ArticleJournal of public health (Oxford, England)2022
Impact of an unannounced standardized veteran program on access to community-based services for veterans experiencing homelessness.
Article in Journal of public health (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The trial behind it
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe United States Department of Veterans Affairs established a program in which actors incognito portray veterans experiencing homelessness with pre-determined needs to identify barriers to access and services at community-based organizations.
methodsFrom 2017 to 2019, actors who varied in gender, skin color and age portrayed one of three scripts at all VA Community-Based Resource and Referral Centers (CRRCs) serving veterans experiencing homelessness in 30 cities and completed an evaluative survey. They carried authentic VA identification and were registered in a VA patient database for each identity. CRRCs were provided with reports annually and asked to implement corrective plans. Data from the survey were analysed for change over time.
resultsAccess to food, counselling, PTSD treatment, and hypertension/prediabetes care services increased significantly from 68-77% in year 2 to 83-97% in year 3 (each P < 0.05 adjusted for script present). A significant disparity in access for African American actors resolved following more uniform adherence to pre-existing policies.
conclusionsThe 'unannounced standardized veteran' (USV) can identify previously unrecognized barriers to needed services and care. Audit and feedback programs based on direct covert observation with systematic data collection and rapid feedback may be an effective strategy for improving services to highly vulnerable populations.
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