MPH, is a doctoral candidate and research associate, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, University of Texas at Austin, 1823 Red River Street, Austin, TX 78712, USA.
PhD, is a research associate, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA.
Health Soc Work. 2024 Apr 29;49(2):87-94. doi: 10.1093/hsw/hlae002.
Homelessness is a complex public health problem in the United States. Current or ongoing history of trauma among individuals adds to the complexity and challenges of homelessness. Our study assessed the moderating role of self-harm in the association between emergency department (ED) service utilization and trauma-induced homelessness (TIH) among adults in Texas. Homeless adults (N = 282) who completed their baseline Vulnerability Index Service Prioritization Decision Assistance Prescreen Tool survey between February 2021 and February 2022 at a Local Mental Health Authority in Texas were selected. The outcome variable, TIH, was assessed by current period of homelessness due to experiencing trauma or abuse. The main independent variable was ED utilization, while self-harm in the past year was assessed as the moderating variable. A multivariate logistic regression with a moderation analysis was conducted while adjusting for the covariates. Individuals who utilized ED services and engaged in self-harm and risky behaviors had greater odds of experiencing current period of TIH. Male respondents were less likely to experience TIH. Finally, engaging in self-harm significantly moderated the association between ED service use and TIH. This study may help inform efforts to develop tailored interventions and promote resilience-based approaches to improve health outcomes among individuals experiencing homelessness due to TIH.
在美国，无家可归是一个复杂的公共卫生问题。个体当前或持续存在的创伤史增加了无家可归问题的复杂性和挑战。我们的研究评估了自我伤害在德克萨斯州成年人急诊部门（ED）服务利用与创伤导致的无家可归（TIH）之间关联中的调节作用。选择了 2021 年 2 月至 2022 年 2 月在德克萨斯州当地心理健康管理局完成基线脆弱性指数服务优先排序决策辅助预筛选工具调查的无家可归成年人（N=282）。结果变量 TIH 通过因经历创伤或虐待而导致的当前无家可归期来评估。主要自变量为 ED 利用，而过去一年的自我伤害被评估为调节变量。在调整协变量的情况下进行了多变量逻辑回归和调节分析。利用 ED 服务并进行自我伤害和危险行为的个体更有可能经历当前的 TIH 期。男性受访者不太可能经历 TIH。最后，自我伤害显著调节了 ED 服务利用与 TIH 之间的关联。这项研究可能有助于为因 TIH 而无家可归的个体制定量身定制的干预措施和促进基于恢复力的方法提供信息，以改善他们的健康结果。
