Evaluation of Veteran-Directed Home and Community Based Services

NCT03145818 | Completed Results

• 1 other identifier: SDR 16-194
• Study Type: observational
• Target: 126
• Locations: 1 country
• Sites: 2

Brief Summary

Veteran-Directed Home and Community Based Services (VD-HCBS) is focused on preserving Veteran's independence and the VA Office of Geriatrics and Extended Care is planning an expansion of VD-HCBS to 90 additional VA Medical Centers over the next 3 years. This proposal seeks to evaluate the VD-HCBS expansion to capture comprehensive information on the impact of VD-HCBS on Veterans' and Caregivers' outcomes, as well as, to identify how the program was implemented.

Conditions

Functional Impairment; Caregiving

Keywords

dissemination

Outcome Measures

Primary Outcomes (2)

• Veteran's Unmet Need for Services, Satisfaction, Unmet Needs, and Quality of Life.

  Satisfaction Survey Number of Veterans responding to VA-specific program survey questions on Veteran satisfaction, unmet needs, and quality of life. Veterans were asked to respond to a 6 question survey by choosing a number from a scale (either from 1-10 or 1-5; low numbers typically indicating satisfaction; higher numbers indicating dissatisfaction) to indicate their level of overall satisfaction with their current health needs and ability to participate in daily activities.

  12 months

• Caregiver Well-being Survey

  Number of caregivers who responded to a VA specific Caregiver survey on financial strain, depressive symptoms, caregiving stress, and health status and positive caregiver experiences. Caregivers were asked to choose the best answer from a scale that reflected the level of intensity (low numbers typically indicating less intensity than the higher numbers) of common caregiving stressors.

  9 months

Study Arms (4)

Veterans

Veterans will be the primary group for whom the VD-HCBS Program is implemented. Veterans enrolled in VD-HCBS will be functionally impaired

Other: VD-HCBS

Caregivers

Caregivers support Veterans independence in their home and community

Other: VD-HCBS

VHA Coordinators

VHA VD-HCBS Coordinators allow the program to operate within the VA

Other: VD-HCBS

ADNA Coordinators

ADNA Coordinators engage with the Veteran, Caregivers, and VA Coordinators to ensure the Veteran is able to maintain independence

Other: VD-HCBS

Interventions

VD-HCBS OTHER

Like the participant-directed programs developed for Medicaid programs,VD-HCBS maximizes Veteran-centered care and independence. VD-HCBS provides Veterans with a monthly financial allotment based on an assessment of the extent of their need for assistance with personal care due to injury or the impact of disease

ADNA Coordinators; Caregivers; VHA Coordinators; Veterans

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Veterans enrolled in VD-HCBS tend to be older with functional impairments which could precipitate facility based care placement

You may qualify if:

• Veterans who are eligible and enrolled in VD-HCBS at the expansion VAMCs

You may not qualify if:

• Non-Veterans
• Those not eligible or enrolled in VD-HCBS
• Enrolled in VD-HCBS at a non-expansion VAMC

Sponsors & Collaborators

• VA Office of Research and Development: lead
• US Department of Veterans Affairs: collaborator
• Department of Health and Human Services: collaborator

Study Sites (2)

Durham VA Medical Center, Durham, NC

Durham, North Carolina, 27705, United States

Location

Providence VA Medical Center, Providence, RI

Providence, Rhode Island, 02908, United States

Location

Related Publications (1)

• Garrido MM, Allman RM, Pizer SD, Rudolph JL, Thomas KS, Sperber NR, Van Houtven CH, Frakt AB. Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services. J Am Geriatr Soc. 2017 Nov;65(11):2446-2451. doi: 10.1111/jgs.15053. Epub 2017 Aug 21.

  PMID: 28832927 RESULT

Related Links

• VA VD-HCBS

Limitations and Caveats

Unexpected events slowed expansion of VD-HCBS

Results Point of Contact

• Title: James Rudolph, MD, Principal Investigator
• Organization: Providence VA Medical Center

James.Rudolph@va.gov

401-273-7100

Study Officials

• James L. Rudolph, MD

  Providence VA Medical Center, Providence, RI

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 1, 2017
• First Posted: May 9, 2017
• Study Start: May 8, 2017
• Primary Completion: August 1, 2019
• Study Completion: August 1, 2019
• Last Updated: November 20, 2020
• Results First Posted: November 20, 2020

Record last verified: 2020-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)