{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:31:23Z","timestamp":1789849883853,"version":"4.0.1"},"reference-count":63,"publisher":"American Public Health Association","issue":"S2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>Objectives. We compared homeless patients\u2019 experiences of care in health care organizations that differed in their degree of primary care design service tailoring.<\/jats:p><jats:p>Methods. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the \u201cPrimary Care Quality-Homeless Survey,\" to reflect the concerns and aspirations of homeless patients.<\/jats:p><jats:p>Results. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P\u2009&lt;\u2009.001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient\u2013clinician relationship (P\u2009&lt;\u2009.001) and perceptions of cooperation among providers (P\u2009=\u2009.004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient\u2013clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results.<\/jats:p><jats:p>Conclusions. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness.<\/jats:p>","DOI":"10.2105\/ajph.2013.301481","type":"journal-article","created":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T20:38:05Z","timestamp":1382474285000},"page":"S331-S339","source":"Crossref","is-referenced-by-count":69,"title":["Comparing Homeless Persons\u2019 Care Experiences in Tailored Versus Nontailored Primary Care Programs"],"prefix":"10.2105","volume":"103","author":[{"given":"Stefan G.","family":"Kertesz","sequence":"first","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl L.","family":"Holt","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn L.","family":"Steward","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard N.","family":"Jones","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Roth","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Stringfellow","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa W.","family":"Kim","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika L.","family":"Austin","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Randal","family":"Henry","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Kay Johnson","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Shanette Granstaff","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joya F.","family":"Golden","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander S.","family":"Young","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori L.","family":"Davis","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Pollio","sequence":"additional","affiliation":[{"name":"Stefan G. Kertesz, Erika L. Austin, N. Kay Johnson, and U. Shanette Granstaff are with the Birmingham VA Medical Center, Birmingham, AL. Cheryl L. Holt is with the University of Maryland, Baltimore. Jocelyn L. Steward is with the University of Alabama, Birmingham. Richard N. Jones is with Brown University, Providence, RI. David L. Roth is with Johns Hopkins University, Baltimore, MD. Erin Stringfellow is with Washington University, St. Louis, MO. Adam J. Gordon is with the VA Pittsburgh Healthcare System..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","volume-title":"Helping America\u2019s Homeless: Emergency Shelter or Affordable Housing?","author":"Burt MR","year":"2001"},{"issue":"5","key":"bib3","first-page":"533","volume":"31","author":"Kleinman LC","year":"1996","journal-title":"Health Serv Res"},{"key":"bib4","volume-title":"Premature Mortality in Homeless Populations: A Review of the Literature","author":"O\u2019Connell JJ","year":"2005"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199806113382406"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199708000-00007"},{"key":"bib7","unstructured":"Kaiser Commission on Medicaid and the Uninsured. Medicaid Coverage and Care for the Homeless Population: Key Lessons to Consider for the 2014 Medicaid Expansion. Washington, DC: The Henry J. Kaiser Family Foundation; 2012."},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.180109"},{"key":"bib9","volume-title":"Frequently Asked Questions About Health Care for the Homeless","author":"National Health Care for the Homeless Council","year":"2011"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-3-405"},{"key":"bib11","volume-title":"Under the Safety Net: The Health and Social Welfare of the Homeless in the United States","author":"Brickner PW","year":"1990"},{"key":"bib12","unstructured":"McMurray-Avila M, Gelberg L, Breakey WR. Balancing act: clinical practices that respond to the needs of homeless people. In: Fosburg LB, Dennis DL, eds.The 1998 National Symposium on Homelessness Research, 1998. Arlington, VA: US Department of Health and Human Services and Department of Housing and Urban Development; 1999:8-1\u20138-49."},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1040008"},{"key":"bib14","volume-title":"Health Care of Homeless People","author":"Brickner PW","year":"1985"},{"key":"bib15","unstructured":"Henry R. Determinants of appointment keeping by veterans with hypertension [dissertation]. Los Angeles, CA: University of California Los Angeles School of Public Health; 2006."},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.179416"},{"issue":"1","key":"bib17","first-page":"108","volume":"4","author":"Shortt SE","year":"2008","journal-title":"Healthc Policy"},{"key":"bib18","volume-title":"Transforming Community Health Centers into Patient-Centered Medical Homes: The Role of Payment Reform","author":"Ku L","year":"2011"},{"key":"bib19","unstructured":"Health Resources and Services Administration. Program Assistance Letter: HRSA Patient-Centered Medical\/Health Home Initiative. Washington, DC: Health Resources and Services Administration; 2011."},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.1007\/s13142-011-0065-8"},{"issue":"2","key":"bib21","first-page":"130","volume":"50","author":"Safran DG","year":"2001","journal-title":"J Fam Pract"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-010-9304-6"},{"key":"bib23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00630.x"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp038222"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-3-200302040-00033"},{"issue":"3","key":"bib26","first-page":"216","volume":"46","author":"Starfield B","year":"1998","journal-title":"J Fam Pract"},{"key":"bib27","volume-title":"Primary Care: America\u2019s Health in a New Era","author":"Committee on the Future of Primary Care for the Institute of Medicine","year":"1996"},{"key":"bib28","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780195125429.001.0001","volume-title":"Primary Care: Balancing Health Needs, Services, and Technology","author":"Starfield B","year":"1998"},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.25.050503.153958"},{"key":"bib30","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0183-7"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1446.2008.00726.x"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.173609"},{"key":"bib33a","doi-asserted-by":"publisher","DOI":"10.1080\/00981380801985341"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199903001-00003"},{"key":"bib35","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199805000-00012"},{"key":"bib36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2008.00371.x"},{"key":"bib37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045980"},{"key":"bib38","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Committee on Quality of Health Care in America IoM","year":"2001"},{"key":"bib39","first-page":"85","volume-title":"Handbook of Item Response Theory","author":"Samejima F","year":"2010"},{"key":"bib40","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-11-61"},{"key":"bib41","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5004"},{"key":"bib42","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2011-000737"},{"issue":"6","key":"bib43","first-page":"1273","volume":"34","author":"Gelberg L","year":"2000","journal-title":"Health Serv Res"},{"key":"bib44","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-6-19"},{"key":"bib45","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000199649.19464.8f"},{"key":"bib46","volume-title":"A Needs Assessment of the Homeless of Birmingham and Jefferson County","author":"LaGory M","year":"2005"},{"key":"bib47","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.09.008"},{"key":"bib48","doi-asserted-by":"publisher","DOI":"10.1111\/1540-6040.00017"},{"key":"bib49","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(03)00026-6"},{"key":"bib52","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/50B.6.S344"},{"key":"bib53","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2005.00404.x"},{"key":"bib54","doi-asserted-by":"publisher","DOI":"10.1023\/A:1011571531303"},{"key":"bib55","volume-title":"WHO ASSIST Phase II Study Group. Technical Report: Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and Pilot Brief Intervention: A WHO Technical Report of Phase II findings","author":"Humeniuk R","year":"2005"},{"key":"bib56","volume-title":"Mplus: Statistical Analysis With Latent Variables User\u2019s Guide","author":"Muthen LK","year":"2007"},{"key":"bib57","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v017.i05"},{"key":"bib58","volume-title":"Health, United States, 2011: With Special Feature on Socioeconomic Status and Health","author":"National Center for Health Statistics","year":"2012"},{"key":"bib59","volume-title":"How to Report Results of the CAHPS Clinician & Group Survey","author":"American Institutes for Research","year":"2010"},{"key":"bib60","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181f53575"},{"key":"bib61","volume-title":"VHA Facility Quality and Safety Report","author":"Office of Quality SaV","year":"2012"},{"key":"bib62","doi-asserted-by":"publisher","DOI":"10.1177\/0095327X0302900403"},{"key":"bib63","volume-title":"Threadbare: Holes in America\u2019s Health Care Safety Net","author":"Hoffman C","year":"2005"},{"key":"bib64","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-006-0046-7"},{"key":"bib65","volume-title":"NCQA\u2019s PCMH 2011 and CMS Stage 1 Meaningful Use Requirements Appendix 2","author":"National Committee for Quality Assurance","year":"2011"},{"key":"bib66","doi-asserted-by":"publisher","DOI":"10.1177\/1049732303262642"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2013.301481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T20:55:23Z","timestamp":1716065723000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2013.301481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,12]]},"references-count":63,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.2105\/AJPH.2013.301481"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2013.301481","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12]]}}}