AJPM focus · 2025
Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study.
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Saleh Tawny, Gelberg Lillian, Chinchilla Melissa Y, Allen Jennifer E, Connor Kristen L, Altman Lisa, Capone-Newton Peter
Аннотация
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.
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.