Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| PII 21-285 | Other Grant/Funding Number | QUERI |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| University of California, Los Angeles | OTHER |
| Center for the Advancement of Critical Time Intervention | UNKNOWN |
| University of Southern California | OTHER |
Not provided
Not provided
Not provided
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.
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.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Replicating Effective Programs (REP) | Experimental | A stakeholder-informed training and technical assistance implementation strategy |
|
| REP + External Facilitation (Enhanced REP) | Active Comparator | REP plus site specific weekly facilitation to support CTI implementation. |
|
| Control Group | No Intervention | No CTI implementation |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Critical Time Intervention | Behavioral | An evidence-based, structured, and time-limited case management practice |
|
| Measure | Description | Time Frame |
|---|---|---|
| Fidelity to CTI | % of Sites with adequate fidelity to CTI at 12 months, as measured by the CTI fidelity scale | 12 months after implementation start |
| Sustainment of CTI | % of Sites with adequate fidelity to CTI at 18 months, as measured by the CTI fidelity scale | 18 months after implementation start |
| Dollars spent delivering CTI at each site | Case manager salary and benefits | Between 6 and 18 months after implementation start |
| Measure | Description | Time Frame |
|---|---|---|
| Housing stability | Days between entry into the GPD case management program and indicator of housing instability | Between 6 and 18 months after implementation start |
| Cost of CTI as Implemented | 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. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Sonya Emi Gabrielian, MD MPH | VA Greater Los Angeles Healthcare System, West Los Angeles, CA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VA Greater Los Angeles Healthcare System, West Los Angeles, CA | West Los Angeles | California | 90073-1003 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42304402 | Derived | Cummings C, Rawal M, Tan G, Finley E, Cordasco KM, Herman D, Edwards L, Gabrielian S. Assessing fidelity to Critical Time Intervention (CTI) for homeless-experienced persons. BMC Health Serv Res. 2026 Jun 16. doi: 10.1186/s12913-026-14939-8. Online ahead of print. | |
| 36192785 | Derived | Gabrielian S, Finley EP, Ganz DA, Barnard JM, Jackson NJ, Montgomery AE, Nelson RE, Cordasco KM. Comparing two implementation strategies for implementing and sustaining a case management practice serving homeless-experienced veterans: a protocol for a type 3 hybrid cluster-randomized trial. Implement Sci. 2022 Oct 3;17(1):67. doi: 10.1186/s13012-022-01236-1. |
| Label | URL |
|---|---|
| Resources for VA Grant and Per Diem (GPD) case management aftercare grantee sites to implement and sustain Critical Time Intervention (CTI) at their sites. | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The investigators are implementing Critical Time Intervention (CTI), an evidence-based, time limited case management practice for individuals experiencing homelessness. The investigators will be randomizing sites receiving CTI into one of two levels of implementation support (low vs. high intensity support).
Not provided
Not provided
Not provided
Not provided
|
| External Facilitation | Other | Site-specific support to help sites develop tailored plans to implement CTI. |
|
|
| Replicating Effective Programs | Other | A stakeholder-informed training and technical assistance implementation strategy |
|
|
| Between 6 and 18 months after implementation start |
| Hospitalization rates | Number of days between entry into the GPD case management program and hospitalization, number of hospitalizations, number of bed days | Between 6 and 18 months after implementation start |
| Cost of Implementation Strategies | Dollars spent on REP versus enhanced REP | Through study completion, 4 years |
| Return on Investment (ROI) of CTI | Dollars saved via improved housing stability and decreased hospitalizations among patients engaged in CTI versus control participants | 6-, 12-, and 18-months after GPD case management program enrollment |
| Outpatient service use | Number of outpatient appointments | Between 6 and 18 months after implementation start |