scholarly journals Developing Tobacco Control Interventions in Permanent Supportive Housing for Formerly Homeless Adults

2019 ◽  
Vol 21 (6) ◽  
pp. 972-982 ◽  
Author(s):  
Natalie M. Alizaga ◽  
Tram Nguyen ◽  
Anne Berit Petersen ◽  
Holly Elser ◽  
Maya Vijayaraghavan
Keyword(s):  
Substance Use ◽  
Tobacco Control ◽  
San Francisco ◽  
Population Based ◽  
Supportive Housing ◽  
Successful Implementation ◽  
Effective Population ◽  
Bay Area ◽  
Permanent Supportive Housing ◽  
Formerly Homeless

Smoke-free policies are effective population-based strategies to reduce tobacco use yet are uncommon in permanent supportive housing (PSH) for formerly homeless individuals who have high rates of smoking. In this study, we partnered with six supportive housing agencies in the San Francisco Bay Area to examine the implementation of smoke-free policies and cessation services. We administered a questionnaire and conducted in-depth, semistructured interviews with agency directors (n = 6), property management staff (n = 23), and services staff (n = 24) from 23 PSH sites on the barriers to implementing tobacco control interventions. All properties restricted smoking in indoor shared areas, but only two had policies restricting smoking in living areas. While there was staff consensus that smoke-free policies were important to reduce tobacco-related harm, participants disagreed on whether smoke-free policies were aligned with PSH’s harm reduction framework. Residents’ comorbid mental illness and substance use and the lack of appropriate enforcement tools were barriers to implementation. Using these formative findings, we present a framework for a toolkit of strategies to increase implementation of smoke-free policies and cessation interventions in PSH. Successful implementation of indoor smoke-free policies in PSH will require concurrent cessation services to support smoking cessation efforts and address the mental health and substance use needs of residents.

scholarly journals Smoke-Free Home Intervention in Permanent Supportive Housing: A Multifaceted Intervention Pilot

2020 ◽  
Author(s):  
Arturo Durazo ◽  
Marlena Hartman-Filson ◽  
Kenneth Perez ◽  
Natalie M Alizaga ◽  
Anne Berit Petersen ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
San Francisco ◽  
Brief Intervention ◽  
Odds Ratio ◽  
San Francisco Bay Area ◽  
Supportive Housing ◽  
Bay Area ◽  
Permanent Supportive Housing ◽  
Voluntary Adoption

Abstract Introduction Smoke-free homes (SFHs), the voluntary adoption of home smoking restrictions, are associated with reduced secondhand smoke exposure. However, SFHs are uncommon in permanent supportive housing (PSH) for formerly homeless adults, who have fivefold higher smoking rates than the general population. We pilot-tested a brief intervention to increase voluntary adoption of SFHs among PSH residents in the San Francisco Bay Area. Aims and Methods We pilot-tested a brief intervention to increase voluntary adoption of SFHs among PSH residents in the San Francisco Bay Area. Rest of the methods, PSH residents (n = 100) and staff (n = 62) from 15 PSH sites participated in the intervention between October 2017 and February 2018. Research staff provided counseling to PSH residents on how to adopt an SFH and trained PSH staff on how to counsel residents on smoking cessation. The primary outcome was self-reported voluntary adoption of an SFH for ≥90 days, and the secondary outcome was carbon monoxide-verified PPA at 6-month follow-up. PSH staff completed the Smoking Knowledge, Attitudes, and Practices survey at baseline and 3-month follow-up. Results At 6 months, 31.3% of PSH residents had adopted an SFH (vs. 13.0% at baseline) and 16.9% reported carbon monoxide-verified PPA. A positive attitude toward an SFH policy was associated with increased odds of SFH adoption (adjusted odds ratio = 8.68, 95% confidence interval: 2.42, 31.17). Voluntary SFH adoption was associated with increased PPA (adjusted odds ratio = 26.27, 95% confidence interval: 3.43, 201.30). PSH staff reported improved attitudes toward and self-efficacy in delivering cessation care, and decreased barriers to discussing smoking cessation among PSH residents between baseline and 3-month follow-up. Conclusions In this single-arm study, a brief intervention increased SFH adoption and PPA among PSH residents. Implications To date, few interventions have addressed SFHs and their association with tobacco use among PSH residents. A “ground-up” approach that relies on buy-in from residents and that promotes voluntary SFHs is an innovative way to increase smoke-free living environments in PSH. This approach could pave a pathway for smoke-free policy implementation in these sites. PSH can play a role in reducing the burden of tobacco use by empowering its residents to adopt voluntary SFHs, which could increase smoking cessation among residents.

scholarly journals Cognition, Health, and Social Support of Formerly Homeless Older Adults in Permanent Supportive Housing

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Anita M Souza ◽  
Jenny Hsin-Chin Tsai ◽  
Kenneth C Pike ◽  
Francesca Martin ◽  
Susan M McCurry
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Global Mental Health ◽  
Case Managers ◽  
Supportive Housing ◽  
Homeless Population ◽  
Physical And Mental Health ◽  
Permanent Supportive Housing ◽  
Formerly Homeless

Abstract Background and Objectives Formerly homeless older adults residing in Permanent Supportive Housing (PSH) represent an invisible subsector of two distinct, yet related populations: the homeless population and the elderly population. Little research is focused on the complex health concerns facing this aging population within the homelessness response system. Of particular concern is the identification and support of individuals with cognitive impairment and co-occurring chronic conditions. We collaborated with a leading housing services provider to develop a systematic screening system for case managers to capture the cognitive, physical, and psychosocial health of older adults served within homeless housing programs. Research Design and Methods PSH residents aged ≥50 years in four sites screened as being without cognitive impairment on the Mini-Cog were enrolled. A brief demographic survey and selected PROMIS measures were used to characterize participants’ demographics, cognition, global physical and mental health, physical functioning, self-efficacy for social interactions, and instrumental support. PSH case managers were trained to recruit participants and collect data. PROMIS scales were scored using the Health Measures Scoring Service. Descriptive statistics, correlations, and one sample t-tests were performed. Results Fifty-three residents (mean age = 60.8 years, range 50–76 years) participated. The majority self-identified as male and were military veterans; 60% reported having a history of two or more episodes of homelessness. All PROMIS scores were significantly (p < .05) lower than reference U.S. population means, with global mental health and cognition having the lowest scores. Discussion and Implications Self-reported cognitive functioning and global mental health were residents’ greatest concerns. Strengthening housing case manager capacity to assess residents’ cognitive and health status could increase support for older adults in PSH. It is feasible to train PSH staff to conduct structured interviews to identify resident cognitive and health needs to help support this “invisible” population to successfully age in place.

scholarly journals Increases in social support co-occur with decreases in depressive symptoms and substance use problems among adults in permanent supportive housing: an 18-month longitudinal study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Zhengqi Tan ◽  
Eun-Young Mun ◽  
Uyen-Sa D. T. Nguyen ◽  
Scott T. Walters
Keyword(s):  
Social Support ◽  
Substance Use ◽  
Depressive Symptoms ◽  
Protective Factor ◽  
Growth Models ◽  
Parallel Process ◽  
Supportive Housing ◽  
Permanent Supportive Housing ◽  
Substance Use Problems ◽  
Over Time

Abstract Background Social support is a well-known protective factor against depressive symptoms and substance use problems, but very few studies have examined its protective effects among residents of permanent supportive housing (PSH), a housing program for people with a history of chronic homelessness. We utilized unconditional latent growth curve models (LGCMs) and parallel process growth models to describe univariate trajectories of social support, depressive symptoms, and substance use problems and to examine their longitudinal associations in a large sample of adults residing in PSH. Methods Participants were 653 adult PSH residents in North Texas (56% female; 57% Black; mean age: 51 years) who participated in a monthly health coaching program from 2014 to 2017. Their health behaviors were assessed at baseline and tracked every six months at three follow-up visits. Results Unconditional LGCMs indicated that over time, social support increased, whereas depressive symptoms and substance use problems decreased. However, their rates of change slowed over time. Further, in parallel process growth models, we found that at baseline, individuals with greater social support tended to have less severe depressive symptoms and substance use problems (coefficients: − 0.67, p < 0.01; − 0.52, p < 0.01, respectively). Individuals with a faster increase in social support tended to have steeper rates of reduction in both depressive symptoms (coefficient: − 0.99, p < 0.01) and substance use problems (coefficient: − 0.98, p < 0.01), respectively. Conclusions This study suggests that plausibly, increases in social support, though slowing over time, still positively impact depressive symptoms and substance use problems among PSH residents. Future PSH programs could emphasize social support as an early component as it may contribute to clients’ overall health.

scholarly journals Geriatric Conditions Among Formerly Homeless Older Adults Living in Permanent Supportive Housing

2019 ◽  
Vol 34 (6) ◽  
pp. 802-803 ◽  
Author(s):  
Benjamin F. Henwood ◽  
John Lahey ◽  
Harmony Rhoades ◽  
Deborah B. Pitts ◽  
Jon Pynoos ◽  
...  
Keyword(s):  
Older Adults ◽  
Supportive Housing ◽  
Permanent Supportive Housing ◽  
Geriatric Conditions ◽  
Formerly Homeless

Moving on from Permanent Supportive Housing: Facilitating Factors and Barriers among People with Histories of Homelessness

2017 ◽  
Vol 98 (2) ◽  
pp. 103-111 ◽  
Author(s):  
Kimberly R. Livingstone ◽  
Daniel B. Herman
Keyword(s):  
Housing Tenure ◽  
Supportive Housing ◽  
Stepping Stone ◽  
Permanent Supportive Housing ◽  
Facilitating Factors ◽  
Formerly Homeless

This study explored factors promoting and impeding formerly homeless permanent supportive housing tenants from moving into more independent community housing. Interviews were conducted with 10 current and 11 former residents. Facilitators included support received during supportive housing tenure, a focus on set goals, supportive housing as a stepping-stone, and a willingness to fight for what they hope to accomplish. Barriers included lack of affordability and rental assistance, fear of becoming homeless again, unacceptability of available housing, and limited help facilitating the transition. Permanent supportive housing residents may benefit from expanded use of support received during tenure. Affordability will likely remain a barrier. Given federal disinvestment in rental subsidies, growth in locally funded programs and other strategies will likely be required.

16. A Home of One's Own: Formerly Homeless Youth's Experiences of Transition into Permanent Supportive Housing

2015 ◽  
Vol 56 (2) ◽  
pp. S9 ◽  
Author(s):  
Sarah Brothers ◽  
Jeffrey Schonberg ◽  
Jessica Lin ◽  
Deborah Karasek ◽  
Colette Auerswald
Keyword(s):  
Supportive Housing ◽  
Permanent Supportive Housing ◽  
Formerly Homeless
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