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Washington DL, Goldzweig CL, Haskell SG, Czarnogorski M, Ochotorena LM, Hamilton A. Partnered Research for Prevention of Homelessness in Women Veterans. Poster session presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Arlington, VA.
Objectives: Ending homelessness among Veterans is a federal priority. Though overall Veteran homelessness is decreasing, homelessness among women Veterans (WVs) is increasing. Previously, we identified risk factors for WVs' homelessness and barriers to receipt of psychosocial services, then developed a secondary screener - the Veterans Homelessness Vulnerability Tool (V-Tool), to complement VA's current/imminent homelessness screening by identifying and linking to services WVs who are predisposed to or at chronic risk for homelessness. Our objective was to pilot the V-Tool at one site. Methods: We conducted semi-structured interviews of clinicians and clinical staff to assess their knowledge, attitudes, and beliefs about vulnerability screening of women in primary care settings, and of the V-Tool screening and referral process. We also conducted interviews with WVs to obtain their understanding of the V-Tool screening questions. We analyzed transcripts for major themes. Results: Interviews revealed four themes addressing V-Tool development and deployment. (1) Target population: Homelessness vulnerability screening should be risk-based rather than universally applied. This was operationalized using CPRS-assessable homelessness risk factors as inclusion criteria for screening eligibility. (2) Screening content: Focus on the impact of the risk factor on Veterans' housing stability, rather than the presence of the risk factor itself. This links the follow-up actions for a positive screen more closely to homelessness services. (3) Referrals: Clinicians and clinical staff overwhelmingly expressed the need for services to be in place prior to initiation of screening. WVs described prior VA experiences when all needed services were not in place. (4) Clinical settings: Mental health and social work staff thought screening could be expanded to those settings, since much of the V-Tool content mirrors what is routinely collected during their intakes. Conclusions: It was critical to obtain multiple perspectives on V-Tool content and process because each group of stakeholders had differing perspectives on and priorities for addressing homelessness risk. Impacts: We refined the V-Tool screening component, computerized the V-Tool for CPRS use, and are conducting a multi-site deployment. The ultimate goal of the V-Tool is to increase identification and referral of at-risk Veterans into VA social service, mental health, and other preventive services, thereby contributing to primary homelessness prevention.
