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Homelessness is a global challenge.

The United Nations Human Settlements Program estimates that 1.1 billion people live in inadequate housing, and the best data available suggest that more than 100 million people have no housing at all.

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Engagement in the Hepatitis C Care Cascade Among Homeless Veterans, 2015

The Veterans Health Administration (VHA) is the largest provider of hepatitis C virus (HCV) care nationally and provides health care to >200 000 homeless veterans each year. We used the VHA’s Corporate Data Warehouse and HCV Clinical Case Registry to evaluate engagement in the HCV care cascade among homeless and nonhomeless veterans in VHA care in 2015. We estimated that, among 242 740 homeless veterans in care and 5 424...

Engaging homeless service providers in educational efforts during a tuberculosis outbreak in Atlanta

During an outbreak of tuberculosis (TB) in the homeless population of metropolitan Atlanta, education of homeless service providers (HSPs) about the implementation of local infection control measures was imperative to limiting the spread of TB and to preventing future outbreaks. By use of educational sessions and teaching posters, two interventions were designed to focus educational efforts from November 2014 to August 2015:...

Using Peer Navigators to Address the Integrated Health Care Needs of Homeless African Americans With Serious Mental Illness

The study examined the impact of a peer navigator program (PNP) developed by a community-based participatory research team and used with a group of African Americans with serious mental illness who were homeless. Sixty-seven research participants were randomly assigned to receive PNP or treatment as usual (control) for one year. Data on general health and mental health, recovery, and quality of life were collected at...

Screening for Food Insecurity in Six Veterans Administration Clinics for the Homeless, June–December 2015

Thomas P. O’Toole

Christopher B. Roberts

Erin E. Johnson

This study assessed findings from a food-insecurity screening of a national sample of Veterans Administration clinics for homeless and formerly homeless veterans. Researchers reviewed results from initial screenings administered at 6 Veterans Administration primary care clinics for the homeless and responses from clinic staff members interviewed about the screening program. A total of 270 patients were screened. The average...

Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons into Spatial Analyses

Tuberculosis (TB) causes significant morbidity and mortality in U.S. cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine if local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address. Data were abstracted for patients with TB disease diagnosed 2008-...

Residential Status and Transportation Are Associated With Improved Retention in Care for Homeless Patients Testing Positive for Hepatitis C Virus

Stephanie Preston

Frances Lee

Jane Andrews

Hepatitis C virus (HCV) infection is an epidemic that disproportionately affects those removed from the healthcare system. These populations include intravenous drug users (IVDU), incarcerated persons, and the homeless. In addition to screening in a variety of clinical settings, testing in non-clinical, community settings is necessary to identify all cases of HCV infection. This study describes rapid HCV testing and retention...

Sexual health, vulnerabilities and risk behaviours among homeless adults

It is well known that homeless individuals are at risk for a variety of health problems, including sexually transmissible infections. Optimisation of health services for the homeless requires knowledge of their sexual health. The sexual health and sexual vulnerability factors of 500 homeless adults (196 women) were assessed in a cross-sectional survey in three Canadian cities. Data indicate that a significant proportion of...

Perceptions of Veteran and Previously Homeless Employability

Jennifer Cook

The present study sought to explore the effects of implicit attitudes on the employability of veterans, previously homeless individuals, and previously homeless veterans. Trend effects revealed veterans were perceived as less dedicated, but better able to handle stress. Previously homeless veterans were given longer occupational probation periods and were paid significantly less by female participants, regardless of being...

The effectiveness of a Housing First adaptation for ethnic minority groups: findings of a pragmatic randomized controlled trial

Little is known about the effectiveness of Housing First (HF) among ethnic minority groups, despite its growing popularity for homeless adults experiencing mental illness. This randomized controlled trial tests the effectiveness of a HF program using rent supplements and intensive case management, enhanced by anti-racism and anti-oppression practices for homeless adults with mental illness from diverse ethnic minority...

Which Homeless Veterans Benefit From a Peer Mentor and How?

Veterans Affairs (VA) is expanding peer support. Research is limited on Veterans’ perspective on benefits from peer services. This study describes homeless Veteran perceptions of value and examine characteristics associated with benefit. From a sample of Veterans in a multisite randomized control trial, the study examines addition of peers in VA Primary Care and homeless-oriented primary care clinics. We used qualitative...

Patterns and predictors of engagement in peer support among homeless veterans with mental health conditions and substance use histories

Marsha Langer Ellison

Chantele Mitchell-Miland

David Smelson

Susan Eisen

Patterns and predictors of engagement in peer support services were examined among 50 previously homeless veterans with co-occurring mental health conditions and substance use histories receiving services from the Veterans Health Administration supported housing program. Veteran peer specialists were trained to deliver sessions focusing on mental health and substance use recovery to veterans for an intended 1-hr weekly...

Mental and Physical Health among Homeless Sexual and Gender Minorities in a Major Urban US City

Sexual and gender minorities have been shown to have greater rates of mental health, substance use disorders, and specific types of health problems compared to heterosexuals. Among the homeless population in several US urban areas, sexual and gender minorities are overrepresented but few studies have examined the mental and physical health status of homeless sexual and gender minorities, with studies on homeless gender...

Appendix C: Homeless Participant Interview

2007 Street Health Toronto

Homeless participant interview.

A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters

Stuart W. Grande

Mary Ganger Castaldo Elizabeth Carpenter-Song

Ida Griesemer

Glyn Elwyn

Are the benefits of recording clinical encounters shared across different groups, or do they vary based on social position? Studies show that educated patients record their clinical visits to enhance their experience, but very little is known about recording benefits among “hard-to-reach” populations. The object to examine the reactions of homeless people to the idea of using a smartphone to record their own clinical...

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

Kirk Dombrowski

Kelley Sittner

Devan Crawford

Melissa Welch-Lazoritz

Patrick Habecker

Bilal Khan

During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in...

"Hospital was the Only Option": Experiences of Frequent Emergency Department Users in Mental Health

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...

Substance Use Among Homeless Individuals with Schizophrenia and Bipolar Disorder

Angelo G.I. Maremmani

The comorbidity of psychiatric disorders and drug use is a well-documented and widespread problem. In particular, substance abuse in individuals with schizophrenia shows a high degree of comorbidity, as does substance use disorder (SUD) in populations suffering from mood disorders as indicated by a lifetime prevalence of over 50% for individuals with BD. The patterns of comorbidity of SUDs, SS, and BD among homeless...

U.S. Minority Homeless Youth’s Access to and Use of Mobile Phones: Implications for mHealth Intervention Design

Donaldson F. Conserve

Lawrence J. Cheskin

Few interventions for homeless youth have leveraged the potential of mHealth technologies, in part because of the limited data on phone behaviors, perceptions, and intervention preferences among youth experiencing homelessness. This study conducted 9 focus groups and 41 individual structured interviews also with homeless youth in underserved communities in Baltimore and Washington, DC, to ascertain how youth perceived their...

A Cost-Benefit Analysis of a Canadian Managed Alcohol Program

In March 2012, Shelter House opened a 15-bed Managed Alcohol Program (MAP) at the Kwae Kii Win Centre in Thunder Bay, Ontario. The mission of Shelter House (2013, p. 5) is “to provide basic needs, dignity, and comfort to people living in poverty and stimulate action to address the root causes of homelessness.” At the Kwae Kii Win Centre, MAP participants are provided with permanent access to adequate housing and supports to...

Managed Alcohol: Housing, Health & Hospital Diversion

In addition to decreasing EMS, Emergency Department, hospitalization and law enforcement utilization rates, Managed Alcohol Programs have effectively improved the quality of life, health and well-being of homeless adults consuming non-beverage alcohol. The model responds to the specialized needs of a population that, at present, is typically displaced and vulnerable in the City of London. These clients are historically...

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