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28-03-2020

Health-related quality of life and related factors among chronically homeless adults living in different permanent supportive housing models: a cross-sectional study

Auteurs: Antoinette L. Spector, Katherine G. Quinn, Timothy L. McAuliffe, Wayne DiFranceisco, Arturo Bendixen, Julia Dickson-Gomez

Gepubliceerd in: Quality of Life Research | Uitgave 8/2020

Abstract

Purpose

Permanent supportive housing (PSH) is an effective intervention to improve residential stability and reduce the utilization of costlier healthcare services for the chronically homeless. However, there has been little focus on health-related quality of life (HRQL) once they enter PSH, and the potential influence of other factors including the PSH model. Study results can shed light on the HRQL of the PSH population and inform strategies to improve PSH program effectiveness in this area.

Methods

In this cross-sectional study, survey methods were used to assess the HRQL of PSH residents in the Chicago metropolitan area. The survey also included questions on socio-demographics, health behaviors, housing and neighborhood characteristics, and housing satisfaction. The SF-36 was used to obtain physical (PCS) and mental component summary (MCS) scores for HRQL. Other variables were selected using the Wilson and Cleary HRQL model. Statistical analyses included summary statistics, bivariate analyses, and fully adjusted linear regression models.

Results

The study sample included 855 adults currently in PSH. The sample was predominantly African American men with an average age of 53 years. Mean scores for PCS and MCS were 39.4 and 46.1, respectively, (out of 100). In adjusted analyses, older age and being on disability were associated with worse PCS. Having HIV was associated with better PCS. Being non-Hispanic Black, living in fixed-sited housing, and being in PSH for longer durations were associated with better MCS. More depressive symptoms was associated with worse PCS and MCS.

Conclusion

While both aspects of the PSH model (housing configuration and service provision) were initially associated with HRQL in unadjusted analyses, housing configuration was the only PSH model variable that remained significant once accounting for other factors. Depressive symptomology and the social environment also appear to be important correlates of HRQL and are potential areas to target in PSH programs.

vorige artikel Body composition and changes in health-related quality of life in older age: a 10-year follow-up of the Helsinki Birth Cohort Study

volgende artikel The impact of metabolic syndrome on mental health-related quality of life and depressive symptoms

Alleen toegankelijk voor geautoriseerde gebruikers

Fazel, S., Geddes, J. R., & Kushel, M. (2014). The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. The Lancet, 384(9953), 1529–1540. https://doi.org/10.1016/S0140-6736(14)61132-6. CrossRef

National Alliance to End Homelessness. (2019). “Chronically Homeless”. National Alliance to End Homelessness. Retrieved May 13, 2019, from https://endhomelessness.org/homelessness-in-america/who-experiences-homelessness/chronically-homeless/.

National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Policy and Global Affairs, Science and Technology for Sustainability Program, and Committee on an Evaluation of Permanent Supportive Housing Programs for Homeless Individuals. (2018). Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes Among People Experiencing Chronic Homelessness. Washington, DC: National Academies Press.

Aubry, T., Nelson, G., & Tsemberis, S. (2015). Housing first for people with severe mental illness who are homeless: A review of the research and findings from the at home–chez soi demonstration project. Canadian Journal of Psychiatry, 60(11), 467–474. https://doi.org/10.1177/070674371506001102. CrossRefPubMedPubMedCentral

Baggett, T. P., O’Connell, J. J., Singer, D. E., & Rigotti, N. A. (2010). The unmet health care needs of homeless adults: A national study. American Journal of Public Health, 100(7), 1326–1333. https://doi.org/10.2105/AJPH.2009.180109. CrossRefPubMedPubMedCentral

Flick, U. (2007). Homelessness and health: Challenges for health psychology. Journal of Health Psychology, 12(5), 691–695. https://doi.org/10.1177/1359105307080576. CrossRefPubMed

Schanzer, B., Dominguez, B., Shrout, P. E., & Caton, C. L. M. (2007). Homelessness, health status, and health care use. American Journal of Public Health, 97(3), 464–469. https://doi.org/10.2105/AJPH.2005.076190. CrossRefPubMedPubMedCentral

Dickson-Gomez, J., et al. (2017). Identifying variability in permanent supportive housing: A comparative effectiveness approach to measuring health outcomes. American Journal of Orthopsychiatry, 87(4), 414–424. https://doi.org/10.1037/ort0000232. CrossRef

Fitzpatrick-Lewis, D., Ganann, R., Krishnaratne, S., Ciliska, D., Kouyoumdjian, F., & Hwang, S. W. (2011). Effectiveness of interventions to improve the health and housing status of homeless people: A rapid systematic review. BMC Public Health. https://doi.org/10.1186/1471-2458-11-638. CrossRefPubMedPubMedCentral

10.

Kyle, T., & Dunn, J. R. (2008). Effects of housing circumstances on health, quality of life and healthcare use for people with severe mental illness: A review. Health & Social Care in the Community, 16(1), 1–15. https://doi.org/10.1111/j.1365-2524.2007.00723.x. CrossRef

11.

Rog, D. J., et al. (2014). Permanent supportive housing: Assessing the evidence. Psychiatric Services, 65(3), 287–294. https://doi.org/10.1176/appi.ps.201300261. CrossRefPubMed

12.

Aidala, A. A., et al. (2016). Housing status, medical care, and health outcomes among people living with HIV/AIDS: A systematic review. American Journal of Public Health, 106(1), e1–e23. https://doi.org/10.2105/AJPH.2015.302905. CrossRefPubMedPubMedCentral

13.

Bowen, E. A., Canfield, J., Moore, S., Hines, M., Hartke, B., & Rademacher, C. (2017). Predictors of CD4 health and viral suppression outcomes for formerly homeless people living with HIV/AIDS in scattered site supportive housing. AIDS Care, 29(11), 1458–1462. https://doi.org/10.1080/09540121.2017.1307920. CrossRefPubMed

14.

Quinn, K., Dickson-Gomez, J., Nowicki, K., Johnson, A. K., & Bendixen, A. V. (2018). Supportive housing for chronically homeless individuals: Challenges and opportunities for providers in Chicago, USA. Health & Social Care in the Community, 26(1), e31–e38. https://doi.org/10.1111/hsc.12467. CrossRef

15.

Hwang, S. W., Gogosis, E., Chambers, C., Dunn, J. R., Hoch, J. S., & Aubry, T. (2011). Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program. Journal of Urban Health, 88(6), 1076–1090. https://doi.org/10.1007/s11524-011-9592-3. CrossRefPubMedPubMedCentral

16.

Fayers, P. M., & Machin, D. (2016). Quality of life: The assessment, analysis, and reporting of patient-reported outcomes (3rd ed.). Hoboken, NJ: Wiley.

17.

Wilson, I., & Cleary, P. (1995). Linking clinical variables with health-related quality of life: A conceptual model of patient outcomes. JAMA, 273(1), 59–65. https://doi.org/10.1001/jama.273.1.59. CrossRefPubMed

18.

Zubritsky, C., Abbott, K. M., Hirschman, K. B., Bowles, K. H., Foust, J. B., & Naylor, M. D. (2013). Health-related quality of life: Expanding a conceptual framework to include older adults who receive long-term services and supports. Gerontologist, 53(2), 205–210. https://doi.org/10.1093/geront/gns093. CrossRefPubMed

19.

Gabrielian, S., et al. (2015). Factors affecting exits from homelessness among persons with serious mental illness and substance use disorders. Journal of Clinical Psychiatry, 76(4), e469–e476. https://doi.org/10.4088/JCP.14m09229. CrossRef

20.

Riley, E. D., Bangsberg, D. R., Perry, S., Clark, R. A., Moss, A. R., & Wu, A. W. (2003). Reliability and validity of the SF-36 in HIV-infected homeless and marginally housed individuals. Quality of Life Research, 12(8), 1051–1058. https://doi.org/10.1023/A:1026166021386. CrossRefPubMed

21.

Riley, E. D., Neilands, T. B., Moore, K., Cohen, J., Bangsberg, D. R., & Havlir, D. (2012). Social, structural and behavioral determinants of overall health status in a cohort of homeless and unstably housed HIV-infected men. PLoS ONE, 7(4), e35207. https://doi.org/10.1371/journal.pone.0035207. CrossRefPubMedPubMedCentral

22.

Riley, E. D., et al. (2003). Depression and drug use impact health status among marginally housed HIV-infected individuals. AIDS Patient Care and STDs, 17(8), 401–406. https://doi.org/10.1089/108729103322277411. CrossRefPubMed

23.

McHorney, C. A., Ware, J. E., Lu, J. F., & Sherbourne, C. D. (1994). The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care, 32(1), 40–66. CrossRefPubMed

24.

Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey: Manual and Interpretation guide. Boston: The Health Institute New England Medical Center.

25.

Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10(2), 77–84. https://doi.org/10.1016/S0749-3797(18)30622-6. CrossRefPubMed

26.

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092. CrossRefPubMed

27.

Saunders, J. M., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. E. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction, 88(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x. CrossRefPubMed

28.

Allen, J. P., Litten, R. Z., Fertig, J. B., & Babor, T. (1997). A review of research on the alcohol use disorders identification test (AUDIT). Alcoholism, 21(4), 613–619. https://doi.org/10.1111/j.1530-0277.1997.tb03811.x. CrossRefPubMed

29.

Cacciola, J. S., Alterman, A. I., Habing, B., & McLellan, A. T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6): Recent status scores for ASI-6. Addiction, 106(9), 1588–1602. https://doi.org/10.1111/j.1360-0443.2011.03482.x. CrossRefPubMedPubMedCentral

30.

McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168(1), 26–33. https://doi.org/10.1097/00005053-198001000-00006. CrossRef

31.

Hays, R. D., Cunningham, W. E., Ettl, M. K., Beck, C. K., & Shapiro, M. F. (1995). Health related quality of life in HIV disease. Assessment, 2(4), 363–380. https://doi.org/10.1177/1073191195002004006. CrossRef

32.

Fleishman, J. A., et al. (2000). Coping, conflictual social interactions, social support, and mood among HIV-infected persons. American Journal of Community Psychology, 28(4), 421–453. https://doi.org/10.1023/A:1005132430171. CrossRefPubMed

33.

Cunningham, W. E., Hays, R. D., Williams, K. W., Beck, K. C., Dixon, W. J., & Shapiro, M. F. (1995). Access to medical care and health-related quality of life for low-income persons with symptomatic human immunodeficiency virus. Medical Care, 33(7), 739–754. CrossRefPubMed

34.

Cunningham, W. E., et al. (1999). The impact of competing subsistence needs and barriers on access to medical care for persons with human immunodeficiency virus receiving care in the United States. Medical Care, 37(12), 1270–1281. CrossRefPubMed

35.

Stata: Software for Statistics and Data Science. Retrieved December 11, 2018, from https://www.stata.com/.

36.

Strine, T. W., Chapman, D. P., Kobau, R., Balluz, L., & Mokdad, A. H. (2004). Depression, anxiety, and physical impairments and quality of life in the US noninstitutionalized population. Psychiatric Services, 55(12), 1408–1413. https://doi.org/10.1176/appi.ps.55.12.1408. CrossRefPubMed

37.

U.S. Department of Housing and Urban Development. (2018). The 2018 Annual Homeless Assessment Report (AHAR) to Congress, Part 1: Point-in-time estimates of homelessness.

38.

Postmes, T., & Branscombe, N. R. (2002). Influence of long-term racial environmental composition on subjective well-being in African Americans. Journal of Personality and Social Psychology, 83(3), 735–751. https://doi.org/10.1037/0022-3514.83.3.735. CrossRefPubMed

39.

Hughes, M., Kiecolt, K. J., Keith, V. M., & Demo, D. H. (2015). Racial identity and well-being among African Americans. Social Psychology Quarterly, 78(1), 25–48. https://doi.org/10.1177/0190272514554043. CrossRef

40.

Maglinte, G. A., Hays, R. D., & Kaplan, R. M. (2012). US general population norms for telephone administration of the SF-36v2. Journal of Clinical Epidemiology, 65(5), 497–502. https://doi.org/10.1016/j.jclinepi.2011.09.008. CrossRefPubMedPubMedCentral

41.

Riley, E. D., Moore, K., Sorensen, J. L., Tulsky, J. P., Bangsberg, D. R., & Neilands, T. B. (2011). Basic subsistence needs and overall health among human immunodeficiency virus-infected homeless and unstably housed women. American Journal of Epidemiology, 174(5), 515–522. https://doi.org/10.1093/aje/kwr209. CrossRefPubMedPubMedCentral

42.

Buchanan, D., Kee, R., Sadowski, L. S., & Garcia, D. (2009). The health impact of supportive housing for HIV-positive homeless patients: A randomized controlled trial. American Journal of Public Health, 99(S3), S675–S680. https://doi.org/10.2105/AJPH.2008.137810. CrossRefPubMedPubMedCentral

43.

Leaver, C. A., Bargh, G., Dunn, J. R., & Hwang, S. W. (2007). The effects of housing status on health-related outcomes in people living with HIV: A systematic review of the literature. AIDS and Behavior, 11(2), 85–100. https://doi.org/10.1007/s10461-007-9246-3. CrossRefPubMed

44.

Weinstein, L. C., Henwood, B. F., Matejkowski, J., & Santana, A. J. (2011). Moving from street to home: Health status of entrants to a housing first program. Journal of Primary Care & Community Health, 2(1), 11–15. https://doi.org/10.1177/2150131910383580. CrossRef

45.

Henwood, B. F., Lahey, J., Rhoades, H., Pitts, D. B., Pynoos, J., & Brown, R. T. (2019). Geriatric conditions among formerly homeless older adults living in permanent supportive housing. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-018-4793-z. CrossRefPubMedPubMedCentral

46.

Henwood, B. F., et al. (2013). Addressing chronic disease within supportive housing programs. Prog Community Health Partnersh, 7(1), 67–75. https://doi.org/10.1353/cpr.2013.0005. CrossRefPubMedPubMedCentral

47.

Henwood, B. F., Katz, M. L., & Gilmer, T. P. (2015). Aging in place within permanent supportive housing. International Journal of Geriatric Psychiatry, 30(1), 80–87. https://doi.org/10.1002/gps.4120. CrossRefPubMed

48.

Rhoades, H., Wenzel, S. L., & Henwood, B. F. (2019). Changes in self-rated physical health after moving into permanent supportive housing. American Journal of Health Promotion, 33(7), 1073–1076. https://doi.org/10.1177/0890117119849004. CrossRefPubMed

Titel: Health-related quality of life and related factors among chronically homeless adults living in different permanent supportive housing models: a cross-sectional study
Auteurs: Antoinette L. Spector
Katherine G. Quinn
Timothy L. McAuliffe
Wayne DiFranceisco
Arturo Bendixen
Julia Dickson-Gomez
Publicatiedatum: 28-03-2020
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 8/2020
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-020-02482-w

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