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NCT Number: NCT05312229

Housing Transitions QUERI

The VA Grant and Per Diem (GPD) case management aftercare program provides six months of case management for homeless-experienced Veterans undergoing housing transitions. This Partnered Implementation Initiative (PII) proposes to implement and evaluate Critical Time Intervention (CTI)-an evidence-based, structured, and time-limited case management practice-in 32 GPD case management aftercare sites across the nation.

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Key information

Conditions

Homelessness

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073-1003, United States

Location status: Recruiting

About this study

The VA Grant and Per Diem case management (GPD-CM) program provides six months of case management for homeless-experienced Veterans (HEVs) undergoing housing transitions. At present, no specific case management paradigm is required in the GPD-CM program, resulting in practice variation across sites. This Partnered Implementation Initiative (PII) implements Critical Time Intervention (CTI)-an evidence-based, structured, and time-limited case management practice-at 32 VA GPD-CM sites. The investigators will use the Replicating Effective Programs (REP) implementation bundle to support CTI implementation at all 32 sites. Half of these sites will also receive 9 months of external facilitation (enhanced REP) as additional support for CTI implementation. In a type 3 hybrid trial, the investigators will use mixed methods to examine the impacts of REP versus enhanced REP. Using trial data, the investigators will develop a business case analysis and implementation playbook for the investigators' program partners to support continued CTI spread and sustainment in the GPD-CM program.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Grant and Per Diem (GPD) case management aftercare grantees in 7 Veterans Integrated Service Networks (VISN), all of whom provide 6-months of case management to Veterans who have experienced homelessness.

Exclusion criteria

  • None

Treatment and study plan

Critical Time Intervention

Behavioral

An evidence-based, structured, and time-limited case management practice

Other names: CTI

External facilitation

Other

Site-specific support to help sites develop tailored plans to implement CTI.

Other names: Coaching

Replicating Effective Programs

Other

A stakeholder-informed training and technical assistance implementation strategy

Other names: REP

Primary outcomes

  1. Fidelity to CTI

    Time frame: 12 months after implementation start

    % of Sites with adequate fidelity to CTI at 12 months, as measured by the CTI fidelity scale

  2. Sustainment of CTI

    Time frame: 18 months after implementation start

    % of Sites with adequate fidelity to CTI at 18 months, as measured by the CTI fidelity scale

  3. Dollars spent delivering CTI at each site

    Time frame: Between 6 and 18 months after implementation start

    Case manager salary and benefits

Secondary outcomes

  1. Housing stability

    Time frame: Between 6 and 18 months after implementation start

    Days between entry into the GPD case management program and indicator of housing instability

  2. Cost of CTI as Implemented

    Time frame: Between 6 and 18 months after implementation start

    Mean monthly cost of CTI case management per GPD case management Veteran served, compared to the mean monthly cost in the non-CTI GPD case management programs.

  3. Hospitalization rates

    Time frame: Between 6 and 18 months after implementation start

    Number of days between entry into the GPD case management program and hospitalization, number of hospitalizations, number of bed days

  4. Cost of Implementation Strategies

    Time frame: Through study completion, 4 years

    Dollars spent on REP versus enhanced REP

  5. Return on Investment (ROI) of CTI

    Time frame: 6-, 12-, and 18-months after GPD case management program enrollment

    Dollars saved via improved housing stability and decreased hospitalizations among patients engaged in CTI versus control participants

  6. Outpatient service use

    Time frame: Between 6 and 18 months after implementation start

    Number of outpatient appointments

Interested in participating?

Recruiting

Interested in participating?

Request Info

Sponsors and collaborators

Lead sponsor

VA Office of Research and Development

Fed

Collaborators

  • Center for the Advancement of Critical Time Intervention
  • University of California, Los Angeles
  • University of Southern California

Registry information

Official study title

Implementing and Sustaining Critical Time Intervention (CTI) in Case Management Programs for Homeless-experienced Veterans (PII 21-285)

Important dates

Study start
2021
Primary completion
2026
Study completion
2026
First posted
Apr 5, 2022
Registry last updated
Jul 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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