Improving Linkage to Health and Other Services for Veterans Leaving Incarceration (PIE)
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|ClinicalTrials.gov Identifier: NCT02964897|
Recruitment Status : Recruiting
First Posted : November 16, 2016
Last Update Posted : December 20, 2018
|Condition or disease||Intervention/treatment||Phase|
|Linkage to Care Homelessness Substance Use Disorder Mental Health||Behavioral: Peer-support plus usual care from the Health Care for Reentry Veterans program Behavioral: Usual care from the Health Care for Reentry Veterans program||Not Applicable|
Veterans leaving incarceration (henceforth, "reentry Veterans") are among the most underserved by the VA and thus are an increasingly high priority population. The Bureau of Justice Statistics estimates that 140,000 Veterans are incarcerated in the U.S. at a given time, approximately 80% of whom are eligible for VA benefits. Many of these Veterans had problems with substance use disorders (SUD)(including alcohol) and/or mental health (MH) issues prior to being incarcerated.
The VA's national Health Care for Reentry Veterans (HCRV) program identifies 10,000-15,000 incarcerated Veterans annually preparing to transition back to the community. A HCRV outreach specialist works with incarcerated VHA-eligible Veterans to establish a post-release plan for linkage to VHA services. This program, with 1-2 outreach specialists per state, has improved the connection between reentry Veterans and the VHA. However, the investigators' analyses of homeless program data linked to VHA administrative data indicate that 43% of eligible HCRV Veterans do not have a VHA outpatient contact in the first 4 months post incarceration. Reducing this number is critical given the elevated rates of chronic health conditions, as well as MH or SUDs in this population.
To address this gap, the investigators will work with the national HCRV office to implement an evidence-based peer support intervention to extend the reach and effectiveness of the HCRV program in linking Veterans to VHA. Peers with incarceration experience are likely to better understand and connect with Veterans on a personal level than the outreach specialist, and thus are more likely to maintain contact and link to VHA during the first months post-release. Peers are gaining popularity in forensic settings (called "forensic peer specialists") with civilian populations and would likely be beneficial for a Veteran population .
The aims of this project are:
- Conduct contextual analysis to identify VHA and community reentry resources, and to describe how reentry Veterans use them.
- Implement peer-support, in one state, to link reentry veterans to VHA primary, mental health, and SUD services. The investigators will use external and internal facilitation as the implementation strategy.
- Spread the peer-support intervention to another, geographically, and contextually different state.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||180 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Supportive Care|
|Official Title:||Veterans Justice Reentry (Post-Incarceration) (QUE 15-284)|
|Actual Study Start Date :||November 27, 2017|
|Estimated Primary Completion Date :||September 30, 2019|
|Estimated Study Completion Date :||September 30, 2020|
Experimental: Intervention Arm with Peer Support
Veterans in this arm will receive the peer-support intervention, in addition to the usual care from the Health Care for Reentry Veterans Program.
Behavioral: Peer-support plus usual care from the Health Care for Reentry Veterans program
a peer mentor who is also a veteran will establish a relationship with each subject and provide instrumental and emotional support to the subject during the first 6 months of the subject's release from incarceration. This is in addition to the usual reentry support provided by the Health Care for Reentry Veterans program.
Other Name: peer mentoring; forensic peer support
Comparison Arm with Usual Care
Veterans in this arm will be receiving usual care from the Health Care for Reentry Veterans program (but they will not receive the peer-support intervention). They will be selected to be frequency-matched to veterans in the intervention arm by date of release from incarceration.
Behavioral: Usual care from the Health Care for Reentry Veterans program
Health Care for Reentry Veterans program provides reentry planning while the veteran is incarcerated. An outreach worker visits the veteran in the incarceration facility to conduct a needs assessment and help create a reentry plan to cover issues such as where they will be housed, what health care appointments they will need in the first 30 days, whether they need legal assistance, etc.
Other Name: HCRV reentry support
- Linkage to healthcare services [ Time Frame: 6 months after release from incarceration ]Participant will have made and kept one or more primary or specialty health care appointments.
- Living in transitional or permanent housing [ Time Frame: 6 months after release from incarceration ]Subject is residing in transitional or permanent housing. Transitional housing is housing that provides appropriate supportive services (e.g. MH or SUD group therapy) to recently homeless persons to help them achieve independent living. Transitional and permanent housing do not include emergency shelters, living on the streets, or living in a structure unfit for human habitation.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02964897
|Contact: Donald K McInnes, ScD MS BA||(781) 687-3507||Keith.McInnes@va.gov|
|Contact: Beth A Petrakis, MPA BA||(781) 687-2975||BethAnn.Petrakis@va.gov|
|United States, Massachusetts|
|Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA||Recruiting|
|Bedford, Massachusetts, United States, 01730|
|Contact: Donald K McInnes, ScD MS BA 781-687-3507 Keith.McInnes@va.gov|
|Contact: Justeen K Hyde, PhD (781) 687-2028 Justeen.Hyde@va.gov|
|Principal Investigator: Allen L. Gifford, MD|
|Principal Investigator: Donald K McInnes, ScD MS BA|
|Principal Investigator:||Donald K McInnes, ScD MS BA||Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA|
|Principal Investigator:||Allen L. Gifford, MD||Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA|