Integrated Service Delivery and Health-Related Quality of Life of Individuals in Permanent Supportive Housing Who Were Formerly Chronically Homeless.

OBJECTIVES: To investigate the impact of an integrated care model on the health-related quality of life (HRQOL) of formerly chronically homeless individuals in permanent supportive housing. METHODS: From 2014 to 2017, eligible individuals in Houston, Texas (n = 323), were placed in 1 of 2 permanent supportive housing service delivery models. Both models included coordinated care teams. In the intervention group, teams had a single plan of care with the partnering clinic. The 9-item Patient Health Questionnaire and 36-item Short Form Survey were administered at baseline and every 6 months for 30 months. We assessed intervention group emergency department use at 2 years. We evaluated change by using hierarchical linear growth models. RESULTS: There was a significant and clinically meaningful increase in HRQOL in the intervention group, with the intervention group reporting improvement over the comparison group. Intervention group emergency department use decreased by 70% (no comparison group). CONCLUSIONS: Those in the intervention group with a single, coordinated plan of care reported significant and clinically meaningful increases in their HRQOL. Public Health Implications. Coordinated care models have potential to reduce societal costs and increase HRQOL, providing a financial and humanitarian justification for the continued investment in collaborative care in permanent supportive housing.

A Community-Academic Collaboration to Support Chronic Disease Self-Management among Individuals Living in Permanent Supportive Housing.

BACKGROUND: Individuals experiencing chronic homelessness with a chronic health condition may qualify for permanent supportive housing (PSH). Given limited PSH resources, it is important to identify priority programming with demonstrated effectiveness. OBJECTIVES: A community-academic partnership was formed to address the priority health needs of individuals living in PSH. METHODS: Community stakeholders identified diabetes self-management as a priority health need. Wisdom, Power, Control (WPC), an evidence-based diabetes self-management program, was piloted for seven weeks with diabetic (type 2) or prediabetic PSH residents. A survey was administered at baseline and program completion. HbA1c was assessed at baseline and 3-month follow-up. RESULTS: Those who completed the Program (N = 10), reported a significant increase in diabetes knowledge, self-efficacy and foot self-care. The average hemoglobin A1c (HbA1c) of the participants significantly decreased from 8.86 to 6.88. CONCLUSIONS: Pilot data from this study provides an example of a community-academic partnership that improved the health of individuals in PSH through evidence-based programming.

Exploring Differences in the Lives and Well-Being of Sexual and Gender Minority Adults Experiencing Homelessness Relative to Their Cisgender Heterosexual Counterparts.

Purpose: To better understand the lives and experiences of sexual and gender minority (SGM) adults experiencing homelessness relative to their cisgender heterosexual (non-SGM) counterparts. Methods: A modified time-location sampling strategy was used to reach a diverse sample of individuals with experiences of homelessness. Interviewer or self-administered paper-based surveys were administered to participants on location. Results: SGM and non-SGM participants reported significant differences in the age at which they became homeless, their current housing, and experiences of violence over the past year. SGM participants reported poorer mental health than their non-SGM counterparts. Conclusion: SGM adults may be uniquely impacted by their experiences of homelessness.