Enhancing Community Integration for Homeless Veterans

加强无家可归退伍军人的社区融合

• 批准号: 9995282
• 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/9995282
• 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; once housed; programs; psychosocial; recruit; skills; social; 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.

退伍军人的无家可归是一个宽泛的问题，也是国家一级的优先事项。尽管很大 为退伍军人提供住房的进展，仍然存在一个基本问题：永久住房是一个 必要但不足以成功进行社区融合。社区整合（例如 与朋友和家人的社会融合；工作和产品活动的能力）对于长期至关重要 心理和身体成果。提供住房只是支持无家可归者恢复的第一步 退伍军人；一旦被安置，他们需要不同类型的援助才能融入社区。 由于这些原因，我们在弗吉尼亚州大洛杉矶（GLA）提议一个RR＆D中心，其任务是 了解并改善无家可归者和最近居住的退伍军人的社区融合。中心将 建立在GLA现有的研究增强和奖励计划（REAP）的基础上，并将扩大 基本上。该中心将建立一个研究人员，教育工作者和临床医生的跨学科社区 生成干预和翻译研究以改善这些退伍军人的社区融合。这 中心将填补一个关键的空白 - 而不是专注于会导致退伍军人无家可归风险的因素，而是 调查人员团队将把他们的技能应用于被忽视的无家可归者社区融合问题 最近居住的退伍军人。它还将吸引和发展专注于此的临床研究人员和受训者 关键问题，诸如试点赠款计划和博士后奖学金计划之类的组件。这是 适合此RR＆D中心将基于GLA，该中心具有最大的无家可归者计划。 Nation，目前正在为经历无家可归的9,000名退伍军人提供住房。 该中心的总体目标是了解和改善无家可归者和 最近居住的退伍军人。为了实现这些目标，将在三个研究重点周围组织该中心 依靠四个服务核心的区域（FA）。 FAS包括： FA1：为预测社区融合的因素进行创新评估， 包括认知（社会和非社交）和动机以及社区融合。 ·FA2：确定确定可以预测社区融合的改善的确定。 ·FA3：制定和适应干预措施，以增强社区融合的无家可归者和最近 - 容纳退伍军人。 这些FA形成了顺序翻译途径。序列涉及三个关键步骤：首先，开发 评估与无家可归者社区融合相关的关键变量的创新方法。 这是一个关键需求 - 例如，无家可归的退伍军人社区融合的关键方面不可能是 适当地捕获了现有措施。其次，使用这些方法来识别 社区整合。识别应在特定认知水平或 动机子过程。第三，使用该信息指导选择和开发干预措施 与恢复相关的治疗靶标。干预方法的范围从社会心理程序到 新方法（例如神经刺激）的药物。试验的范围从早期证明 概念研究在相对较小的样本中对新的治疗方法进行了评估 在其他人群中已验证但未验证的现有干预措施的后期改编 在无家可归的人群中。然后将该中心的调查结果（包括经过验证的干预措施）传递给 VA卫生服务调查人员实施和传播。 该中心将支持四个服务核心。其中包括：招聘核心，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 三个FA中的每个FA的关键服务。