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
{"title":"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","authors":"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","doi":"10.1016/j.focus.2025.100383","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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 <em>t</em>-tests assessed demographic and health differences. Thematic analysis of personal health inventory reflections explored wellness priorities.</div></div><div><h3>Results</h3><div>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%) (<em>p</em><0.001). Whole Health participants at Care, Treatment, and Rehabilitation Service were older (56.8±13.4 vs 53.8±13.7 years; <em>p</em>=0.006), with different age group distribution (<em>p</em>=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 (<em>p</em><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%).</div></div><div><h3>Conclusions</h3><div>Whole Health programs may be effective and acceptable among homeless-experienced veterans when integrated into supportive housing environments.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 5","pages":"Article 100383"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study\",\"authors\":\"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\",\"doi\":\"10.1016/j.focus.2025.100383\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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 <em>t</em>-tests assessed demographic and health differences. Thematic analysis of personal health inventory reflections explored wellness priorities.</div></div><div><h3>Results</h3><div>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%) (<em>p</em><0.001). Whole Health participants at Care, Treatment, and Rehabilitation Service were older (56.8±13.4 vs 53.8±13.7 years; <em>p</em>=0.006), with different age group distribution (<em>p</em>=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 (<em>p</em><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%).</div></div><div><h3>Conclusions</h3><div>Whole Health programs may be effective and acceptable among homeless-experienced veterans when integrated into supportive housing environments.</div></div>\",\"PeriodicalId\":72142,\"journal\":{\"name\":\"AJPM focus\",\"volume\":\"4 5\",\"pages\":\"Article 100383\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AJPM focus\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2773065425000719\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AJPM focus","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2773065425000719","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
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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