Trial reportImplementation science : IS2026
Comparing two strategies to support the implementation of evidence-based practices for substance use disorders in VA's permanent supportive housing program: a protocol for a type 3 hybrid cluster-randomized controlled trial.
Trial report in Implementation science : IS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07141394 (Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing), which is not on this map. Not yet cited in PubMed.
What it found
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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.
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.
Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) (QUE 25-013)
Who cites it
0 citing papers in PubMed.
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Authors and funding
8 authors.
Funding
Abstract
backgroundHomeless-experienced Veterans (HEVs) have higher rates of substance use disorders (SUDs) than housed Veterans, which impairs their ability to retain housing. The Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) initiative, which provides subsidized permanent housing and supportive services, contributed to the 50% reduction in Veteran homelessness over the past decade. However, ~ 40% of Veterans exit HUD-VASH within two years, often due to untreated SUDs. We will use two strategies to support the implementation of Medications for Addiction Treatment (MAT) and Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) in 12 HUD-VASH sites; conduct an evaluation of this implementation effort; and generate an implementation playbook to support continued spread of MAT and CBT-SUD in HUD-VASH.
methodsWe will use Replicating Effective Programs (REP) to implement MAT and CBT-SUD at 12 sites over 18 months. After 9 months of REP alone, half (n = 6) of these sites will also receive Consumer Engagement (CE) for 9 months, activating HEVs to adopt these practices via peer coaching. We will conduct a type 3 hybrid cluster-randomized trial to compare the impacts of REP versus REP + CE. Randomization will occur at two levels: implementation start date (3 cohorts) and the implementation strategy (REP versus REP + CE). We will use stratified block randomization to balance site size among sites receiving each strategy across cohorts. We will use mixed methods to assess the impacts of REP versus REP + CE on implementation outcomes (reach [primary outcome], adoption, and sustainment); Veteran outcomes (primarily housing); provider and Veteran experiences; and costs and budget impacts. We hypothesize that REP + CE will have higher implementation costs than REP but result in improved MAT and CBT-SUD implementation and Veteran outcomes, leading to a business case for REP + CE. DISCUSSION: Implementing MAT and CBT-SUD within HUD-VASH can improve HEVs' housing and health. By identifying effective strategies to support the implementation of these practices, we aim to inform other implementation efforts of behavioral health practices in homeless service settings.
trial registrationThis project was registered with ClincialTrials.gov as "Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing." Trial registration NCT07141394, registered 8/26/2025 ( https://clinicaltrials.gov/study/NCT07141394?term=CARE-VASH&rank=1 ).
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