# Feasibility of Mobile Technology-Based Assessments of Community Reintegration in Homeless Veterans

> **NIH VA I21** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2021 · —

## Abstract

Veteran homelessness is a national crisis and Los Angeles has the highest homeless Veteran population in the
US. Despite impressive progress in providing housing for Veterans, particularly through the HUD-VASH
program, a fundamental problem remains: Permanent housing is a necessary first step, but not a
sufficient condition, for successful community reintegration. Community reintegration, defined as full
engagement in work, social, independent living, and recreational activities, does not arise automatically once
housing is provided. Despite the provision of housing, recidivism (return to homelessness) is high. Further,
the few relevant studies of non-VA samples demonstrate a failure to thrive after supported housing is provided
(e.g., vocational and social functioning remain poor). HUD-VASH clinicians describe similarly poor outcomes
in Veterans, but there are hardly any data on the types, severity, and causes of problems in community
reintegration in recently-housed Veterans (RHVs). This information is essential for developing recovery-
focused treatments that can be implemented in this complex, rapidly growing Veteran population.
In 2015, our team established the VA Research Enhancement Award Program (REAP) on Enhancing
Community Integration for Homeless Veterans in Los Angeles. The REAP is devoted to understanding the
scope of reintegration problems, identifying their determinants, and developing novel interventions. We have
identified two major challenges in our work with RHVs and their treatment providers. 1. Inadequacy of
measures: Existing measures of community integration lack the sensitivity needed to identify the specific
challenges faced by RHVs, and there have been no fine-grained assessments of how RHVs actually spend
their time. 2. Poor rates of participation: It is extremely difficult to engage RHVs in treatment and research
that require repeated visits to the VA campus. Consequently, our research assessments provide only single
cross-sectional snapshots of integration that fail to capture the dynamic fluctuations in their lives. Furthermore,
failure to engage in available treatment services contributes to recidivism and poor outcomes. We therefore
believe it is necessary to look beyond traditional assessment and treatment modalities to address these
challenges. New mobile technologies appear ideally suited this purpose.
The goal of this proposal is to evaluate the feasibility of Digital Phenotyping (DP) delivered via mobile
smartphone technology to assess community integration in RHVs with Serious Mental Illnesses (SMIs). We
will use both active (Ecological Momentary Assessment [EMA] of social contact) and passive (Global
Positioning System measures of mobility in the community) DP indices. Active EMA indices involve cueing
participants to complete brief surveys multiple times per day over a week to obtain more fine-grained,
ecologically valid information than traditional cross-sectional measures. Passive indices are automaticall...

## Key facts

- **NIH application ID:** 10000777
- **Project number:** 5I21RX003165-02
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Michael F. Green
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10000777

## Citation

> US National Institutes of Health, RePORTER application 10000777, Feasibility of Mobile Technology-Based Assessments of Community Reintegration in Homeless Veterans (5I21RX003165-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10000777. Licensed CC0.

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