Homeless Care Management App

Study Overview
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Brief Summary
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There is a significant revolving door of incarceration among homeless adults, a population with substantial health disparities. Homeless adults who receive the professional coordination of individualized care (i.e., case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be re-incarcerated. The proposed study will use mobile technology to address these barriers and fill gaps in the understanding of the causes of the revolving door of homeless incarceration. This research represents a step toward integrated service connection and healthcare service provision for one of the most underserved, high need, and understudied populations in the United States. Smart phone apps that increase the use of available healthcare services and identify predictors of key outcomes (e.g., homelessness, re-arrest, medication compliance) could be used to reach hard to reach populations with histories of significant and persistent health disparities (e.g., homeless adults).

Official Title
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m-Health to Increase Service Utilization in Recently Incarcerated Homeless Adults

Conditions
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Substance Use Disorders, Mental Health Impairment, Health Behavior, Adherence, Patient

Intervention / Treatment
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* Behavioral: In-Person Case Management at Homeless Recovery Program
* Behavioral: Unlimited Smartphone
* Behavioral: Smartphone Based Case Management (SPCM) app


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: released from Dallas County Jail in the past month plan to reside in the Dallas area for the next year enrolled in The Bridge Homeless Recovery Program willing and able to attend the baseline visit, randomization visit, and the 1, 3, and 6-month follow-up visits score ≥ 4 on the REALM-SF indicating > 6th grade English literacy level score >24 on the Mini-Mental State Exam indicating no substantial cognitive impairment. Exclusion Criteria Cannot read English Under the age of 18

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Usual Case Management (UCM)<br>Group receives standard case management at the shelter | Behavioral: In-Person Case Management at Homeless Recovery Program<br>* In-Person Case Management at Homeless Recovery Program<br>|
| Experimental: UCM + Smartphone<br>Group receives standard case management and an unlimited smartphone | Behavioral: In-Person Case Management at Homeless Recovery Program<br>* In-Person Case Management at Homeless Recovery Program<br>Behavioral: Unlimited Smartphone<br>* Smartphone with unlimited calls, texts, and data plan<br>|
| Experimental: Smartphone Based Case Management (SPCM)<br>Group receives standard case management and an unlimited smartphone with the SPCM app | Behavioral: In-Person Case Management at Homeless Recovery Program<br>* In-Person Case Management at Homeless Recovery Program<br>Behavioral: Unlimited Smartphone<br>* Smartphone with unlimited calls, texts, and data plan<br>Behavioral: Smartphone Based Case Management (SPCM) app<br>* Smartphone Based Case Management app<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of case management sessions completed | Total number of sessions completed between the randomization visit and 6-month follow-up | 6-month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of homeless nights | Total number of self-reported homeless nights (via Timeline Follow Back Procedures) | 6 months | 
| Number of arrests | Total number of times each participant is booked into Dallas County Jail (using jail arrest records) | 12 months | 
| Alcohol use | Number of days of alcohol use (via Timeline Follow Back procedures) | 6 months | 
| Drug use | Number of days of drug use (via Timeline Follow Back procedures) | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Case Management, Homelessness, Smartphone, Health Related Quality of Life, Mental Health, Substance Use Disorders