A Qualitative Examination of the Experiences of Veterans Treatment Court Graduates in Allegheny County, Pennsylvania.

U.S. Veterans treatment courts (VTCs) serve justice-involved Veterans with behavioral health and reintegration issues. However, there is paucity of efforts examining VTC participants' experiences and distinguishing the unique operations of VTCs. We summarize a descriptive history of a large VTC program in a major metropolitan area (Pittsburgh, Pennsylvania) and examine the experiences of this VTC's participants. We used content analysis to code VTC graduation proceeding transcripts with complementary content data from resources distributed by the presiding Judge to entering participants. From 2009 through 2016, 118 Veterans were graduated, averaging 9 to 12 months for completion for those with felony or non-felony charges, and blended monitoring with positive reinforcement within a three-stage program. From 62 VTC graduates across eight graduations, testimonies centered on gratitude toward the treatment team, treatment readiness, treatments received, and reintegration. As several theoretical frameworks on behavior change exist, opportunities remain to enhance the delivery of the VTC.

Characteristics and Health Needs of Veterans in Jails and Prisons: What We Know and Do Not Know about Incarcerated Women Veterans.

PURPOSE: The majority of U.S. veterans in prisons and local jails are men, but incarcerated women veterans remain an important and understudied group. METHODS: This study reported differences in sociodemographic, health, and criminal justice characteristics using Veterans Affairs (VA) administrative data on a national sample of 30,964 incarcerated veterans (30,440 men and 524 women) who received outreach from the VA Health Care for Reentry Veterans program between 2007 and 2011. Descriptive statistics and multivariable logistic regressions determined gender and racial differences in this population. RESULTS: Compared with incarcerated veterans who were men, incarcerated women veterans were younger (d = 0.68), had significantly lower lifetime arrests (AOR, 0.65; p < .001; 99% CI, 0.49-0.87), and were less likely to have been incarcerated for a violent offense (AOR, 0.47; p < .001; 99% CI, 0.35-0.63). Notably, 58% of women were of reproductive age. Women were more likely to have reported eye problems, hypertension, chronic obstructive pulmonary disease, and seizure disorder, and were more likely to receive a preliminary diagnosis of mood disorder than men. Women were more likely to have received VA benefits, used VA health care before, and be willing to use VA services after release. A few important differences emerged when stratified by race. CONCLUSIONS: These findings suggest that incarcerated women veterans are interested in VA health care services, but there is lack of information about women's health needs through the Health Care for Reentry Veterans program. The inclusion of Health Care for Reentry Veterans screening questions about women's health issues may support the VA's interests to better engage women veterans in care.

Telehealth Protocol to Prevent Readmission Among High-Risk Patients With Congestive Heart Failure.

BACKGROUND: Congestive heart failure is the leading cause of hospital readmissions. We aimed to assess adherence to and effectiveness of a telehealth protocol designed to prevent hospital admissions for congestive heart failure. METHODS: We recruited a random sample of 50 patients with congestive heart failure (mean age 61 years) from a managed care organization. We developed a telehealth platform allowing for daily, real-time reporting of health status and video conferencing. We defined adherence as the percentage of days on which the patient completed the daily check-in protocol. To assess efficacy, we compared admission and readmission rates between the 6-month intervention period and the prior 6 months. Primary outcomes were admissions and readmissions due to congestive heart failure, and secondary outcomes were admissions and readmissions due to any cause. RESULTS: Forty-eight patients (96%) completed the protocol. Approximately half (46%) were at high risk for readmission according to standardized measures. Median 120-day adherence was 96% (interquartile range, 92%-98%), and adherence did not significantly differ across sex, race, age, living situation, depression, cognitive ability, or risk for readmission. Approximately equal proportions of patients were admitted for all causes during the 6-month intervention period versus the comparison period (37% vs 43%; P = .32). Half as many patients were admitted for congestive heart failure during the 6-month intervention period compared with the comparison period (12% vs 25%; P = .11). CONCLUSION: Adherence to this telehealth protocol was excellent and consistent, even among high-risk patients. Future research should test the protocol using a more rigorous randomized design.