{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:08:47Z","timestamp":1791511727932,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To understand existing care practices and policies, and potential enhancements, to improve the effectiveness of the US Department of Veterans Affairs (VA) Supportive Services for Veteran Families (SSVF) Health Care Navigators (HCN) in linking Veterans experiencing housing instability in rural areas with health care services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Study Setting<\/jats:title>\n                    <jats:p>We used primary data collected during semistructured interviews with HCNs (n\u2009=\u200921) serving rural areas across the United States during Spring 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We applied the Consolidated Framework for Implementation Research (CFIR) 2009 and the Social Ecological Model (SEM) to the collection and analysis of qualitative data to understand how HCNs administer services within SSVF and the larger community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection\/Extraction Methods<\/jats:title>\n                    <jats:p>We used rapid qualitative methods to summarize and analyze data. Templated matrix summaries identified facilitators and barriers to linking Veterans with health care services and policy and practice implications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>Using CFIR 2009, we identified contextual factors affecting successful implementation of HCN services within SSVF; we offer a crosswalk between CFIR 2009 and the version updated in 2022. Framing facilitators and barriers within the SEM provided insight into whether implementation strategies should be addressed at a community, interpersonal, or intrapersonal level within the SEM. Facilitators included sufficient knowledge, training, and mentorship opportunities for HCNs and their capacity to collaborate within their organization and with other community\u2010based organizations. Barriers included lack of local technology and housing resources, inadequate understanding of Veterans' service eligibilities and pathways to access those services, and deficient collaboration with the VA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Understanding facilitators and barriers experienced by HCN when linking unstably housed Veterans in rural areas with health care services can inform future strategies, including policy changes such as increased training to support HCNs' understanding of eligibility, benefits, and entitlements as well as improving communication and collaboration between VA and community partners.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.14316","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T04:34:40Z","timestamp":1715315680000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Connecting unstably housed veterans living in rural areas to health care: Perspectives from Health Care Navigators"],"prefix":"10.1111","volume":"59","author":[{"given":"Kalea","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Health Behavior School of Public Health, University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Birmingham, AL Veterans Affairs Health Care System  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meagan","family":"Cusack","sequence":"additional","affiliation":[{"name":"School of Social Policy &amp; Practice, University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gala","family":"True","sequence":"additional","affiliation":[{"name":"South Central Mental Illness, Research, Education and Clinical Center  New Orleans Louisiana USA"},{"name":"Southeast Louisiana Veterans Heath Care System  New Orleans Louisiana USA"},{"name":"Section of Community and Population Medicine, Department of Medicine Louisiana State University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor E.","family":"Harris","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles Healthcare System  Los Angeles California USA"},{"name":"Health Systems Research Center for the Study of Healthcare Innovation, Implementation, and Policy  Los Angeles California USA"},{"name":"Department of Psychiatry and Biobehavioral Sciences, Los Angeles David Geffen School of Medicine University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill S.","family":"Roncarati","sequence":"additional","affiliation":[{"name":"Center for Healthcare Organization &amp; Implementation Research (CHOIR), VA Bedford Healthcare System  Bedford Massachusetts USA"},{"name":"Department of Health Policy and Management Harvard T.H. Chan School of Public Health  Bedford Massachusetts USA"},{"name":"Boston Health Care for the Homeless Program  Bedford Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Antonellis","sequence":"additional","affiliation":[{"name":"Southeast Louisiana Veterans Heath Care System  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Brecht","sequence":"additional","affiliation":[{"name":"Department of Health Behavior School of Public Health, University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Birmingham, AL Veterans Affairs Health Care System  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-3526","authenticated-orcid":false,"given":"Ann Elizabeth","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Department of Health Behavior School of Public Health, University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Birmingham, AL Veterans Affairs Health Care System  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500401"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50"},{"key":"e_1_2_7_4_1","unstructured":"SSVF Program Office.SSVF Health Care Navigator One Pager. SSVF Initiatives: Department of Veterans of Affairs.2020."},{"key":"e_1_2_7_5_1","volume-title":"The 2022 Annual Homelessness Assessment Report (AHAR) to Congress Part 1: Point\u2010in\u2010Time Estimates of Homelessness","author":"U.S. Department of Housing and Urban Development Office of Community Planning and Development","year":"2022"},{"issue":"6","key":"e_1_2_7_6_1","first-page":"1273","article-title":"The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people","volume":"34","author":"Gelberg L","year":"2000","journal-title":"Health Serv Res"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.2.200"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10511482.2020.1716823"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00534.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470.2013.853597"},{"key":"e_1_2_7_11_1","unstructured":"FarriganT.Veterans are positioned to contribute economically to rural communities. USDA ERS.2017Accessed 5 February 2024.https:\/\/www.ers.usda.gov\/amber\u2010waves\/2017\/september\/veterans\u2010are\u2010positioned\u2010to\u2010contribute\u2010economically\u2010to\u2010rural\u2010communities\/#:~:text=USDA%20ERS%20%2D%20Veterans%20Are%20Positioned%20To%20Contribute%20Economically%20to%20Rural%20Communities"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.22912"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3346-9"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1108\/HCS-10-2016-0013"},{"key":"e_1_2_7_15_1","first-page":"39","volume-title":"Rapid Assessment Process: An Introduction","author":"Beebe JR","year":"2002"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112516"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01111-5"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001553"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2021.2003838"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-022-01930-z"},{"key":"e_1_2_7_21_1","volume-title":"Theory at a Glance: A Guide for Health Promotion Practice","author":"Rimer B","year":"2005"},{"key":"e_1_2_7_22_1","volume-title":"Telehealth in the Pandemic\u2014How Has it Changed Health Care Delivery in Medicaid and Medicare","author":"U.S. Government Accountability Office","year":"2022"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0892-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12116"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2015.04.001"},{"key":"e_1_2_7_26_1","unstructured":"Infrastructure Investment and Jobs Act. Pub. L. No. 117\u201058 (2021\u20102022).https:\/\/www.congress.gov\/bill\/117th-congress\/house-bill\/3684"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.14077"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.2196\/40065"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465816000539"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAQ.0000305946.31193.61"},{"key":"e_1_2_7_31_1","unstructured":"Hopkins (Ed).Framework for Action on Interprofessional Education & Collaborative Practice. World Health Organization. Accessed 5 February 2024 athttps:\/\/www.who.int\/publications\/i\/item\/framework\u2010for\u2010action\u2010on\u2010interprofessional\u2010education\u2010collaborative\u2010practice"},{"key":"e_1_2_7_32_1","volume-title":"Addressing Concurrent Housing Instability, Criminal Justice Involvement, and Unemployment among Veteran Health Administration Service Users [Dissertation","author":"Cusack M","year":"2023"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmilitary-2021-001903"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0"}],"container-title":["Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.14316","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1475-6773.14316","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.14316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:52:41Z","timestamp":1780642361000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1475-6773.14316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,10]]},"references-count":33,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/1475-6773.14316"],"URL":"https:\/\/doi.org\/10.1111\/1475-6773.14316","archive":["Portico"],"relation":{},"ISSN":["0017-9124","1475-6773"],"issn-type":[{"value":"0017-9124","type":"print"},{"value":"1475-6773","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,10]]},"assertion":[{"value":"2024-05-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14316"}}