Evaluating whole health engagement among homeless-experienced Veterans in an emergency shelter: A quality improvement study

Abstract: Background : Whole Health (WH) programs aim to integrate mental, physical, and social health to improve Veteran well-being. Homeless-Experienced Veterans (HEVs) may face barriers to engagement due to housing instability and comorbidities. This study evaluated WH participation among HEVs at the VA Greater Los Angeles CTRS site compared to the broader VAGLAHS Veteran population. Methods : A retrospective quality improvement study analyzed WH participation among 619 HEVs at CTRS, 25,520 WH participants at VAGLAHS, and 84,358 total VAGLAHS Veterans. Chi-square and t-tests assessed demographic and health differences. Thematic analysis of Personal Health Inventory (PHI) reflections explored wellness priorities. Results : WH participation was higher among CTRS HEVs (42%) vs. the broader VAGLAHS WH population (22%) (p < 0.001). WH participants at CTRS were older (56.8 ± 13.4 vs. 53.8 ± 13.7 years; p = 0.006), with different age group distribution (p = 0.02). Chronic pain, PTSD, depression, and substance use were more prevalent among HEVs than the general Veteran population (p < 0.001). Early WH engagement was associated with longer shelter stays. PHI themes included personal development (88%), housing (68%), and family/social connection (56%). Conclusions : WH programs may be effective and acceptable among HEVs when integrated into supportive housing environments.

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