Evidence map›Paper›PMID 40680272›Full record

ArticleJMIR research protocols2025

Intervention for Justice-Involved Homeless Veterans With Co-Occurring Substance Use and Mental Health Disorders: Protocol for a Randomized Controlled Hybrid Effectiveness-Implementation Trial.

Kathryn Bruzios, Paige M Shaffer, Daniel M Blonigen, Michael A Cucciare, Michael Andre, Thomas Byrne, Jennifer Smith, David Smelson

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in JMIR research protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04523337 (A Randomized Controlled Trial of MISSION-CJ for Justice-Involved Homeless Veterans With Co-Occurring Substance Use and Mental Health Disorders), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04523337 nacompletednot on this map

A Randomized Controlled Trial of MISSION-CJ for Justice-Involved Homeless Veterans With Co-Occurring Substance Use and Mental Health Disorders

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2021 to 2026Enrolled134ConditionsSubstance Use Disorder, Mental Health Disorder, HomelessnessArmsMaintaining Maintaining Independence and Sobriety through Systems Integration Outreach and Networking- Criminal Justice, Maintaining Maintaining Independence and Sobriety through Systems Integration Outreach and Networking Peer Support
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kathryn Bruzios *Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.ORCID 0000-0001-9674-348X
Paige M Shaffer *Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.ORCID 0000-0002-6520-1044
Daniel M Blonigen *Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States.ORCID 0000-0003-3420-6704
Michael A Cucciare *Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR, United States.ORCID 0000-0001-5516-609X
Michael Andre *Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.ORCID 0000-0003-2130-0689
Thomas Byrne *Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.ORCID 0000-0003-4824-0284
Jennifer Smith *Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States.ORCID 0009-0009-0822-7713
David Smelson *Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States.ORCID 0000-0001-9161-9818

Funding

HSRD VA I01 HX002701HSRD VA IK6 HX003763
6 · The paper itself

Abstract

backgroundThe US Veterans Affairs mental health residential rehabilitation treatment programs (MH RRTPs) provide residential care for veterans experiencing homelessness. However, those with co-occurring mental health and substance use disorders and criminal legal involvement require additional interventions to address risk factors for recidivism.

objectiveWe aimed to (1.1) evaluate whether the Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking Criminal Justice version (MISSION-CJ) intervention lowers criminal recidivism and improves health-related outcomes; (1.2) examine the mechanisms that impact outcomes; and (2) qualitatively assess the implementation of MISSION-CJ.

methodsVeterans participating in an MH RRTP (N=226) will be randomized to the enhanced usual care (EUC) or MISSION-CJ conditions in a hybrid type 1 randomized controlled trial to test the effectiveness and implementation of MISSION-CJ, a multicomponent intervention for co-occurring disorder. Both conditions will receive 6 months of services beginning within a week of MH RRTP enrollment (duration of stay: 3 months) and continue for 3 months after the MH RRTP in the community. The veterans in the EUC group (113/226, 50%) will receive a peer support curriculum and community outreach and linkage delivered by a peer support specialist. The veterans in the MISSION-CJ group (113/226, 50%) will receive team-based (case manager and peer support specialist) care, including treatment planning, case management using a critical time intervention model to promote referrals and linkages, enhanced dual recovery therapy sessions, and peer support sessions. Assessments, including questions regarding substance use and mental health history, criminal history and recidivism risk, housing, employment, medication adherence, mutual-help group attendance, antisocial attitudes, affiliations with peers, community involvement, and treatment services received, will be conducted at baseline and 6 months and 15 months after baseline. We will use generalized linear mixed effects regression models to evaluate MISSION-CJ based on outcomes (objective 1.1). We will conduct mediation analysis to examine mechanisms of action (objective 1.2). For the qualitative evaluation (objective 2), we will use thematic analysis to identify themes.

resultsAs of March 2025, 118 veterans (site 1: n=52, 44.1% and site 2: n=66, 55.9%) have been enrolled. Overall, 58 veterans (site 1: n=27, 47% and site 2: n=31, 53%) have been randomized to the MISSION-CJ group, and 60 veterans (site 1: n=25, 42% and site 2: n=35, 58%) have been randomized to the EUC group. Overall, 23 interviews for the qualitative evaluation have been completed with veterans. Veterans are continuing to receive treatment and completing follow-up assessments. The findings from this trial and qualitative evaluation will be available by 2026. The quantitative and qualitative components of this project are intended to work synergistically to reinforce knowledge of MISSION-CJ's effectiveness, implementation, and scalability.

conclusionsIf effective, the implementation of MISSION-CJ alongside the MH RRTPs may be advantageous to address risk factors related to recidivism.

trial registrationClinicalTrials.gov NCT04523337; https://clinicaltrials.gov/study/NCT04523337. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/70750.

Indexed as

Ill-Housed PersonsMental DisordersSubstance-Related DisordersVeteransAdultCriminal LawFemaleHumansMaleRandomized Controlled Trials as TopicRecidivismResidential TreatmentUnited StatesUnited States Department of Veterans Affairsco-occurring disordercriminal justicehybrid trialmental healthsubstance useveterans

Identifiers

PMID40680272
PMCPMC12317293

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.