Field Placement: VA West Los Angeles -- Northside Care Center
Location: Los Angeles, CA
Preceptor: Jim McGuire, PhD
Student Name: Natasha Cox
Year: 2003

The Northside Care Center houses the outpatient Mental Health Clinic, Homeless Access Center and a primary care clinic at the West Los Angeles Veterans Administration Healthcare System. It is a novel approach to continuous, integrated health care for homeless, mentally ill and at-risk veterans. The Greater Los Angeles VA Healthcare System is the largest of it kind in the nation, serving over 70,000 veterans, with a large homeless population. United States Congress mandates that every VA have services specifically designed to serve homeless veterans. The Northside Center was borne of this mandate, and has evolved into a co-located facility to improve the physical and mental health of this vulnerable population.

My preceptor this summer was Jim McGuire, PhD, a researcher for the nation’s VA’s homeless programs. I worked in the Homeless Access Center in the Northside Center from July 1 through September 19,2003. I participated in the evaluation of the Northside Center through his Primary Care Study, supervised on a daily basis by Jessica Blue-Howells, the Study Coordinator. The study utilizes a naturalistic two-group longitudinal design. Veterans are tracked for eighteen months, the control group (Phase I) was recruited before the Northside center was established and obtained their services at sites throughout the VA. The experimental group (Phase II) is recruited at the Northside Center. Participants agree to enroll in the on-site Primary Care clinic, and obtain same-day medical care. This summer, I enrolled thirteen veterans into Phase II, and conducted twelve follow up interviews using two questionnaires that measured health care utilization, substance use, mental status, health status, demographic status and social support. In addition I also participated in another aspect of the Northside Care Center’s evaluation, administering twelve interviews to staff in the Access Center and the Primary Care Clinic to collect data related to their perspectives regarding the success and challenges of the integration efforts.

I also had the opportunity to develop health education curriculum for veterans in Northside Center. I developed four “Healthy Lifestyle” classes for the clinical support staff at the Primary Care Clinic to deliver to its veterans. This was a goal written into the Northside Center’s grant proposal but had not yet been achieved. I worked with other VA health educators, dieticians and clinical staff to create a basic curriculum to promote healthy behaviors among homeless, mentally ill and at-risk veterans. Topics of the classes include hearth health, nutrition and making healthy food choices, physical activity and stress, talking to your provider, and preventative health care. In developing these materials I used concepts from the Stages of Change, and Health Belief Models to guide my thinking. Two classes have been given so far, and the feedback from both the veterans and the teaching staff has been very positive. Over the course of the summer I gained valuable experience administering informed consents, lengthy questionnaires (an enrollment interview usually lasted two hours), and discussing sensitive themes such as mental status, homelessness, and drug use with study participants. I was able to experience research and evaluation in a real world setting. In addition my experience participating in the development and implementation of health education programs, gave my important insight into the attention to detail and planning necessary to successfully execute such projects.

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