Understanding the dynamic process of human behavior changes towards disaster preparedness: an application of the integrated TTM with SCT and PMT.

Integrating the Transtheoretical Model with Social Cognitive Theory and Protection Motivation Theory, we propose a new model to study the progress of behavior changes towards disaster preparedness along three developmental stages: from "not prepared" (NP), to "intention to prepare" (IP), to "already prepared" (AP). Using the 2021 National Household Survey data (FEMA, N = 6,180), we tested this model by employing a series of nested weighted generalized ordered logistic regressions. We found that, although Hispanics have a larger prevalence of IP than their non-Hispanic white counterparts, they are less likely to move to the AP stage.

Leveraging integrated data for program evaluation: Recommendations from the field.

Use of administrative data to inform decision making is now commonplace throughout the public sector, including program and policy evaluation. While reuse of these data can reduce costs, improve methodologies, and shorten timelines, challenges remain. This article informs evaluators about the growing field of Integrated Data Systems (IDS), and how to leverage cross-sector administrative data in evaluation work.

Moving on trial: protocol for a pilot randomised controlled trial of models of housing and support to reduce risks of COVID-19 infection and homelessness.

Background: It is estimated that around 160,000 households in Britain experience homelessness each year, although no definitive statistics exist. Between March and September 2020, as part of the initial 'Everyone In' government response to COVID-19 in England, 10,566 people were living in emergency accommodation and nearly 18,911 people had been moved into settled accommodation. However, some forms of temporary accommodation may not be suitable as shared facilities make it impossible for people to adhere to government guidelines to reduce the spread of COVID-19.

Development of a homelessness risk screening tool for emergency department patients.

Objective: To develop a screening tool to identify emergency department (ED) patients at risk of entering a homeless shelter, which could inform targeting of interventions to prevent future homelessness episodes.

Data Sources: Linked data from (1) ED patient baseline questionnaires and (2) citywide administrative homeless shelter database.

Study Design: Stakeholder-informed predictive modeling utilizing ED patient questionnaires linked with prospective shelter administrative data.

At the Intersection of Homeless Encampments and Heroin Addiction: Service Use Barriers, Facilitators, and Recommendations from the City of Philadelphia's Encampment Resolution Pilot.

We provide an overview of the pilot and evaluation measures used for an independent evaluation of the Encampment Resolution Pilot (ERP) wherein the City of Philadelphia closed two homeless encampments in May 2018 and sought to assist those displaced by the closures with housing and treatment services. The evaluation used the Rapid Assessment, Response, and Evaluation method to collect qualitative findings on service use barriers and facilitators from open-ended interviews with people staying in the encampments (N = 27) and service providers (N = 10). We assessed how the ERP allowed providers to "push the system" by removing access barriers, and providing amenable, effective, and accessible housing and drug treatment services that led to more widely adopted best practices.

Association Between Registered Sex Offender Status and Risk of Housing Instability and Homelessness among Veterans.

Research is limited about whether and to what extent registered sex offenders (RSOs) face an increased risk of housing instability. The intersection of RSO and housing instability is particularly salient for veterans as there are disproportionately higher rates of veterans among both RSOs and homeless populations. This study assessed the relationship between RSO status and risk of housing instability and homelessness among military veterans.

Association of Homelessness with Hospital Readmissions-an Analysis of Three Large States.

Background: Individuals experiencing homelessness have higher hospitalization and mortality rates compared with the housed. Whether they also experience higher readmission rates, and if readmissions vary by region or cause of hospitalization is unknown.

Objective: Evaluate the association of homelessness with readmission rates across multiple US states.

Homeless Shelter Entry in the Year After an Emergency Department Visit: Results From a Linked Data Analysis.

Study Objective: Housing instability is prevalent among emergency department (ED) patients and is known to adversely affect health. We aim to determine the incidence and timing of homeless shelter entry after an ED visit among patients who are not currently homeless.

Methods: We conducted a random-sample survey of ED patients at an urban public hospital from November 2016 to September 2017.

When Crises Converge: Hospital Visits Before And After Shelter Use Among Homeless New Yorkers.

People who are homeless use more hospital-based care than average, yet little is known about how hospital and shelter use are interrelated. We examined the timing of emergency department (ED) visits and hospitalizations relative to entry into and exit from New York City homeless shelters, using an analysis of linked health care and shelter administrative databases. In the year before shelter entry and the year following shelter exit, 39.

Gender Differences in Factors Associated with Unsheltered Status and Increased Risk of Premature Mortality among Individuals Experiencing Homelessness.

Background: Among individuals experiencing homelessness, unsheltered status is associated with poor health and access to care and an increased risk for premature death. Insufficient research has explored gender differences in these outcomes; the objective of this study was to address this gap in the research.

Methods: This study used survey data collected during the 100,000 Homes Campaign.

Homelessness, Unsheltered Status, and Risk Factors for Mortality: Findings From the 100 000 Homes Campaign.

Objectives: People who live in unsheltered situations, such as the streets, often have poorer health, less access to health care, and an increased risk of premature mortality as compared with their sheltered counterparts. The objectives of this study were to (1) compare the characteristics of people experiencing homelessness who were sleeping primarily in unsheltered situations with those who were accessing homeless shelters and other sheltered situations, (2) identify correlates of unsheltered status, and (3) assess the relationship between unsheltered status and increased risk of mortality.

Methods: Using primary data collected as part of the 100    000 Homes Campaign-a national effort to help communities find homes for vulnerable and chronically homeless Americans-we estimated 2 generalized linear mixed models to understand the correlates of unsheltered status and risk factors for mortality.

Posthumously Assessing a Homeless Population: Services Use and Characteristics.

Objective: Data on services use, characteristics, and geographic distribution of homeless individuals who died in Philadelphia from 2009 to 2011 provided perspective on assessments of the homeless population that rely on conventional counts and surveys.

Methods: Data from the City of Philadelphia Medical Examiner's Office were used to parse homeless decedents into three groups on the basis of use of homelessness services (known users, occasional users, and nonusers), and differences among the groups were assessed by using descriptive and multivariate methods.

Results: Of 141 adult decedents, 49% made substantial use of the homelessness services system (known users), 27% made occasional use of these services (occasional users), and 24% had no record of use of homelessness services (nonusers).

Characteristics and Likelihood of Ongoing Homelessness Among Unsheltered Veterans.

Introduction: Unsheltered homelessness is an important phenomenon yet difficult to study due to lack of data. The Veterans Health Administration administers a universal homelessness screener, which identifies housing status for Veterans screening positive for homelessness.

Methods: This study compared unsheltered and sheltered Veterans, assessed differences in rates of ongoing homelessness, and estimated a mixed-effect logistic regression model to examine the relationship between housing status and ongoing homelessness.

Screening for Homelessness in the Veterans Health Administration: Monitoring Housing Stability through Repeat Screening.

Objective: This study examined veterans' responses to the Veterans Health Administration's (VHA's) universal screen for homelessness and risk of homelessness during the first 12 months of implementation.

Methods: We calculated the baseline annual frequency of homelessness and risk of homelessness among all veterans who completed an initial screen during the study period. We measured changes in housing status among veterans who initially screened positive and then completed a follow-up screen, assessed factors associated with such changes, and identified distinct risk profiles of veterans who completed a follow-up screen.

Homeless Veterans Eligible for Medicaid Under the Affordable Care Act.

Objective: Among homeless veterans and those at risk of homelessness currently enrolled in Veterans Affairs (VA) health care, this study examined the proportion likely to become eligible for Medicaid in 2014 and their health needs.

Methods: A total of 114,497 homeless and at-risk veterans were categorized into three groups: currently covered by Medicaid, likely to become eligible for Medicaid, and not likely.

Results: Seventy-eight percent of the sample was determined to be likely to become eligible for Medicaid in states that expand Medicaid.

Testing Alternative Definitions of Chronic Homelessness.

Objective: This study examined the potential impact of a proposed change to the official federal definition of chronic homelessness.

Methods: Using administrative data from the emergency shelters in a large U.S.

Development and validation of an instrument to assess imminent risk of homelessness among veterans.

Objectives: Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S.

Validation of self-reported veteran status among two sheltered homeless populations.

Objectives: We assessed the accuracy of self-reported veteran status among sheltered homeless adults to assess the reliability of using self-report to determine the number of veterans in homeless populations and examine whether there are demographic correlates to inaccurate reporting of veteran status.

Methods: Records on 5,860 sheltered adults from Columbus, Ohio, and 16,346 sheltered adults from New York City (NYC) were matched with U.S.

Risk factors for becoming homeless among a cohort of veterans who served in the era of the Iraq and Afghanistan conflicts.

Objectives: In this population-based cohort study, we assessed baseline risk factors for homelessness, including the role of service in the Iraq or Afghanistan conflicts, among a large cohort of recent veterans.

Methods: Data for this study came from administrative records for 310,685 veterans who separated from active military duty from July 1, 2005, to September 30, 2006. We used survival analysis methods to determine incidence rates and risk factors for homelessness, based on baseline data for military factors, demographic characteristics, and diagnoses of behavioral health disorders and traumatic brain injury.

Relationship among adverse childhood experiences, history of active military service, and adult outcomes: homelessness, mental health, and physical health.

Objectives: We determined whether a report of adverse childhood experiences predicts adult outcomes related to homelessness, mental health, and physical health and whether participation in active military service influences the relationship between childhood and adult adversity.

Methods: Using data from the 2010 Washington State Behavioral Risk Factor Surveillance System, we tested by means of logistic regression the relationship between adverse childhood experiences and 3 adult outcomes--homelessness, mental health, and physical health--as well as differences among those with a history of active military service.

Results: Adverse childhood experiences separately predicted increased odds of experiencing homelessness as an adult and mental health and physical health problems.

Community-level characteristics associated with variation in rates of homelessness among families and single adults.

Objectives: We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics.

Methods: We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions.

Results: Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models.