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Veterans were included in one or more trials if they were 18\u2009years or older, had recent evidence of housing instability, had received care in VA for at least 1\u2009year, and had never before enrolled in SSVF. Patients who enrolled in SSVF after meeting eligibility were assigned to the treatment group, while patients who did not enroll in SSVF were assigned to a control group. We extracted patients' housing outcomes from the EHR and modeled the probability of being unstably housed each day while accounting for confounders and irregular visit times.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources and Analytic Sample<\/jats:title><jats:p>We extracted housing status and covariates from the VA Corporate Data Warehouse. Housing instability was ascertained using a combination of structured data elements and natural language processing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>We identified 238,059 unique patients who met the eligibility criteria for one or more trials. The risk of housing instability decreased in both arms over the three years after initiating a trial but was lower among SSVF enrollees, with a risk difference of \u221212.9% (95% confidence band \u221214.6%, \u221211.2%) on Day 120 and an attenuated difference of \u22122.4% (\u22124.0%, \u22120.7%) on Day 1095.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SSVF is one of the largest rapid rehousing and homelessness prevention programs in the nation. We found that SSVF improves housing outcomes over the three years following enrollment, but the effect reduces over time. These findings can inform policy and program design for improving housing outcomes for homeless\u2010experienced individuals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14428","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T21:33:24Z","timestamp":1735594404000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The effect of a Veterans Affairs rapid rehousing and homelessness prevention program on long\u2010term housing instability"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3711-2682","authenticated-orcid":false,"given":"Alec B.","family":"Chapman","sequence":"first","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"},{"name":"Department of Population Health Sciences University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Scharfstein","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4824-0284","authenticated-orcid":false,"given":"Thomas","family":"Byrne","sequence":"additional","affiliation":[{"name":"National Center on Homelessness Among Veterans  Washington, DC USA"},{"name":"School of Social Work Boston University  Boston Massachusetts USA"},{"name":"Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center  Bedford Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-3526","authenticated-orcid":false,"given":"Ann Elizabeth","family":"Montgomery","sequence":"additional","affiliation":[{"name":"National Center on Homelessness Among Veterans  Washington, DC USA"},{"name":"Birmingham VA Health Care System  Birmingham Alabama USA"},{"name":"School of Public Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Suo","sequence":"additional","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atim","family":"Effiong","sequence":"additional","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christa","family":"Shorter","sequence":"additional","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Huebler","sequence":"additional","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"},{"name":"Department of Population Health Sciences University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"},{"name":"Department of Population Health Sciences University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-648X","authenticated-orcid":false,"given":"Jack","family":"Tsai","sequence":"additional","affiliation":[{"name":"National Center on Homelessness Among Veterans  Washington, DC USA"},{"name":"School of Public Health University of Texas Health Sciences Center  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lillian","family":"Gelberg","sequence":"additional","affiliation":[{"name":"National Center on Homelessness Among Veterans  Washington, DC USA"},{"name":"Department of Family Medicine David Geffen School of Medicine at UCLA  Los Angeles California USA"},{"name":"Office of Healthcare Transformation and Innovation VA Greater Los Angeles Healthcare System  Los Angeles California USA"},{"name":"Department of Health Policy &amp; 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