ABSTRACT Objective: The objective of this research was to examine and explain elements that enhanced or thwarted program growth of the United States Veterans Health Administration Medical Foster Home program. Methods: This qualitative study was conducted nationally through individual interviews over the phone and in-person (n = 22) with coordinators (n = 15 at slow-growth programs; n = 6 at fast-growth programs), program support assistants (PSAs) (n = 1 at slow-growth program), and home-based primary care team members (n = 3), as well as three in-person focus groups (n = 28 total participants) with home-based primary care team members. All participants (N = 53) were involved with programs in existence for at least two years. Results: Facilitators and barriers that enhanced or thwarted program growth emerged around four themes: A full-time coordinator; Unmitigated home-based primary care team engagement; Pursuit and receipt of appropriate referrals; and Match between caregiver, home, and Veteran. Conclusions: To facilitate program growth, program leaders should consider themes identified and how to foster situations and shape policies that put themes into practice.

中文翻译：

---

启动医疗寄养家庭计划：发展这种替代疗养院安置的关键组成部分

摘要 目的：本研究的目的是检查和解释增强或阻碍美国退伍军人健康管理局医疗寄养家庭计划发展的因素。方法：这项定性研究是通过电话和面对面（n = 22）与协调员（n = 15 在缓慢增长项目中；n = 6 在快速增长项目中）、项目支持助理（PSA )（n = 1 在缓慢增长计划中）和以家庭为基础的初级保健团队成员（n = 3），以及三个面对面的焦点小组（n = 28 名参与者）和以家庭为基础的初级保健团队成员. 所有参与者（N = 53）都参与了至少两年的现有计划。结果：围绕四个主题出现了促进或阻碍项目增长的促进因素和障碍：全职协调员；完全以家庭为基础的初级保健团队参与；寻求和接受适当的推荐；照顾者、家庭和退伍军人之间的匹配。结论：为促进项目发展，项目领导者应考虑确定的主题，以及如何促进情况和制定将主题付诸实践的政策。