Implementing and Supporting Critical Time Intervention Case Management for Homeless Veterans Across 32 VA Sites

What this Trial Is About

This research focuses on homeless-experienced Veterans undergoing housing transitions and evaluates the implementation of Critical Time Intervention CTI, a structured and time-limited case management practice. The study addresses the current variation in case management approaches across VA Grant and Per Diem GPD case management aftercare sites by implementing CTI at 32 sites nationwide. The goal is to assess how well CTI can be integrated and sustained within these programs. Participants in this study are involved in one of three groups receiving a stakeholder-informed training and technical assistance strategy called Replicating Effective Programs REP, REP combined with site-specific weekly external facilitation to support CTI implementation enhanced REP, or no CTI implementation as a control group. The study uses the REP implementation bundle to support CTI at all sites, with half receiving additional facilitation for nine months. This is a type 3 hybrid trial designed to compare REP versus enhanced REP methods. Throughout the study, researchers will monitor how faithfully CTI is implemented and maintained over time, as well as the costs involved in delivering CTI and the implementation strategies. They will also evaluate Veteran housing stability, hospitalization rates, outpatient service use, and the financial return on investment linked to CTI. The study spans up to four years, with assessments at intervals including 6, 12, and 18 months after CTI implementation starts, aiming to develop resources to help sustain CTI in the future.

Housing Transitions QUERI