This study aims to understand the comparative effectiveness of two PSH models (PB-PSH and SS-PSH) on quality of life and COVID-19 related health behaviors by following for 6 months a cohort of 800 PEH who have been placed in either PB (n=400) or SS (n=400). In a natural observational experiment, participants will complete 6 monthly mobile-based questionnaires exploring quality of life including physical, mental, social, and housing/environmental health, COVID-19 prevention practices (i.e., handwashing, social distancing, face covering), and past-30-day healthcare utilization. A sub-sample of 40 participants living in both PB-PSH and SS-PSH will be qualitatively interviewed longitudinally to help contextualize quantitative findings. Focus groups will also be conducted with providers of PSH and qualitative interviews will be conducted with other key stakeholders to understand perspectives on the challenges of implementing and sustaining COVID-19 related prevention practices while maintaining a continuity of care.
This study will aim to understand the comparative effectiveness of PB-PSH and SS-PSH on patient-centered quality of life, health care utilization, and health behaviors that will reduce COVID-19 risk by following a diverse sample of 800 PEH who are placed in PB-PSH (n = 400) or SS-PSH (n = 400) for 6 months. Barriers and facilitators will also be identified that may affect PSH implementation during the pandemic and its aftermath. The specific aims are: Aim 1: To test the comparative effectiveness of PB-PSH and SS-PSH on COVID-19-related health behaviors (COVID-19-related personal health practices including social distancing) for PEH over time. Aim 2: To test the comparative effectiveness of PB-PSH and SS-PSH on patient-centered quality of life (i.e., general life satisfaction; physical, mental, social, and environmental health) for PEH over time. Aim 3: To test the comparative effectiveness of PB-PSH and SS-PSH on health care utilization health behaviors and unmet need for care for physical health, mental health, substance use disorders, for PEH over time. Aim 4: To contextualize quantitative findings through longitudinal qualitative inquiry with 40 participants, purposively sampled from PB-PSH and SS-PSH, based on whether they are following social distancing guidelines. Aim 5: To understand service providers, policy makers, and other stakeholders perspectives on challenges of implementing and sustaining COVID-19-related prevention practices and continuity of care in PSH.
Study Type
OBSERVATIONAL
Enrollment
563
Los Angeles Homeless Services Authority (LAHSA)
Los Angeles, California, United States
Life Satisfaction
The NIH Toolbox item Bank v2.0 contains 10 items and will be utilized for participants to self-rate their life satisfaction
Time frame: Change of Life satisfaction from baseline to 6 months
Quality of physical health
Self-rated physical health and frequency/quantity of health-related activities will be assessed with the PROMIS Global Health Scale Version 1.2. Scores range from 1-10, with higher scores reflecting better functioning.
Time frame: Change in quality of physical health from baseline to 6 months
Degree of mental health symptomatology
The PROMIS will also be utilized to assess self-rated frequency the participant is bothered by mental health symptoms. The lowest possible score is 8 and the highest possible score is 40. Higher scores reflect more problematic symptomatology.
Time frame: Change in symptomatology from baseline to 6 months
Social Isolation
The PROMIS will be utilized to assess social isolation including perceptions of being avoided, excluded, detached, disconnected from, or unknown by, others. Scores range from 6 to 40 with higher scores representing increased perceptions of isolation.
Time frame: Change in social isolation from baseline to 6 months
Housing Environment
The Housing Environment Scale will assess residential satisfaction and neighborhood quality/safety. There are 5 subscales assessing the following: physical quality of the home, perceived quality of the neighborhood, perceived social climate in neighborhood, physical quality of home, and the physical quality of the neighborhood. Scales contain a range of 14 to 17 items with scores that range from 14 to 85 with higher scores representing increased satisfaction with environment.
Time frame: Change in satisfaction with housing environment from baseline to 6 months
COVID-19 Prevention practices
The NIH Disaster Research Response Platform will assess participant frequency of handwashing, social distancing, and use of face covering.
Time frame: Change in use of prevention practices from baseline to 6 months
Healthcare Utilization
Participants will record their past 30-day use of physical and mental health treatment, social services, and support provided by the permanent supportive housing program
Time frame: Change in utilization from baseline to 6 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.