Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Medication for Addiction Treatment (MAT), Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD).
- Who it may be relevant to
- Registry conditions: Homelessness, Substance Use Disorder (SUD). Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Coordinated Access for Addiction Recovery and Equity in VA Supportive Housing (CARE-VASH) (QUE 25-013)
Overview
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.
Detailed 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.
Interventions
- Drug Medication for Addiction Treatment (MAT)
MAT includes medications for alcohol use disorder (MAUD) and medications for opioid use disorder (MAUD). It reduces substance use, increases SUD treatment engagement, enhances quality of life, and reduces overdoses. - Behavioral Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)
An evidence-based psychotherapy that uses cognitive behavioral therapy to further recovery goals across SUD diagnoses.
Primary outcome measures
- Reach of MAT (Medications for Addiction Treatment) [Time frame: 18 months post-implementation]
- Reach of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) [Time frame: 18 months post-implementation]
- Adoption of MAT (Medications for Addiction Treatment) [Time frame: 18 months post-implementation]
- Adoption of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) [Time frame: 18 months post-implementation]
- Sustainment of MAT (Medications for Addiction Treatment) [Time frame: 18-27 months post-implementation]
- Sustainment of CBT-SUD (Cognitive Behavioral Therapy-Substance Use Disorders) [Time frame: 18-27 months post-implementation]
Secondary outcome measures (4)
- Housing retention [Time frame: 1 year after implementation by cohort]
- Provider experience [Time frame: Baseline and 18 months post-implementation]
- Cost impact of Medications for Addiction Treatment (MAT) and Cognitive Behavioral Therapy-Substance Use Disorders (CBT-SUD) [Time frame: 18 months (during the course of implementation)]
- Acute care utilization [Time frame: 1 year after implementation by cohort]
Eligibility criteria
Inclusion criteria
- Homeless-experienced Veterans (HEVs) enrolled in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) Program.
Exclusion criteria
- None
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Other
Study locations
United States · 1 center
- VA Greater Los Angeles Healthcare System, West Los Angeles, CA — West Los Angeles
Publications
- Gabrielian S, Chang ET, Treichler EBH, Barnard J, Nelson RE, Wong MS, Jackson NJ, Finley EP. 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. Implement Sci. 2026 Mar 24;21(1):30. doi: 10.1186/s13012-026-01498-z. PMID 41877142
Identifiers
NCT: NCT07141394 · QUX 25-001 · QUE 25-013