About

Alesia Montgomery is a faculty member associated with the UCLA Department of African American Studies. The provided page does not contain specific details about her research focus, background, or key contributions. Therefore, no detailed biography can be generated from the available information.

Research topics

• Psychiatry
• Medicine
• Political Science
• Sociology
• Finance
• Environmental health
• Internal medicine
• Demography
• Economic growth
• Psychology
• Economics
• Gerontology

Selected publications

• Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability

  JAMA Health Forum · 2026-01-23 · 1 citations

  articleOpen access

  Importance: Homelessness is associated with negative health outcomes and increased health care costs. The United States Department of Veterans Affairs (VA) Supportive Services for Veteran Families (SSVF) program provides housing-related financial assistance and other supports to veterans experiencing housing instability; however, little is known regarding short-term assistance interventions with a prevention focus. Objective: To estimate potential impacts of the SSVF program in mortality and health care cost outcomes over 3 years following program entry. Design, Setting, and Participants: Using observational data, outcomes were compared between veterans who enrolled in SSVF with those who did not for each month from October 2015 to December 2018. A propensity score for SSVF enrollment was calculated using observable characteristics including demographics, housing history, health care cost history, comorbidities, and geography. Using inverse probability of treatment weighting-a propensity score-based method that creates a pseudopopulation in which treatment groups are balanced on observed covariates-the potential impacts of SSVF enrollment in mortality were estimated using a Cox proportional hazards regression and health care costs with a generalized linear model over the 3 years following the trial index date. Data were from the VA electronic health record for a cohort of veterans receiving care in the VA system. Each trial drew on veterans with evidence of homelessness in structured and unstructured medical records during the previous month. Data were analyzed from November 1, 2023, to September 9, 2025. Exposure: The exposure was enrollment in the SSVF program, from the Homeless Management Information System data. Main outcome: The main outcomes were all-cause mortality and VA health care costs. Results: The cohort consisted of 693 383 patient-trials with 26 649 (3.8%) enrolling in SSVF (mean [SD] age, 52.7 [12.6] years; 89.6% male) and 666 734 (96.5%) in the no SSVF group (mean [SD] age, 53.8 [13.0] years; 90.8% male). Enrollment in SSVF was associated with a decrease in the risk of mortality (hazard ratio, 0.87; 95% CI, 0.82-0.92). In addition, enrollment in SSVF was associated with an increase in outpatient costs ($7534; 95% CI, $6767-$8302) and a decrease in inpatient costs (-$10 020; 95% CI, -$13 644 to -$6396). Conclusions and Relevance: In this study, federal prevention solutions to homelessness were associated with improved health outcomes and lower inpatient costs, which should inform national policy debates within and beyond the VA.

  PublisherOA PDFDOI

• Age differences in the association between services to address housing instability and suicide mortality among Veterans

  Journal of Social Distress and the Homeless · 2026-02-05

  articleSenior authorCorresponding
  PublisherDOI

• Identifying Staff Behaviors and Client Outcomes of High-Performing Staff at a National Homeless Hotline for Veterans

  The Journal of Behavioral Health Services & Research · 2026-04-27

  articleOpen accessSenior author

  Crisis call centers serve important functions for public health. With the rise of artificial intelligence (AI) and potential roles in crisis call centers, it is important to examine what human behaviors influence the effectiveness of call center outcomes. The authors studied the U.S. Department of Veterans Affairs (VA) National Call Center for Homeless Veterans (NCCHV) to (1) examine differences in staff behaviors between top and average performers and (2) evaluate client outcomes of top-performing and average-performing staff. Of 159 NCCHV staff, 10 top-performing and 10 average-performing staff were randomly selected based on their annual performance ratings from fiscal years 2020-2023. For each NCCHV staff selected, three audio-recorded calls were sampled and blindly rated by researchers on a list of nine coded behaviors (e.g., empathy, thoroughness). Healthcare outcomes of clients served by these NCCHV staff were examined through analysis of their VA medical records data. Results found that top-performing staff were significantly more likely to be rated as tactful and empathetic, thorough with information gathering, and less likely to be rated as providing inappropriate advice and being forceful/rigid with clients than average-performing staff. Clients served by top-performing NCCHV staff showed significant increases in VA healthcare use including outpatient healthcare and homeless services after calling NCCHV which were not observed in clients served by average-performing NCCHV staff. Together, these findings suggest human behaviors of homeless call center staff influence client engagement with care, emphasizing the importance of staff training and caveating any potential use of AI in these call centers.

  PublisherOA PDFDOI

• Patient and Primary Care Characteristics Associated with Emergency Department Utilization Among Homeless-Experienced Veterans

  Journal of General Internal Medicine · 2026-05-14

  articleOpen access

  BACKGROUND: Efforts to address high emergency department (ED) use among persons experiencing homelessness may be strengthened by identifying risk factors and clarifying whether the primary care experience influences subsequent ED utilization. Although homeless-tailored primary care clinics receive more favorable patient ratings, it remains unclear whether patient experience or clinic type predicts future ED use. OBJECTIVE: To identify clinical and social predictors of high ED utilization among homeless-experienced veterans (HEVs) and to test whether (a) unfavorable care ratings predict higher ED use and (b) care in homeless-tailored primary care clinics predicts lower ED use compared with mainstream clinics. DESIGN: A retrospective cohort study linking national survey data with electronic health record data was conducted to assess ED utilization during the 1-year following survey completion. PARTICIPANTS: Five thousand seventy-nine HEVs engaged in Veterans Health Administration primary care who completed the 2018 Primary Care Quality-Homeless Services Tailoring (PCQ-HoST) survey. MAIN MEASURES: Primary care type (homeless-tailored or mainstream), patient-reported primary care experience on a validated survey, and ED utilization (defined as high based on four or more visits). KEY RESULTS: Among 5079 HEVs, 474 (9.3%) had high ED utilization. High utilization was associated with current and chronic homelessness, chronic pain, medical and psychiatric comorbidities, and substance use disorders. An unfavorable primary care experience was associated with higher odds of subsequent high ED utilization (OR 1.31; 95% CI 1.26-1.68). Primary care clinic type was not independently associated with high ED utilization. In post hoc count-based models, care in a homeless-tailored clinic was associated with 0.15 fewer ED visits annually. CONCLUSIONS: Among HEVs engaged in primary care, high ED utilization is driven primarily by clinical complexity and housing instability. However, an unfavorable patient-reported primary care experience was independently associated with subsequent ED use, suggesting that improving primary care interactions may contribute to broader efforts to address high ED utilization in this population.

  PublisherOA PDFDOI

• The association between residential relocation and mortality among Veterans with experience of housing instability in rural areas

  The Journal of Rural Health · 2026-03-01

  article1st authorCorresponding

  PURPOSE: Housing instability deleteriously affects health outcomes (i.e., lack of access to care, premature mortality). Veterans experiencing housing instability in rural areas-which often lack housing options, transportation, and services-have greater odds of residential relocation compared to urban Veterans, and they most frequently relocate to urban areas. Urban relocation is associated with changes in health outcomes, including increased services use, but studies have not examined the association between residential relocation and mortality. METHODS: This study used Veterans Affairs electronic health record data for 28,058 Veterans who experienced housing instability at a rural residence and then, within 2 years, changed their residential location by ≥40 mi or from a rural-to-urban location. We assessed the risk of mortality during the 6 months following residential relocation, controlling for sociodemographics, baseline comorbid health conditions, and time-varying services use. FINDINGS: One-third of the rural Veterans experiencing housing instability had a rural-to-rural relocation (n = 7227), whereas the remaining had a rural-to-urban relocation (n = 17,375). Veterans with a rural-to-rural relocation were older and had more comorbid medical conditions compared to Veterans with rural-to-urban relocation; however, Veterans with a rural-to-urban relocation had 28% greater odds of mortality during the 6 months following residential relocation than Veterans with rural-to-rural relocation. CONCLUSIONS: Rural-to-rural relocation was associated with reduced odds of mortality, even when controlling for services utilization, age, and baseline comorbidities. Future research should explore if and how remaining in rural environments is protective and identify ways to support care coordination following residential relocations among Veterans with experience of housing instability.

  PublisherDOI

• Differential mortality among US veterans: Social determinants of health, substance use disorder, and substance use treatment

  American Journal on Addictions · 2026-04-03

  articleSenior authorCorresponding

  BACKGROUND AND OBJECTIVES: Veterans face disproportionate suicide and mortality risks driven by intersecting social determinants of health (SDH), including housing instability, unemployment, and justice involvement, and co-occurring substance use disorders (SUD). This study examined how these intersecting factors influence mortality and whether SUD treatment mitigated mortality risks among US veterans. METHODS: Using national Veterans Health Administration data (2014-2019), we identified 215,944 veterans with SUD and an indicator of one of three adverse SDH: housing instability, justice involvement, or unemployment. We tracked suicide and all-cause mortality for 1 year following SDH exposure. We used discrete-time survival models to assess associations between month-specific SUD treatment and mortality outcomes, controlling for demographic, clinical (i.e., mental health conditions, suicidal behavior), and contextual covariates. RESULTS: Nearly half of veterans (48%) received SUD treatment. Those who received treatment had lower all-cause mortality (2.1% vs. 4.3%; p < .001) but no significant difference in suicide mortality (0.14% vs. 0.15%; p = .75). [Correction added on 22 April 2026, after first online publication: The preceding sentence has been revised in this version.] SUD treatment was associated with a 24% (aOR = 1.24; 95% CI: 1.16-1.34) reduction in all-cause mortality, though its interaction with each adverse SDH was not statistically significant. Suicide deaths remained concentrated among White veterans, those aged 18-34, with no service connection, and with time-varying suicidal ideation or attempts (p < .001). DISCUSSION AND CONCLUSIONS: Engagement in SUD treatment reduces all-cause mortality among veterans facing compounded social adversity but does not independently mitigate suicide deaths. SCIENTIFIC SIGNIFICANCE: Integrated approaches that embed suicide prevention within addiction and SDH-focused care are essential to address the multifactorial drivers of veterans' suicidal mortality.

  PublisherDOI

• Primary Care Continuity and Utilization Patterns for Veterans With Homeless Experience

  JAMA Network Open · 2026-02-02

  articleOpen access

  Importance: Continuity of care is a key aspect of high-quality primary care. Vulnerable populations often experience fragmented care. Some US Department of Veterans Affairs (VA) clinics offer primary care in patient aligned care teams (PACTS) tailored for veterans with homeless experience (VHE), termed H-PACTs. Objectives: To test the hypothesis that primary care continuity would be higher for VHEs in H-PACTs than for VHEs in mainstream VA PACTs and to compare other service utilization patterns by primary care clinic type. Design, Setting, and Participants: Retrospective observational cohort study including national survey data combined with VA electronic health records data from primary care clinics at 26 VA medical centers. Participants were VHEs who completed the national survey and had 2 or more primary care visits in the 12 months before the survey. The survey was completed between April and October 2018 and data were analyzed from April 2020 to November 2025. Exposure: Enrollment in H-PACTs or mainstream PACTs. Main Outcomes and Measures: Continuity was calculated using the usual provider of care (UPC) measure, which is the proportion of primary care visits with the most frequently seen clinician. High continuity was defined as a UPC of 0.75 or higher. Multivariable regression models examined the association of H-PACT enrollment with high continuity, and other utilization measures included mental health, specialty visits, emergency department (ED) visits, and hospitalizations. Results: A total of 2271 VHEs in H-PACTs (2140 [94.2%] male; 932 [41.0%] Black, 1050 [46.2%] White, and 263 [11.6%] other; mean [SD] age, 58.1 [9.3]) and 1627 VHE in mainstream PACTs (1393 [85.6%] male; 674 [41.4%] Black, 740 [45.5%] White, and 192 [11.8%] other; mean [SD] age, 60.7 [12.1]) were included. Compared with those in mainstream PACTs, VHEs in H-PACTs had a higher mean (SD) UPC (0.81 [0.23] vs 0.77 [0.25]; χ21 = 21.6; P < .001) and were more likely to achieve high continuity (1483 patients [65.3%] vs 938 [57.7%]; χ22 = 25.0; P < .001). After multivariable adjustment, care in H-PACTs remained associated with high continuity (odds ratio [OR], 1.48; 95% CI, 1.33-1.66). In adjusted analyses, compared with those in mainstream PACTs, VHEs in H-PACTs had significantly more primary care visits (4.6 vs 4.0; z score = 5.28; P < .001), fewer specialty visits (6.2 vs 7.9 visits; z score = -4.66; P < .001), and were less likely to have an ED visit (OR, 0.83; 95% CI, 0.75-0.92). Conclusions and Relevance: In this study, VHEs in H-PACT clinics had higher primary care continuity with no indication of substitution of specialty or emergency visits for primary care. The H-PACT model is associated with less intensive health care delivery.

  PublisherDOI

• The price of shame: A scoping review examining the effects of shame on sexual and gender minority populations in the United States

  SSM - Mental Health · 2026-02-05 · 1 citations

  articleOpen access

  Sexual and gender minority (SGM) people experience a higher prevalence of adverse health outcomes compared to their heterosexual and cisgender counterparts due, in part, to shame related to sexual orientation and gender identity. The purpose of this scoping review was to identify and synthesize empirical evidence of the effects of shame on SGM populations in the United States. Following PRISMA-ScR guidelines, we systematically searched for studies that were (1) peer-reviewed; (2) original research; (3) written in English; (4) quantitatively measuring shame; (5) among groups identifying as sexual minority, gender minority, or both; (6) within the United States. We identified 22 studies meeting inclusion criteria, most of which were cross-sectional and focused on sexual minority men. Across studies, shame was consistently associated with exposure to distal and proximal stressors, general psychological processes (e.g., affective, social, and cognitive), health-compromising behaviors (e.g., substance use, sexual compulsivity), and adverse health outcomes. Notably, few studies focused on gender minority individuals, and subgroup or intersectional analyses were uncommon. The literature supports shame as an important correlate of health-related outcomes among SGM populations, but is limited by cross-sectional designs, heterogenous measurement approaches, and limited attention to subgroup differences. Future research should prioritize longitudinal and mechanistic studies, improve measurement harmonization, and evaluate established shame-reduction approaches with SGM-affirming adaptations and scalable delivery strategies to improve reach and advance health equity. • Scoping review of shame among sexual and gender minority (SGM) populations • Shame linked to minority stressors, health behaviors, and adverse health outcomes • Shame mediates pathways from stressors to mental and physical health in SGM people • Review reveals major research gaps: causality, measurement, subgroup differences • Findings highlight need for interventions targeting shame to reduce SGM inequities

  PublisherDOI

• A Mixed Methods Assessment of Strain and Related Support Needs of Family Caregivers of Hospitalized Older Adults with Delirium

  Nursing Research and Reviews · 2025-04-01

  articleOpen access

  Background: High distress is common among delirium caregivers, yet little is known about their caregiver strain and support needs across a comprehensive spectrum including physical, financial, and spiritual domains. Purpose: The purpose of this sequential mixed methods study was to assess strain and related support needs of family caregivers of older adults with delirium. Patients and Methods: Family caregivers of older adults hospitalized with delirium were recruited from an Acute Care for Elders (ACE) Unit at an academic medical center. Semi-structured interviews were used to expand on caregiver perceptions of strain and related support needs that were initially reported in quantitative assessments. A side-by-side tabular joint display was used to display quantitative and qualitative results, then weaving was used to explain and integrate the results from both phases in narrative form. Results: An attempt to screen 380 caregiver/patient dyads resulted in 16 dyads enrolled in the study with 2 caregiver interviews. Caregivers were predominantly female (75%), in good health or better (81%), had some college or higher (82%), and half of the caregivers were White (56%). Many caregivers (69%) reported high levels of strain. Descriptively, strain scores were higher among caregivers who were female, White, and older, with no previous delirium experience, and with no delirium education. Good communication with staff, facilitation of family communication, and peer social support were emphasized as being important for their ability to cope. Conclusion: With an understanding of delirium caregiver strain and support needs, healthcare professionals are better positioned to buffer the impact of strain on family caregiver health and well-being. The findings of this study can inform future interventions to decrease delirium caregiving strain. Keywords: acute care for elders unit, caregiver burden, caregivers, delirium, hospitalization, social support

  PublisherDOI

• Change in Outpatient Care Following Migration Among Veterans with Experience of Housing Instability

  Journal of General Internal Medicine · 2025-04-07

  letterOpen access1st authorCorresponding
  PublisherOA PDFDOI

Recent grants

• Identifying and Measuring Risk for Homelessness among Veterans

  NIH · 2015–2019

Frequent coauthors

• Thomas Byrne

  Boston University

  150 shared

• John R. Blosnich

  University of Southern California

  94 shared

• Stefan G. Kertesz

  90 shared

• Melissa E. Dichter

  Temple University

  87 shared

• Lillian Gelberg

  85 shared

• Meagan Cusack

  University of Pennsylvania

  79 shared

• Sonya Gabrielian

  Center for the Study of Healthcare Provider Behavior

  73 shared

• Richard E. Nelson

  VA Salt Lake City Healthcare System

  70 shared

Education

• PhD, Health Behavior

  University of Alabama at Birmingham School of Public Health

  2009

• MPA

  Columbia University School of International and Public Affairs

  2002

• MSW

  Columbia University School of Social Work

  2002

• BA

  Boston College

  1998

Awards & honors

• Alfred P. Sloan Postdoctoral Fellowship at UCLA’s Center on…
• Alfred P. Sloan Foundation Pre-Doctoral Fellowship at UC Ber…
• Rockefeller Graduate Summer Internship in Womanist Studies a…