Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH)

VA Office of Research and Development

Status: Begins enrollment in 7 months

Conditions: Homelessness; Substance Use Disorder (SUD)

Treatments: Behavioral: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD); Drug: Medication for Addiction Treatment (MAT)

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT07141394

QUX 25-001

QUE 25-013 (Other Grant/Funding Number)

Details and patient eligibility

About

The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program provides subsidized permanent housing with case management to homeless-experienced Veterans (HEVs). Up to 40% of Veterans exit HUD-VASH within two years of attaining housing; substance use disorders (SUDs) are one of the largest causes of returns to homelessness for HEVs. CARE-VASH QUERI proposes to implement and evaluate two evidence-based SUD services - Medications for addiction treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD) - among Veterans in HUD-VASH.

Full description

The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program provides subsidized, permanent housing and supports to Veterans experiencing homelessness. Substance use disorders (SUDs) are a common primary or contributing factor to negative exits from HUD-VASH. The Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) QUERI will implement two evidence-based practices (EBPs) for SUDs-Medications for Addiction Treatment (MAT) and cognitive behavioral therapy for SUDs (CBT-SUD)-in 12 HUD-VASH sites. We will use the Replicating Effective Programs (REP) implementation bundle to support EBP implementation at all 12 sites. Half the sites (n=6) will also receive 9 months of consumer engagement (REP+CE). In a type 3 hybrid trial, we will use mixed methods to examine the impacts of REP vs. REP+CE. Using our trial data, we will develop a budget impact analysis and implementation playbook for our program partners to spread and sustain MAT and CBT-SUD in HUD-VASH.

Enrollment: 7,908 estimated patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Homeless-experienced Veterans (HEVs) enrolled in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program.

Exclusion criteria

• None

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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7,908 participants in 3 patient groups

Replicating Effective Programs (REP)

Experimental group

Description:

A stakeholder-informed training and technical assistance implementation strategy

Treatment:

Drug: Medication for Addiction Treatment (MAT)

Behavioral: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)

REP + Consumer Engagement (CE)

Active Comparator group

Description:

REP plus CE package (educational materials, peer coaching, toolkit) to support MAT and CBT-SUD implementation.

Treatment:

Drug: Medication for Addiction Treatment (MAT)

Behavioral: Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)

Control Group

No Intervention group

Description:

No MAT or CBT-SUD implementation