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Publication Date: 2019
Health utility assessments are important for economic evaluations but few instruments have been validated in homeless people with mental illness. We examined the convergent validity of the EuroQol-5 Dimension 3-level questionnaire (EQ-5D-3L) as a measure of quality of life in homeless adults with mental illness.
Publication Date: 2017
Background
Little is known about homeless patients in intensive care units (ICUs).
Objectives
To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital.
Methods
63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients.
Results
Compared to matched non-homeless, homeless patients (average age 48±12 y...
Publication Date: 2017
Objectives:
This study aimed to identify challenges and facilitators of sustaining a Housing First intervention at the conclusion of a research demonstration project in Toronto.
Methods:
This qualitative study included key informant interviews with organizational leaders (N=13) and focus groups with service team members (N=14) and program participants (N=9) of the At Home/Chez Soi Research Demonstration Project. Thematic analysis was used to iden...
Publication Date: 2017
Objective
Chronic pain is an important public health issue. However, characteristics and needs of marginalized populations have received limited attention. Studies on prevalence and correlates of chronic pain among homeless persons are lacking. We assessed chronic pain among homeless persons with mental illness in the At Home/Chez Soi study.
Design
Cross-sectional data from a randomized controlled trial on homelessness and mental health.
Setting...
Publication Date: 2017
OBJECTIVES:
The objective of the study is to characterize the associations between a history of incarceration and subsequent housing stability over a two-year follow-up period among a sample of homeless and vulnerably housed individuals.
METHODS:
The study was a prospective cohort study of homeless and vulnerably housed adults in three Canadian cities. Between 2009 and 2012, data were collected using structured, in-person interviews at baseline...
Publication Date: 2017
Objective:
This study attempted to determine if Housing First (HF) decreased suicidal ideation and attempts compared to treatment as usual (TAU) amongst homeless persons with mental disorders, a population with a demonstrably high risk of suicidal behaviour.
Method:
The At Home/Chez Soi project is an unblinded, randomised control trial conducted across 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montreal, Moncton) from 2009 to 2013....
Publication Date: 2017
Objective
This study compares the effect of Housing First on older (≥50 years old) and younger (18–49 years old) homeless adults with mental illness participating in At Home/Chez Soi, a 24-month multisite randomized controlled trial of Housing First.
Method
At Home/Chez Soi, participants (n = 2148) were randomized to receive rent supplements with intensive case management or assertive community treatment, based on their need level for mental hea...
Publication Date: 2017
The Coordinated Access to Care for Homeless People (CATCH) program is a brief multidisciplinary case management intervention for homeless adults discharged from hospital in Toronto, Canada. Here we describe the rationale for CATCH program development, details of the mixed methods evaluation underway, and the characteristics of 225 CATCH service users. Funded in 2010 by the local health authority, CATCH aimed to improve access, continuity of care,...
Publication Date: 2016
This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually fo...
Publication Date: 2017
Advance care planning is relevant for homeless individuals because they experience high rates of morbidity and mortality. The impact of advance directive interventions on hospital care of homeless individuals has not been studied. The objective of this study was to determine if homeless individuals who complete an advance directive through a shelter-based intervention are more likely to have information from their advance directive documented and...
Publication Date: 2016
Objective
To characterize the prevalence of self-reported head injury with loss of consciousness (LOC) and associated demographic, clinical and service use factors in a sample of homeless adults with mental illness.
Method
Participants in the At Home/Chez Soi study were interviewed at the time of study enrollment regarding their history of head injuries, mental and physical health diagnoses, and justice system and healthcare interactions. Sociode...
Publication Date: 2016
Purpose
The purpose of this study was to examine whether homeless or vulnerably housed individuals experienced response shift over a 12-month time period in their self-reported physical and mental health status.
Methods
Data were obtained from the Health and Housing in Transition study, a longitudinal multi-site cohort study in Canada (N = 1190 at baseline). Multi-group confirmatory factor analysis (MG-CFA) and methods for response shift detec...
Publication Date: 2016
Objective:
To examine the factors associated with incident traumatic brain injury (TBI) among homeless and vulnerably housed persons over a 3-year follow-up period.
Setting and participants:
Data were obtained from the Health and Housing in Transition study, which tracked the health and housing status of 1190 homeless or vulnerably housed individuals in 3 Canadian cities for 3 years.
Design and Main Measures:
Main measure was self-reported incide...
Publication Date: 2016
Abstract
Background
Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with h...
Publication Date: 2016
Most of the research on gambling behaviour among youth has been quantitative and focused on measuring prevalence. As a result, little is known about the contextual experiences of youth gambling, particularly among those most vulnerable. In this paper, we explore the previous experiences of youth gambling in a sample of adult men experiencing housing instability and problem gambling. We present findings from a qualitative study on problem gambling...
Publication Date: 2016
The experiences of individuals with mental illness and addictions who frequently present to hospital emergency departments (EDs) have rarely been explored. This study reports findings from self-reported, quantitative surveys (n = 166) and in-depth, qualitative interviews (n = 20) with frequent ED users with mental health and/or substance use challenges in a large urban centre. Participants presented to hospital for mental health (35 %), alcohol/d...
Publication Date: 2016
Researchers, policy-makers, and political leaders in Canada and the US are championing the ‘Housing First’ (HF) intervention as a solution to homelessness. HF supplies people experiencing both homelessness and challenges around mental health with housing and a range of supports that can include case-coordination, psychiatry, and primary care. While HF’s impact on the housing status of individual participants has received considerable scientific a...
Publication Date: 2016
Phenomenon
Homelessness is a major public health concern. Given that homeless individuals have high rates of mortality and morbidity, are more likely to be users of the healthcare system, and often report unmet health needs, it is important to examine how homelessness is addressed in medical education. We wanted to examine content and framing of issues related to homelessness in the case-based learning (CBL) curriculum and provide insights about...
Publication Date: 2015
Objectives
Research suggests that homeless people with mental illness may have difficulty obtaining employment and disability benefits. Our study provides a comprehensive description of sources of income and employment rates in a large Canadian sample.
Methods
Participants (n = 2085) from the 5 sites of the At Home/Chez Soi study were asked about their income, employment, and desire for work during the pre-baseline period. The proportion of parti...
Publication Date: 2015
Objectives
Medication adherence is an important determinant of successful medical treatment. Marginalized populations, such as homeless and vulnerably housed individuals, may face substantial barriers to medication adherence. This study aimed to determine the prevalence of, reasons for, and factors associated with medication nonadherence among homeless and vulnerably housed individuals. Additionally, we examined the association between medication...