Developing Cross-Sector Collaborations to Meet the Social Needs of Veterans

VA HSR& D资助的多利益相关者研究确定了研究可以支持VA目标的方法 解决退伍军人未满足的社会需求。该公司确定了VA的孤立性质，缺乏 寻找VA患者并将其与非VA社会服务联系起来的有效模式，以及证据不足 关于基于保健的社会需求干预措施对健康的影响，认为这是可以解决的三个障碍 通过研究。这一混合方法试点研究将开始，通过建立伙伴关系， 研究团队、相关VA计划办公室和一个一直在开发多部门 自2015年以来，该网络增加了退伍军人获得健康和社会服务的机会。通过他们的美国服务 倡议，退伍军人和军人家庭研究所（IVMF）建立协调的公共和私人网络， 组织支持退伍军人。他们的服务范围，全面的护理协调方法， 以军事为中心的重点使AmericaServes成为退伍军人管理局医疗设施加入的一个有前途的合作，以增加 退伍军人获得非VA社会服务。尽管有潜在的好处，但对AmericaServes的初步分析表明， 客户数据以及与IVMF、退伍军人体验办公室和其他VA计划办公室的通信， 表明VA医疗机构是否以及如何参与AmericaServes网络或类似网络存在很大差异 合作者这种参与对退伍军人健康相关结果的影响也是未知的。 本研究的总体目标是增加指导VA医疗参与所需的证据基础。 在美国服务等合作机构的设施。作为关键的第一步，该项目将确定VA医疗如何 目前参与AmericaServes网络的设施以及阻碍或促进合作的因素 跨组织。该项目还将建立链接AmericaServes和VA管理数据，以确定 加强合作的机会领域，并为确定这种合作的影响奠定基础。 在未来的研究中就退伍军人健康相关成果进行合作。该项目有三个具体目标。 目标1是确定正式和非正式的水平，以及正式和非正式的障碍和促进因素 参与美国退伍军人管理局医疗设施服务网络。Himmelman的发展观 对于组织间的协作，团队将进行半结构化的 采访了来自AmericaServes Networks和VA医疗机构的关键线人。快速 定性分析将用于比较不同参与水平的障碍和促进因素。 目标2是确定AmericaServes客户的数量、百分比和特征， 获得VA医疗设施的服务。所有2019年AmericaServes客户的AmericaServes数据将被 与来自VA管理数据源的社会人口统计学和临床数据合并，以确定服务的退伍军人 这两个组织。重叠地区退伍军人的人口统计学、临床和服务利用特征 组将与退伍军人服务只由VA或只由AmericaServes。 目标3是制定知情的建议，以指导VA医疗的参与 基于社区的社会服务网络中的设施（例如，AmericaServes）。联合展示将用于 整合和总结VA的定性（目标1）和定量（目标2）分析结果 参与AmericaServes网络。将与利益相关者参与小组讨论调查结果 包括来自IVMF，VA计划办公室和社区退伍军人参与的退伍军人的代表 板.这些讨论将被用来确定加强合作的机会领域， 组织，并制定建议，以指导退伍军人管理局医疗设施在社区的未来参与- 基于社会服务网络。这项试点研究的伙伴关系、调查结果和建议将为 未来的观察和实验研究，研究与社区为基础的社会 服务网络，以连接退伍军人事务部医疗设施的退伍军人，以退伍军人健康的非退伍军人事务部社会服务。

A VA HSR&D-funded multi-stakeholder workgroup identified ways in which research could support the VA’s goal of addressing Veterans’ unmet social needs. The workgroup identified the siloed nature of VA, the lack of effective models for finding and connecting VA patients with non-VA social services, and insufficient evidence on the health impact of healthcare-based social needs interventions as three barriers that could be addressed by research. This mixed methods pilot study will begin to address these gaps by building partnerships between the research team, relevant VA program offices, and an organization that has been developing multi-sector networks to increase Veteran access to health and social services since 2015. Through their AmericaServes Initiative, the Institute for Veterans and Military Families (IVMF) builds coordinated networks of public and private organizations to support Veterans. Their breadth of services, wraparound care coordination approach, and military-centric focus make AmericaServes a promising collaborative for VA medical facilities to join to increase Veteran access to non-VA social services. Despite the potential benefits, preliminary analyses of AmericaServes client data and communication with IVMF, the Veterans Experience Office, and other VA program offices, indicate wide variation in whether and how VA medical facilities participate in AmericaServes Networks or similar collaboratives. The impact of such participation on Veteran health-related outcomes is also unknown. The overall objective of this research is to grow the evidence base needed to guide participation of VA medical facilities in collaboratives such as AmericaServes. As a critical first step, this project will identify how VA medical facilities currently participate in AmericaServes Networks and factors that impede or facilitate collaboration across organizations. The project will also establish link AmericaServes and VA administrative data to identify areas of opportunity for increased collaboration and lay the groundwork for determining the impact of such collaboration on Veteran health-related outcomes in future studies. The project has three specific aims. Aim 1 is to characterize the level of, as well as the barriers to and facilitators of, formal and informal participation of VA medical facilities in AmericaServes Networks. Guided by Himmelman’s Developmental Continuum of Change Strategies for inter-organizational collaboration, the team will conduct semi-structured interviews with key informants from a sample of AmericaServes Networks and VA medical facilities. Rapid qualitative analysis will be used to compare the barriers to and facilitators of different levels of participation. Aim 2 is to identify the number, percentage, and characteristics of AmericaServes clients who also receive services from VA medical facilities. AmericaServes data on all 2019 AmericaServes clients will be merged with sociodemographic and clinical data from VA administrative data sources to identify Veterans served by both organizations. Demographic, clinical, and service utilization characteristics of Veterans in the overlapping group will be compared with Veterans served only by VA or only by AmericaServes. Aim 3 is to develop stakeholder-informed recommendations to guide participation of VA medical facilities in community-based social service networks (e.g., AmericaServes). Joint displays will be used to integrate and summarize findings from the qualitative (Aim 1) and quantitative (Aim 2) analyses of VA participation in AmericaServes Networks. Findings will be discussed with a Stakeholder Engagement Panel including representatives from IVMF, VA program offices, and Veterans from Community Veteran Engagement Boards. These discussions will be used to identify areas of opportunity for increased collaboration across organizations and to develop recommendations to guide future participation of VA medical facilities in community- based social service networks. The partnerships, findings, and recommendations from this pilot study will inform future observational and experimental studies examining the impact of working with community-based social service networks to connect Veterans in VA medical facilities to non-VA social services on Veteran health.