Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study

AJPM focus Pub Date : 2025-06-25 DOI:10.1016/j.focus.2025.100383

Tawny Saleh MD, MS , Lillian Gelberg MD, MSPH, FAAFP , Melissa Y. Chinchilla PhD, MCP, MSHPM , Jennifer E. Allen ANP-BC, MSN , Kristen L. Connor MSPH , Lisa Altman MD , Peter Capone-Newton MD, PhD, MPH

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Abstract

Introduction

Whole Health programs aim to integrate mental, physical, and social health to improve veteran well-being. Homeless-experienced veterans may face barriers to engagement owing to housing instability and comorbidities. This study evaluated Whole Health participation among homeless-experienced veterans at the VA Greater Los Angeles Care, Treatment, and Rehabilitation Service site compared with that among the broader VA Greater Los Angeles Healthcare System veteran population.

Methods

A retrospective quality improvement study analyzed Whole Health participation among 619 homeless-experienced veterans at Care, Treatment, and Rehabilitation Service; 25,520 Whole Health participants at VA Greater Los Angeles Healthcare System; and 84,358 total VA Greater Los Angeles Healthcare System veterans. Chi-square and t-tests assessed demographic and health differences. Thematic analysis of personal health inventory reflections explored wellness priorities.

Results

Whole Health participation was higher among Care, Treatment, and Rehabilitation Service homeless-experienced veterans (42%) than among the broader VA Greater Los Angeles Healthcare System Whole Health population (22%) (p<0.001). Whole Health participants at Care, Treatment, and Rehabilitation Service were older (56.8±13.4 vs 53.8±13.7 years; p=0.006), with different age group distribution (p=0.02). Chronic pain, post-traumatic stress disorder, depression, and substance use were more prevalent among homeless-experienced veterans than among the general veteran population (p<0.001). Early Whole Health engagement was associated with longer shelter stays. Personal health inventory themes included personal development (88%), housing (68%), and family/social connection (56%).

Conclusions

Whole Health programs may be effective and acceptable among homeless-experienced veterans when integrated into supportive housing environments.

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评估紧急避难所中无家可归经验丰富的退伍军人的整体健康参与：一项质量改进研究

全面健康计划旨在整合心理、身体和社会健康，以改善退伍军人的福祉。由于住房不稳定和合并症，有无家可归经验的退伍军人可能面临参与的障碍。本研究评估了退伍军人管理局大洛杉矶护理、治疗和康复服务站的无家可归经验退伍军人的整体健康参与情况，并将其与更广泛的退伍军人管理局大洛杉矶医疗保健系统退伍军人人口进行了比较。方法采用回顾性质量改善研究，分析619名在护理、治疗和康复服务中心工作的退伍军人的整体健康参与情况；VA大洛杉矶医疗保健系统的25,520名Whole Health参与者；以及84,358名退伍军人管理局大洛杉矶医疗保健系统退伍军人。卡方检验和t检验评估了人口统计学和健康差异。个人健康清单反映的专题分析探讨了健康优先事项。结果护理、治疗和康复服务无家可归的退伍军人的整体健康参与率（42%）高于退伍军人管理局大洛杉矶医疗保健系统整体健康人群（22%）（p<0.001）。护理、治疗和康复服务的全健康参与者年龄较大(56.8±13.4岁vs 53.8±13.7岁；P =0.006)，不同年龄组分布差异有统计学意义（P =0.02）。慢性疼痛、创伤后应激障碍、抑郁和药物使用在无家可归的退伍军人中比在普通退伍军人中更为普遍（p<0.001）。早期全面健康参与与较长的庇护所停留时间有关。个人健康调查主题包括个人发展（88%）、住房（68%）和家庭/社会关系（56%）。结论将整体健康计划融入支持性住房环境中，对有无家可归经历的退伍军人可能是有效和可接受的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AJPM focus Health, Public Health and Health Policy

CiteScore

0.50

自引率

0.00%

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