Department of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2701 N. Summit Ave., Milwaukee, WI, 53202, USA.
Qual Life Res. 2020 Aug;29(8):2051-2061. doi: 10.1007/s11136-020-02482-w. Epub 2020 Mar 28.
Permanent supportive housing (PSH) is an effective intervention to improve residential stability and reduce the utilization of costlier healthcare services for the chronically homeless. However, there has been little focus on health-related quality of life (HRQL) once they enter PSH, and the potential influence of other factors including the PSH model. Study results can shed light on the HRQL of the PSH population and inform strategies to improve PSH program effectiveness in this area.
In this cross-sectional study, survey methods were used to assess the HRQL of PSH residents in the Chicago metropolitan area. The survey also included questions on socio-demographics, health behaviors, housing and neighborhood characteristics, and housing satisfaction. The SF-36 was used to obtain physical (PCS) and mental component summary (MCS) scores for HRQL. Other variables were selected using the Wilson and Cleary HRQL model. Statistical analyses included summary statistics, bivariate analyses, and fully adjusted linear regression models.
The study sample included 855 adults currently in PSH. The sample was predominantly African American men with an average age of 53 years. Mean scores for PCS and MCS were 39.4 and 46.1, respectively, (out of 100). In adjusted analyses, older age and being on disability were associated with worse PCS. Having HIV was associated with better PCS. Being non-Hispanic Black, living in fixed-sited housing, and being in PSH for longer durations were associated with better MCS. More depressive symptoms was associated with worse PCS and MCS.
While both aspects of the PSH model (housing configuration and service provision) were initially associated with HRQL in unadjusted analyses, housing configuration was the only PSH model variable that remained significant once accounting for other factors. Depressive symptomology and the social environment also appear to be important correlates of HRQL and are potential areas to target in PSH programs.
永久性支持性住房（PSH）是一种有效的干预措施，可改善长期无家可归者的居住稳定性并减少对成本更高的医疗保健服务的利用。然而，他们进入 PSH 后，很少关注与健康相关的生活质量（HRQL），也很少关注其他因素的潜在影响，包括 PSH 模式。研究结果可以阐明 PSH 人群的 HRQL，并为改善这一领域的 PSH 计划效果提供策略。
在这项横断面研究中，使用调查方法评估了芝加哥大都市区 PSH 居民的 HRQL。该调查还包括社会人口统计学、健康行为、住房和邻里特征以及住房满意度的问题。SF-36 用于获取 HRQL 的身体成分（PCS）和心理成分综合（MCS）评分。其他变量使用 Wilson 和 Cleary HRQL 模型选择。统计分析包括汇总统计、双变量分析和完全调整的线性回归模型。
研究样本包括 855 名目前在 PSH 的成年人。该样本主要是年龄在 53 岁左右的非裔美国男性。PCS 和 MCS 的平均得分分别为 39.4 和 46.1（满分 100 分）。在调整分析中，年龄较大和残疾与较差的 PCS 相关。患有 HIV 与较好的 PCS 相关。非西班牙裔黑人、居住在固定住房中和在 PSH 中居住时间较长与较好的 MCS 相关。更多的抑郁症状与较差的 PCS 和 MCS 相关。
虽然 PSH 模型的两个方面（住房配置和服务提供）在未调整分析中最初与 HRQL 相关，但在考虑其他因素后，住房配置是唯一与 HRQL 相关的 PSH 模型变量。抑郁症状和社会环境似乎也是 HRQL 的重要相关因素，也是 PSH 计划的潜在目标领域。
