Preimplementation Evaluation of a Self-Directed Care Program in a Veterans Health Administration Regional Network:...

Area of Science:

• Gerontology
• Health Services Research
• Public Health

Background:

• The Veteran-Directed Care (VDC) program supports veterans at risk of institutionalization, enabling them to receive care at home through veteran-selected caregivers.
• VDC is a collaborative effort between Department of Veterans Affairs (VA) Medical Centers (VAMCs) and external Aging and Disability Network Agency providers.

Purpose of the Study:

• To identify facilitators, barriers, and adaptations in VDC implementation across seven VAMCs within Veterans Integrated Service Network (VISN) 8.
• To understand leadership and stakeholder perspectives on VDC program reach and implementation.
• To characterize veterans utilizing VDC programs in VISN 8 and compare them to national VDC participants.

Main Methods:

• A mixed-methods approach utilizing electronic surveys, semistructured interviews, and administrative data.
• The study is guided by the Consolidated Framework for Implementation Research (CFIR version 2.0).
• Participants include VAMC and agency staff, leadership, enrolled veterans, and those who declined VDC, along with their caregivers.

Main Results:

• Descriptive statistics will be calculated for survey data, including means, standard deviations, and percentages.
• Qualitative analysis of interviews will identify facilitators, barriers, and adaptations using CFIR domains.
• Administrative data will be used to describe the characteristics of veterans served by VDC programs in VISN 8.

Conclusions:

• Findings will inform national VDC program expansion efforts by the VA.
• The study will provide insights into the experiences of VDC program stakeholders to improve service delivery.
• Results aim to facilitate VDC program growth within VISN 8 and guide the establishment of new programs nationwide.