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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 7/2015

01-07-2015 | Original Research

Tailoring Outreach Efforts to Increase Primary Care Use Among Homeless Veterans: Results of a Randomized Controlled Trial

Authors: Thomas P. O’Toole, MD, Erin E. Johnson, BA, Matthew L. Borgia, AM, Jennifer Rose, PhD

Published in: Journal of General Internal Medicine | Issue 7/2015

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ABSTRACT

BACKGROUND

Homeless individuals often have significant unmet health care needs that are critical to helping them leave homelessness. However, engaging them in primary and mental health care services is often elusive and difficult to achieve.

OBJECTIVE

We aimed to increase health-seeking behavior and receipt of health care among homeless Veterans.

DESIGN

This was a multi-center, prospective, community-based, two-by-two randomized controlled trial of homeless Veterans.

PARTICIPANTS

Homeless Veterans not receiving primary care participated in the study.

INTERVENTIONS

An outreach intervention that included a personal health assessment and brief intervention (PHA/BI), and/or a clinic orientation (CO) was implemented.

MAIN MEASURE

We measured receipt of primary care within 4 weeks of study enrollment.

KEY RESULTS

Overall, 185 homeless Veterans were enrolled: the average age was 48.6 years (SD 10.8), 94.6 % were male, 43.0 % were from a minority population, 12.0 % were unsheltered, 25.5 % were staying in a dusk-to-dawn emergency shelter, 26.1 % were in transitional housing, while 27.7 % were in an unstable, doubled-up arrangement. At one month, 77.3 % of the PHA/BI plus CO group accessed primary care and by 6 months, 88.7 % had been seen in primary care. This was followed by the CO-only group, 50.0 % of whom accessed care in the first 4 weeks, the PHI/BI-only arm at 41.0 % and the Usual Care arm at 30.6 %. Chi-squared tests by group were significant (p < 0.001) at both 4 weeks and 6 months. There was no difference in attitudes about care at baseline and 6 months or in use patterns once enrolled in care.

CONCLUSIONS

Our findings suggest that treatment-resistant/avoidant homeless Veterans can be effectively engaged in primary and other clinical care services through a relatively low intensity, targeted and tailored outreach effort.
Appendix
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Metadata
Title
Tailoring Outreach Efforts to Increase Primary Care Use Among Homeless Veterans: Results of a Randomized Controlled Trial
Authors
Thomas P. O’Toole, MD
Erin E. Johnson, BA
Matthew L. Borgia, AM
Jennifer Rose, PhD
Publication date
01-07-2015
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 7/2015
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-015-3193-x

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