Life Meaning in a Social Context Among Formerly Homeless Residents of Permanent Supportive Housing.

Objective: Experiencing a life of meaning is considered fundamental to "what makes life worth living," yet investigation of life meaning among persons with lived experiences of homelessness is lacking. This study seeks to understand life meaning among formerly homeless residents of permanent supportive housing through an examination of its association with social context.

Method: Data were collected through interviews with 383 persons with experience of chronic homelessness who were provided permanent supportive housing (PSH).

Distance Between Home and the Admitting Hospital and Its Effect on Survival of Low Socioeconomic Status Population With Bacteremia.

Objective: Bacteremia is the presence of bacteria in the bloodstream. The objective of this study was to determine the relationship between low socioeconomic status (SES) and the epidemiology, process of care, and outcomes of patients with bacteremia (SAB).

Methods: We conducted a multicenter, retrospective, cohort study that evaluated adult patients with SAB in 3 Los Angeles County hospitals from July 15, 2012, through May 31, 2018.

Mental health change in the transition to permanent supportive housing: The role of housing and social networks.

Aims: Permanent Supportive Housing (PSH) may improve homeless adults' mental health via housing stabilization and/or improved relational factors, however, the role of housing and social networks on PSH residents' mental health change is minimally understood.

Methods: Interviews were conducted with a baseline sample of adults experiencing homelessness ( N = 421), across their initial year in PSH (3-months, 6-months, and 12-months). Generalized linear mixed models assessed changes in positive past-month psychiatric disability screenings (Modified-Colorado Symptom Index [MCSI]) and probable posttraumatic stress disorder (PC-PTSD) in controlled models, and between and within-subject effects of time-varying social network correlates on mental health changes.

Child Abuse Victimization, Depression, and Substance Use Among Homeless Women: Application of General Strain Theory.

The main purpose of this study was to investigate the association between child abuse and substance use among homeless women based on a framework of General Strain Theory, which emphasizes the strong relationship between deviant behaviors and personally experienced strain. In this study, as the strain associated with substance use, child abuse experience in the past was assessed. This research tested three hypotheses about (a) the association between physical and sexual abuse during childhood and substance use (heavy drinking, marijuana use, and crack cocaine use), (b) the mediating effect of depressive symptoms, and (c) the moderating effect of positive social supports on the relationship between abuse during childhood and substance use with a survey and interview data of a randomly selected sample of 445 homeless women in a temporary shelter setting in Los Angeles County between June 2007 and March 2008.

Changes in Self-Rated Physical Health After Moving Into Permanent Supportive Housing.

Purpose: Homelessness is associated with poor health outcomes and heightened risk of premature mortality. Permanent supportive housing (PSH) is a key solution for ending homelessness, but there is insufficient evidence of a relationship between PSH and improvements in physical health. Self-rated health-a consistent predictor of mortality-is a meaningful approach to understanding health improvements in PSH.

Do HIV risk and prevention behaviors change over time among adults in permanent supportive housing?

Persons experiencing homelessness have a disproportionate burden of HIV infection and high rates of HIV risk behavior. Permanent supportive housing (PSH) has been identified as a primary solution to homelessness, but little is known about HIV sexual risk behavior among persons in PSH, nor about how HIV risk and prevention behavior may change as persons move from homelessness into PSH. Utilizing longitudinal data from 421 persons prior to moving in and over their first year living in PSH, this study assesses change over time in HIV risk and prevention behavior utilizing generalized linear mixed models.

Everyday discrimination among formerly homeless persons in permanent supportive housing.

Experiences of discrimination are associated with poor health and are particularly common among persons experiencing homelessness. Permanent supportive housing (PSH) provides a foundation for improved well-being among persons with homelessness histories, but research on discrimination among this population is lacking. We examined changes in experiences of, and perceived reasons for, everyday discrimination when persons moved into PSH.

Social networks and substance use after transitioning into permanentsupportive housing.

Background: Substance use disorders are common among persons experiencing homelessness, and research has identified social networks as important correlates of substance use in this population. Permanent supportive housing (PSH), particularly Housing First, which uses a harm reduction model not requiring substance abstinence, is a key solution for ending homelessness. However, conflicting evidence exists regarding the associations between moving into PSH and changes in substance use, and there is limited understanding of how networks may influence such changes.

Understanding Risk Environments in Permanent Supportive Housing for Formerly Homeless Adults.

In this study, we used ethnographic methods and a risk environment framework to consider how contextual factors produce or reduce risk for substance use with a sample of 27 adults who recently moved into permanent supportive housing (PSH). Most apparent was how the social and physical environments interacted, because most participants focused on how having an apartment had dramatically changed their lives and how they interact with others. Specific themes that emerged that also involved economic and policy environments included the following: isolation versus social engagement; becoming one's own caseworker; and engaging in identity work.

What's next? A grounded theory of the relationship between ontological security, mental health, social relationships, and identity formation for young adults in supportive housing.

This qualitative study of 29 young adults (aged 18-25) living in permanent supportive housing (PSH) resulted in a grounded theory that shows how PSH generally provides a sense of for young adults-much like for older adults-who are also experiencing significant developmental change processes. Simply stated, ontological security refers to a concept of well-being in the world that is rooted in a sense of order in one's social and material environment. Thematic analyses indicated that the presence of markers of ontological security (for example, constancy, routine, control) positively affected participants' mental health and well-being, which helped with positive identity construction.

Availability of comprehensive services in permanent supportive housing in Los Angeles.

Studies have often described a specific model or models of permanent supportive housing (PSH), yet few studies have systematically examined what services are typically offered to PSH tenants in any given service system and how those services are offered. Using telephone surveys from 23 PSH agency supervisors and qualitative data collected from 11 focus groups with 60 frontline providers and 17 individual interviews with supervisors from a subset of surveyed agencies-all of which were completed between July 2014 and December 2015-the goal of this study is to better understand what services are being offered in PSH organisations located in Los Angeles and what barriers frontline providers face in delivering these services. Survey findings using statistical frequencies suggest the existence of robust support services for a high-needs population and that single-site providers may offer more services than scatter-site providers.

Examining the health status of homeless adults entering permanent supportive housing.

Background: Permanent supportive housing (PSH) has been recognized as an effective intervention and the national policy for addressing chronic homelessness in the United States. Due to an aging cohort of homeless adults and prioritizing those who are most vulnerable for housing, the health status of those entering PSH is likely worse than those previously reported in the literature.

Methods: This report examined the self-reported health and health conditions of a sample of 421 homeless adults entering PSH between 2014 and 2016.

Provider perceptions on HIV risk and prevention services within permanent supportive housing.

Permanent supportive housing (PSH) is an evidence-based solution to homelessness for persons experiencing chronic or long-term homelessness and one or more physical or behavioral health problems. Health services through PSH typically focus on physical and behavioral health. With the exception of programs specifically designed for persons living with HIV/AIDS, little attention has focused on services through PSH to prevent transmission of HIV or other sexually transmitted infections (STIs), yet sexual risk behavior continues after homeless persons move into PSH.

Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing.

Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.

Pilot Test of an Adapted, Evidence-Based HIV Sexual Risk Reduction Intervention for Homeless Women.

Women experiencing homelessness are at heightened risk for HIV, yet risk reduction interventions specifically designed for this population are lacking. This study reports on a pilot efficacy trial of a brief evidence-based intervention, Sister To Sister (STS), that we specifically adapted for homeless women in the temporary/emergency settings where they typically seek services. Seventy-nine women, recruited from three service sites in Los Angeles County, were assigned to the 40-min adapted STS intervention or an information-only control group.

Experience of Domestic Violence During Childhood, Intimate Partner Violence, and the Deterrent Effect of Awareness of Legal Consequences.

The concept of intergenerational transmission of intimate partner violence (IPV) has been an important topic of research. Experts have contended that this brutal path in which violence is transmitted to subsequent generations may be avoidable. This study examined whether public perceptions of the legal regulation of IPV and the certainty of sanction deter the prevalence of IPV.

Adapting an evidence-based intervention for homeless women: engaging the community in shared decision-making.

As interest grows in the diffusion of evidence-based interventions (EBIs), there is increasing concern about how to mitigate implementation challenges; this paper concerns adapting an EBI for homeless women. Complementing earlier focus groups with homeless women, homeless service providers (n = 32) were engaged in focus groups to assess capacity, needs, and barriers with implementation of EBIs. Deductive analyses of data led to the selection of four EBIs.

Predisposing, enabling and need correlates of mental health treatment utilization among homeless men.

There is significant unmet need for mental health treatment among homeless men, but little is known about the correlates of treatment utilization in this population. Within the framework of the Behavioral Model for Vulnerable Populations, this study examines predisposing, enabling and need factors that may be associated with mental health care utilization. Participants were a representative sample of 305 heterosexually active homeless men utilizing meal programs in the Skid Row region of LA.

Social networks, time homeless, and social support: A study of men on Skid Row.

Homeless men are frequently unsheltered and isolated, disconnected from supportive organizations and individuals. However, little research has investigated these men's social networks. We investigate the structure and composition of homeless men's social networks, vis-a-vis short- and long-term homelessness with a sample of men drawn randomly from meal lines on Skid Row in Los Angeles.

To use or not to use: a stage-based approach to understanding condom use among homeless youth.

This study used a stage-based approach to understand condom use behavior in a representative sample of 309 sexually active homeless youth recruited from shelters, drop-in centers, and street sites in Los Angeles County. Focusing on the youth's most recent sexual event, the three stages of condom use examined were: (1) whether the partners decided prior to the event about using condoms; (2) whether a condom was available at the event; and (3) whether a condom was used at the event. Logistic regression analysis was used to identify attitudinal, relationship, and contextual correlates of each of these three stages.

Masculinity and HIV Risk among Homeless Men in Los Angeles.

HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women's HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention.

Sex trade behavior among heterosexually active homeless men.

Sex trade behavior is fairly common among homeless adults and may contribute to higher rates of HIV/AIDS in this population. This study provides a detailed examination of the sex trade-related attitudes and behaviors of homeless men by: (1) determining the prevalence of sex trade-related behaviors, including sex with female sex workers (FSWs); (2) identifying risk factors for having sex with FSWs; and (3) comparing men's relationships with FSWs and non-FSWs in terms of relationship qualities and HIV-related risk behaviors, such as condom use. Structured interviews were conducted with a probability sample of 305 heterosexually active homeless men recruited from meal lines in Los Angeles.

Correlates of prescription drug misuse among heterosexually active homeless men.

Objective: Prescription drug misuse (PDM) is an emerging epidemic in the United States. This study examines the prevalence and correlates of PDM among homeless men. Homeless men experience higher risk for substance misuse and associated health problems and are particularly vulnerable to PDM and its negative health consequences.

The HIV risk reduction needs of homeless women in Los Angeles.

Background: Substance use, housing instability, and transactional sex all contribute to HIV risk engagement among homeless women. Because of the increased risk of HIV among homeless women, this study sought to understand the context of sexual behaviors and condom use among homeless women and elucidate modifiable factors that can be targeted by interventions.

Methods: Homeless women (n = 45) participated in focus groups (n = 6) at shelters throughout Los Angeles County.