Johnson Erin E, Borgia Matthew, Rose Jennifer, O'Toole Thomas P
VA National Center on Homelessness Among Veterans.
Providence VA Medical Center COIN.
Psychol Serv. 2017 May;14(2):167-173. doi: 10.1037/ser0000124.
It is well established that providing stable housing to homeless persons improves health outcomes. It is less clear whether engagement in clinical care facilitates housing outcomes. We present a post hoc analysis of a prospective, community-based randomized controlled trial of homeless veterans not actively receiving or assigned to a primary care. Study subjects were interviewed at baseline, 1 month and 6 months and survey results were supplemented/verified by review of all notes in their VA electronic medical record for 6 months postenrollment. A total of 142 subjects with complete data were included in this analysis: 82 (57.7%) were in a stable sheltering/housing arrangement (transitional housing, stably doubled-up, independent housing) at baseline and stayed stable; 36 (25.4%) started in an unstable sheltering arrangement (unsheltered, emergency sheltered, unstable doubled-up arrangement) and moved into stable sheltering/housing while 24 (17.0%) individuals either started in and stayed unstably sheltered or went from a stable to an unstable arrangement. Of 36 individuals who transitioned from unstable to stable sheltering/housing, 25 (69.4%) accessed primary care within 1 month compared with 37.5% of the persistently unstable sheltering group and 57.3% of the stably sheltered/housed group (p = .05). Of those with care within 1 month, their average time from unstable to stable housing was 84.8 days compared with 165.9 days for those who do not access care (p = .02). Of those receiving primary care within 1 month of enrollment, 88.9% were in stable sheltering at 6 months. These findings suggest an important role for clinical engagement in helping achieve housing stability for homeless veterans. (PsycINFO Database Record
为无家可归者提供稳定住房能改善健康状况，这一点已得到充分证实。而参与临床护理是否有助于实现住房改善尚不清楚。我们对一项针对未积极接受或被分配初级护理的无家可归退伍军人的前瞻性、基于社区的随机对照试验进行了事后分析。在基线、1个月和6个月时对研究对象进行访谈，并通过查阅其退伍军人事务部电子病历中入组后6个月的所有记录来补充/核实调查结果。本分析共纳入142名有完整数据的受试者：82名（57.7%）在基线时处于稳定的庇护/住房安排（过渡性住房、稳定合住、独立住房）且保持稳定；36名（25.4%）开始时处于不稳定的庇护安排（无庇护、紧急庇护、不稳定合住安排）并迁入稳定的庇护/住房，而24名（17.0%）个体要么开始时处于不稳定的庇护状态并一直保持，要么从稳定状态转变为不稳定状态。在从不稳定转变为稳定庇护/住房的36名个体中，25名（69.4%）在1个月内接受了初级护理，相比之下，持续不稳定庇护组的这一比例为37.5%，稳定庇护/住房组为57.3%（p = 0.05）。在1个月内接受护理的人中，他们从不稳定住房到稳定住房的平均时间为84.8天，而未接受护理的人则为165.9天（p = 0.02）。在入组后1个月内接受初级护理的人中，88.9%在6个月时处于稳定庇护状态。这些发现表明临床参与在帮助无家可归退伍军人实现住房稳定方面发挥着重要作用。（PsycINFO数据库记录）
