促进无家可归者康复的第一步 退伍军人;一旦安置，他们需要不同类型的援助，以融入社区。 出于这些原因，我们建议在VA大洛杉矶（GLA）建立一个RR&D中心，其使命是 了解并改善无家可归者和最近入住的退伍军人的社区融合。该中心将 建立在GLA现有的研究增强和奖励计划（REAP）的基础上，并将其扩展 实质上。该中心将建立一个由研究人员、教育工作者和临床医生组成的跨学科社区 产生干预和转化研究，以改善这些退伍军人的社区融合。这 该中心将填补一个关键的空白-而不是专注于退伍军人无家可归的风险因素， 一个调查小组将运用他们的技能，解决被忽视的无家可归者融入社区的问题， 最近入住的退伍军人它还将吸引和培养专注于此的临床研究人员和学员 关键问题，如试点赠款计划和博士后奖学金计划的组成部分。是 适合这个RR&D中心将设在GLA，其中有最大的无家可归者计划的任何VA在 国家，目前正在为超过9,000名无家可归的退伍军人提供住房。 该中心的首要目标是了解和改善无家可归者的社区融合， 最近入住的退伍军人为实现这些目标，中心将围绕三个研究重点进行组织 区域（FA）依赖于四个服务核心。FA包括： FA 1：制定和验证对预测社区融合的因素的创新评估， 包括认知（社会和非社会）和动机，以及社区融合。 ·FA 2：确定预测社区融合改善的决定因素。 ·FA 3：制定和调整干预措施，以加强无家可归者的社区融合，最近- 退伍军人！ 这些FA形成连续的翻译途径。该序列包括三个关键步骤：首先， 创新的方法来评估与无家可归的退伍军人融入社区有关的关键变量。 这是一个关键的需求-例如，无家可归的退伍军人社区融合的关键方面不能被 充分利用现有措施。其次，使用这些方法来确定 社区融合。识别应在具体的认知水平上具有足够的精确性， 动机子过程。第三，利用这些信息指导选择和制定干预措施， 恢复相关的治疗目标。干预方法可以从心理社会程序， 从药物到神经刺激等新方法。这些试验可以从早期的证据- 概念研究，在相对较小的样本中评估新治疗方法的可行性， 对已在其他人群中验证但尚未验证的现有干预措施的后期调整 无家可归的人。该中心的调查结果，包括经过验证的干预措施，将被传递给 VA卫生服务调查员的实施和传播。 该中心将支持四个服务核心。其中包括：招募核心，临床评估 核心、数据管理和统计核心以及技术核心。这四个核心将提供 为三个FA中的每一个提供关键服务。