Clinical trial NCT04769349: Effectiveness of Supportive Housing on COVID-19 Related Outcomes for People Experiencing Homelessness
Official title: Effectiveness of Supportive Housing on COVID-19 Related Outcomes for People Experiencing Homelessness
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Housing
Covid19
Mental Health
Physical Health
Social Interaction
Healthcare
Lead sponsor: University of Southern California
Sponsor class: OTHER
Collaborators: name: University of California, Los Angeles
First posted: 2021-02-24
Enrollment: 563
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: 800 adults experiencing homelessness who have been approved for permanent supportive housing (PSH) in Los Angeles

Brief summary: 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.

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

* adults (aged 18+) with recent (past 12 months) lived experience with homelessness
* approved for PSH
* proficient in English
* able to provide informed consent

Exclusion Criteria:

* aged younger than 18
* not approved for PSH
* not proficient in English
* unable to provide informed consent

Primary outcomes:
measure: Life Satisfaction
timeFrame: Change of Life satisfaction from baseline to 6 months
measure: Quality of physical health
timeFrame: Change in quality of physical health from baseline to 6 months
measure: Degree of mental health symptomatology
timeFrame: Change in symptomatology from baseline to 6 months
measure: Social Isolation
timeFrame: Change in social isolation from baseline to 6 months
measure: Housing Environment
timeFrame: Change in satisfaction with housing environment from baseline to 6 months
Secondary outcomes:
measure: COVID-19 Prevention practices
timeFrame: Change in use of prevention practices from baseline to 6 months
measure: Healthcare Utilization
timeFrame: Change in utilization from baseline to 6 months
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: Los Angeles Homeless Services Authority (LAHSA)
state: California
Study officials:
affiliation: University of Southern California
name: Benjamin Henwood
role: PRINCIPAL_INVESTIGATOR
References: