Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study

Introduction: Whole Health programs aim to integrate mental, physical, and social health to improve veteran well-being. Homeless-experienced veterans may face barriers to engagement owing to housing instability and comorbidities. This study evaluated Whole Health participation among homeless-experie...

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Main Authors: Tawny Saleh, MD, MS, Lillian Gelberg, MD, MSPH, FAAFP, Melissa Y. Chinchilla, PhD, MCP, MSHPM, Jennifer E. Allen, ANP-BC, MSN, Kristen L. Connor, MSPH, Lisa Altman, MD, Peter Capone-Newton, MD, PhD, MPH
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:AJPM Focus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773065425000719
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author Tawny Saleh, MD, MS
Lillian Gelberg, MD, MSPH, FAAFP
Melissa Y. Chinchilla, PhD, MCP, MSHPM
Jennifer E. Allen, ANP-BC, MSN
Kristen L. Connor, MSPH
Lisa Altman, MD
Peter Capone-Newton, MD, PhD, MPH
author_facet Tawny Saleh, MD, MS
Lillian Gelberg, MD, MSPH, FAAFP
Melissa Y. Chinchilla, PhD, MCP, MSHPM
Jennifer E. Allen, ANP-BC, MSN
Kristen L. Connor, MSPH
Lisa Altman, MD
Peter Capone-Newton, MD, PhD, MPH
author_sort Tawny Saleh, MD, MS
collection DOAJ
description Introduction: Whole Health programs aim to integrate mental, physical, and social health to improve veteran well-being. Homeless-experienced veterans may face barriers to engagement owing to housing instability and comorbidities. This study evaluated Whole Health participation among homeless-experienced veterans at the VA Greater Los Angeles Care, Treatment, and Rehabilitation Service site compared with that among the broader VA Greater Los Angeles Healthcare System veteran population. Methods: A retrospective quality improvement study analyzed Whole Health participation among 619 homeless-experienced veterans at Care, Treatment, and Rehabilitation Service; 25,520 Whole Health participants at VA Greater Los Angeles Healthcare System; and 84,358 total VA Greater Los Angeles Healthcare System veterans. Chi-square and t-tests assessed demographic and health differences. Thematic analysis of personal health inventory reflections explored wellness priorities. Results: Whole Health participation was higher among Care, Treatment, and Rehabilitation Service homeless-experienced veterans (42%) than among the broader VA Greater Los Angeles Healthcare System Whole Health population (22%) (p<0.001). Whole Health participants at Care, Treatment, and Rehabilitation Service 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, post-traumatic stress disorder, depression, and substance use were more prevalent among homeless-experienced veterans than among the general veteran population (p<0.001). Early Whole Health engagement was associated with longer shelter stays. Personal health inventory themes included personal development (88%), housing (68%), and family/social connection (56%). Conclusions: Whole Health programs may be effective and acceptable among homeless-experienced veterans when integrated into supportive housing environments.
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spelling doaj-art-af9ee1204920460bb7d8e64b2145bab42025-08-20T03:14:36ZengElsevierAJPM Focus2773-06542025-10-014510038310.1016/j.focus.2025.100383Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement StudyTawny Saleh, MD, MS0Lillian Gelberg, MD, MSPH, FAAFP1Melissa Y. Chinchilla, PhD, MCP, MSHPM2Jennifer E. Allen, ANP-BC, MSN3Kristen L. Connor, MSPH4Lisa Altman, MD5Peter Capone-Newton, MD, PhD, MPH6David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Division of Informatics, Department of Computational Biomedicine, Cedars Sinai Health System, Los Angeles, California; Address correspondence to: Tawny Saleh, MD, MS, Division of Informatics, Department of Computational Biomedicine, Cedars Sinai Health System, 6500 Wilshire Blvd. Suite 200, Los Angeles, CA 90034.David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California; Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CaliforniaDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CaliforniaVeterans Administration Greater Los Angeles Healthcare System, Los Angeles, CaliforniaVeterans Administration Greater Los Angeles Healthcare System, Los Angeles, CaliforniaDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CaliforniaDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CaliforniaIntroduction: Whole Health programs aim to integrate mental, physical, and social health to improve veteran well-being. Homeless-experienced veterans may face barriers to engagement owing to housing instability and comorbidities. This study evaluated Whole Health participation among homeless-experienced veterans at the VA Greater Los Angeles Care, Treatment, and Rehabilitation Service site compared with that among the broader VA Greater Los Angeles Healthcare System veteran population. Methods: A retrospective quality improvement study analyzed Whole Health participation among 619 homeless-experienced veterans at Care, Treatment, and Rehabilitation Service; 25,520 Whole Health participants at VA Greater Los Angeles Healthcare System; and 84,358 total VA Greater Los Angeles Healthcare System veterans. Chi-square and t-tests assessed demographic and health differences. Thematic analysis of personal health inventory reflections explored wellness priorities. Results: Whole Health participation was higher among Care, Treatment, and Rehabilitation Service homeless-experienced veterans (42%) than among the broader VA Greater Los Angeles Healthcare System Whole Health population (22%) (p<0.001). Whole Health participants at Care, Treatment, and Rehabilitation Service 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, post-traumatic stress disorder, depression, and substance use were more prevalent among homeless-experienced veterans than among the general veteran population (p<0.001). Early Whole Health engagement was associated with longer shelter stays. Personal health inventory themes included personal development (88%), housing (68%), and family/social connection (56%). Conclusions: Whole Health programs may be effective and acceptable among homeless-experienced veterans when integrated into supportive housing environments.http://www.sciencedirect.com/science/article/pii/S2773065425000719Whole Healthhomeless-experienced veteransveterans affairsintegrated carechronic diseaseshelter health
spellingShingle Tawny Saleh, MD, MS
Lillian Gelberg, MD, MSPH, FAAFP
Melissa Y. Chinchilla, PhD, MCP, MSHPM
Jennifer E. Allen, ANP-BC, MSN
Kristen L. Connor, MSPH
Lisa Altman, MD
Peter Capone-Newton, MD, PhD, MPH
Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
AJPM Focus
Whole Health
homeless-experienced veterans
veterans affairs
integrated care
chronic disease
shelter health
title Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
title_full Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
title_fullStr Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
title_full_unstemmed Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
title_short Evaluating Whole Health Engagement Among Homeless-Experienced Veterans in an Emergency Shelter: A Quality Improvement Study
title_sort evaluating whole health engagement among homeless experienced veterans in an emergency shelter a quality improvement study
topic Whole Health
homeless-experienced veterans
veterans affairs
integrated care
chronic disease
shelter health
url http://www.sciencedirect.com/science/article/pii/S2773065425000719
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