Patterns and predictors of engagement in peer support among homeless veterans with mental health conditions and substance use histories.
Patterns and predictors of engagement in peer support services were examined among 50 previously homeless veterans with co-occurring mental health conditions and substance use histories receiving services from the Veterans Health Administration supported housing program.



Veteran peer specialists were trained to deliver sessions focusing on mental health and substance use recovery to veterans for an intended 1-hr weekly contact over 9 months. Trajectories of peer engagement over the study's duration are summarized. A mixed-effects log-linear model of the rate of peer engagement is tested with three sets of covariates representing characteristics of the veterans. These sets were demographics, mental health and substance use status, and indicators of community participation and support.



Data indicate that veterans engaged with peers about once per month rather than the intended once per week. However, frequency of contacts varied greatly. The best predictor of engagement was time, with most contacts occurring within the first 6 months. No other veteran characteristic was a statistically significant predictor of engagement. Older veterans tended to have higher rates of engagement with peer supporters.



Planners of peer support services could consider yardsticks of monthly services up to 6 months. Peer support services need a flexible strategy with varying levels of intensity according to need. Peer support services will need to be tailored to better engage younger veterans. Future research should consider other sources of variation in engagement with peer support such as characteristics of the peer supporters and service content and setting. (PsycINFO Database Record
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital.
Marsha Langer
0000-0003-3535-4768
ML
Ellison
Department of Sociology, University of Massachusetts.
Russell K
RK
Schutt
Department of Statistics, Harvard University.
Mark E
ME
Glickman
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital.
Mark R
MR
Schultz
VISN 4 MIRECC, Veterans Administration Pittsburgh Healthcare System.
Matthew
M
Chinman
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital.
Kristina
K
Jensen
VISN 4 MIRECC, Veterans Administration Pittsburgh Healthcare System.
Chantele
C
Mitchell-Miland
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital.
David
D
Smelson
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital.
Susan
S
Eisen
D006703:Ill-Housed Persons; D006801:Humans; D007398:Interpersonal Relations; D001523:Mental Disorders; D008603:Mental Health; D010379:Peer Group; D019966:Substance-Related Disorders; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*