Views on health activation and support services among formerly homeless adults living in Permanent Supportive Housing in the United States.

Permanent Supportive Housing disparities empowerment health activation homelessness mixed methods self-advocacy

Journal

Health & social care in the community
ISSN: 1365-2524
Titre abrégé: Health Soc Care Community
Pays: England
ID NLM: 9306359

Informations de publication

Date de publication:
01 2022
Historique:
revised: 01 03 2021
received: 24 09 2020
accepted: 11 03 2021
pubmed: 25 4 2021
medline: 31 12 2021
entrez: 24 4 2021
Statut: ppublish

Résumé

Individuals who have experienced chronic homelessness often have unmet physical and mental health needs and experiences of trauma and stigma. This study aimed to measure, for the first time, health activation (self-advocacy and empowerment) levels among formerly homeless adults living in Permanent Supportive Housing or PSH (referred to hereafter as residents). In addition, residents' experiences accessing health services, and their sense of health activation and efforts to manage their health within PSH settings, were explored. A mixed-methods study was conducted in Southern California (October 2018-June 2019) using a validated survey and interviews with a randomly selected group of residents (n = 61) from three PSH agencies. Activation levels were measured using the Patient Activation Measure. Descriptive and univariate survey analyses were conducted. Interview data was analysed using NVivo. Two coders coded all transcripts, and team meetings were held to reach consensus. Results showed most residents were female (64%), racial and ethnic minorities (66%), on average 54-year-olds, with 37 months of PSH residency, and 43% were taking some action to manage their health (intermediate activation level). Challenges accessing care were due to breakdowns in care, unpleasant experiences with providers, low health literacy and feeling overwhelmed by co-occurring chronic conditions. Health activation related to knowing when to take care of their health on their own and when to seek care. Unique challenges emerged related to PSH, such as lack of resident control within the housing setting and limited personnel responding to health emergencies. These challenges were magnified because residents live alone, per PSH requirements.

Identifiants

pubmed: 33894078
doi: 10.1111/hsc.13384
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

154-164

Informations de copyright

© 2021 John Wiley & Sons Ltd.

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Auteurs

Monica Perez Jolles (M)

Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

Dean Rivera (D)

Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

Gabrielle Jacobs (G)

Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

Kathleen C Thomas (KC)

Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Asheville, NC, USA.
Division of Research, UNC Health Sciences at MAHEC, Asheville, NC, USA.

Janet U Schneiderman (JU)

Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

Suzanne Wenzel (S)

Richard M. and Ann L. Thor Professor in Urban Social Development, USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.

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