Search Results (446)

Background/Objectives: The aim of this study was to evaluate baseline health measurements among transitional housing residents (n = 29) participating in an 8-week pilot wellness intervention. Methods: Researchers measured anthropometrics, body composition, muscular strength, cardiovascular indicators, physical activity, diet quality, and health-related perceptions. Researchers analyzed data using descriptive statistics and conventional content analysis. Results: Most participants were male, White, and food insecure. Mean BMI (31.8 ± 8.6 kg/m²), waist-to-hip ratio (1.0 ± 0.1 males, 0.9 ± 0.1 females), body fat percentage (25.8 ± 6.1% males, 40.5 ± 9.4% females), blood pressure (131.8 ± 17.9/85.2 ± 13.3 mmHg), and daily step counts exceeded recommended levels. Absolute grip strength (77.1 ± 19.4 kg males, 53.0 ± 15.7 kg females) and perceived general health were below reference standards. The Healthy Eating Index-2020 score (39.7/100) indicated low diet quality. Common barriers to healthy eating were financial constraints (29.6%) and limited cooking/storage facilities (29.6%), as well as to exercise, physical impediments (14.8%). Conclusions: Residents living in transitional housing have less favorable body composition, diet, and grip strength measures, putting them at risk for negative health outcomes. Wellness interventions aimed at promoting improved health-related outcomes while addressing common barriers to proper diet and exercise among transitional housing residents are warranted. Full article

While IPV is often studied as a predictor of housing insecurity, few U.S. studies explore how different forms of housing instability may contribute to intimate partner violence (IPV) risk. Using a mixed-methods approach and a cross-sectional design, this study examined the association between four housing instability domains and IPV among a sample of tenants that had either experienced eviction or were at high risk for eviction. Tenants in Harris and Travis counties (Texas, USA) completed an online survey (n = 1085; March–July 2024). Housing instability was assessed across four domains: homelessness, lease violations, utility hardship, and poor housing quality. IPV was measured using the Hurt, Insult, Threaten, Scream Screener. Covariate-adjusted logistic regression models suggest indicators within the four housing instability domains were associated with IPV risk. Within the homelessness domain, experiences with lifetime homelessness (AOR = 1.92, 95%CI 1.61–2.28), in the past 12 months living in unconventional spaces (AOR = 2.10, 95%CI 1.92–2.29), and moving in with others (AOR = 1.20, 95%CI 1.06–1.36) were associated with IPV. Within the lease violations domain, missed rent payments (AOR = 1.69, 95%CI 1.68–1.71) and non-payment lease violations (AOR = 2.50, 95%CI 2.29–2.73) in the past 12 months were associated with IPV. Utility shutoffs (AOR = 1.62, 95%CI 1.37–1.91) and unsafe housing (AOR = 1.65, 95%CI 1.31–2.09) in the past 12 months were associated with IPV. Homelessness, housing-related economic hardships and substandard living conditions predict an elevated risk of IPV. Full article

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

The article analyzes the effects of psychosocial interventions on adherence to tuberculosis (TB) treatment among vulnerable populations in Romania. The study includes 4104 patients from disadvantaged groups (rural, injecting drug users, homeless), beneficiaries of a national multidisciplinary support program. Multivariate analyses conducted on drug-susceptible TB (DS-TB) patients within this cohort identified some predictors of therapeutic success, such as extrapulmonary diagnosis, peer-to-peer educational support, and a higher level of education. At the same time, men, occupationally inactive people and those in the initial phase of treatment at project entry showed lower adherence. The results support the integration of psychosocial interventions in TB management. Full article

Homelessness is characterised by a wide range of risk factors of a multidimensional and unstable nature. The COVID-19 pandemic intensified these risk factors associated with homelessness but also prompted the development of prevention and care actions. This study identified and mapped the intervention programmes carried out for people experiencing homelessness in the wake of the COVID-19 pandemic. To achieve the study purpose, a thematic analysis of the scientific literature was conducted following the search strategy and analysis methodology characteristic of informetrics and scientometrics. The sources of information used were WoS, Scopus, PubMed, PsycINFO and ERIC. The paucity of planned actions, most of which have a local impact, reinforces the need to strengthen research that presents robust evidence on this issue. China and Europe are under-represented compared to other types of studies linked to COVID-19 and the prevalence of homelessness. Several clusters are distinguished among the plans: they are carried out in buildings or in geographical areas and according to the impact on the group (preventive, substance-related disorder support, health care and diagnostic). Among the emerging themes, health and social variables are represented, including communication and trust between health, community and homeless groups. The reduction in the thematic dimensionality shows equal planning between health care actions (81.8%) and psychosocial and prevention support (72.8%), an aspect that confirms the importance of joint actions. In this line, among the various clusters of the network analysis, the relationship between hotel, mental health support, substance-related disorder, social intervention and access to permanent housing was found. The studies analysed also highlight social exclusion, stigma, victimisation, living conditions and the risk of contagion among this group. This situation has not gone unnoticed among the studies analysed, which present proposals for the continuation of the projects. Full article

Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12–17 years old) in the United States. Methods: Data from the 2018–2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic regression assessed treatment outcomes and factors associated with treatment completion. Results: Only 36.8% of adolescents completed treatment. The most common reasons for not completing treatment were dropping out (28.4%) and transferring to another facility/program (17.0%). Males and Black non-Hispanic adolescents had lower odds of completing treatment (OR = 0.79, 95%CI: 0.75–0.84), while Hispanic (OR = 1.13, 95%CI: 1.08–1.18), Asian (OR = 1.56, 95%CI: 1.3–1.86) and Native Hawaiian/Pacific Islander adolescents (OR = 2.31, 95%CI: 2.04–2.61) had higher odds of completion compared to their White counterparts. Independent living arrangements, homelessness, arrests in the past 30 days and younger age (<15 years old) decreased the likelihood of treatment completion. Adolescents with co-occurring mental health and substance use disorders also had lower completion rates (OR = 0.79, 95%CI: 0.77–0.86). Referral from schools/employers and treatment settings were associated with a higher success, particularly with stays of 4–6 months and 7–12 months. Conclusion: This study highlights the need for targeted CUD treatment programs that support at-risk adolescents, especially those experiencing homelessness or facing legal issues. High dropout and transition rates suggest a need for continuity of care and program integration between facilities. Strengthening coordination among public health officials, community organizations, and stakeholders is essential to developing culturally responsive treatment interventions that address social determinants of health, substance use, and mental health in this vulnerable population. Full article

When individuals transition from homelessness into housing, their new home should serve as a place of healing and dignity. This paper presents empirical evidence on the impact of trauma-informed design (TID), an approach to designing affordable housing that supports the health and well-being of people with lived experience of homelessness. The study used a mixed-methods, quasi-experimental design across five permanent supportive housing (PSH) sites—three with TID features and two without. Residents completed surveys at two timepoints, and both the residents and the staff participated in semi-structured interviews. The quantitative results revealed a complex pattern: while some aspects of relationships and self-awareness improved at TID sites, measures of psychological safety and compassion declined. Additionally, conflict, psychological aggression, physical aggression, and mild violence increased over the same period. Qualitative findings highlight that safety is a nuanced, context-dependent experience that exists along a spectrum. The residents at the TID sites described opportunities to experience higher levels of safety. Together, the quantitative and qualitative data paint a complex picture of life in PSH. A key finding is that safety, conflict, and relationships are interwoven, evolving over time as the residents adapt to their environment. Full article

In some regions, extreme heat can result in pavement temperatures that are high enough to cause severe burn injuries within seconds of skin contact. This risk is elevated for unhoused individuals who may lack adequate clothing and shelter and have susceptibility to other risk factors, including substance use and in turn loss of consciousness. While prior studies have shown worse outcomes for unhoused individuals due to delays in care and higher susceptibility, there is a lack of data on the impact of pavement burns specifically within this population. This single-institution retrospective cohort study aims to explore burn severity and hospital outcomes in housed vs. unhoused patients with pavement burns. The data were analyzed using independent samples t-tests and logistic regression when appropriate, with p < 0.05 considered statistically significant. A total of 305 individuals met the inclusion/exclusion criteria and comprised the final study cohort, 17.7% of which were unhoused. There was no significant difference in TBSA, survival to discharge, or hospital length of stay between housed and unhoused patients. While unhoused individuals may still be at heightened risk for pavement burns due to exposure to extreme heat and a lack of protective measures, these results may additionally suggest consistent emergency care for patients regardless of housing status. Furthermore, these results highlight the importance of developing targeted outreach and prevention programs and equitable emergency care protocols for vulnerable populations. Full article

Urban environments are increasingly affected by extreme weather conditions, posing significant risks to vulnerable populations, such as the homeless. This research applies geospatial analysis to identify areas of extreme heat and moisture within the Athens metropolitan area in Greece. The analysis utilizes satellite-derived land surface temperature (LST), vegetation density index (NDVI), build-up density index (NDBI), Topographic Wetness Index (TWI), and other terrain-based factors to develop high-fidelity risk zones. These zones are critical for informing targeted interventions and policy measures aimed at protecting vulnerable groups from heat waves and extreme moisture. This research integrates a geospatial analysis approach for mapping and evaluating heat and moisture vulnerability zones. This approach integrates remote sensing data, GIS-based modeling, and terrain analysis. The findings can provide local authorities and social services with the necessary information to design adaptive strategies for climate change resilience. Full article

Globally, 1–3% of the population has an intellectual disability, but some remain undiagnosed, resulting in limited access to essential health and social care services, poor health outcomes, and higher risks of homelessness, substance abuse, and imprisonment. A formal diagnosis enables early intervention and support. A scoping review was conducted to explore research on undiagnosed intellectual disability, screening processes, and identifying indicators. Method: The scoping review search was conducted using academic databases such as CINAHL, PsycINFO, Scopus, and PubMed, along with eight grey literature sources. In addition, the reference lists of the included studies were explored. Information specialists supported and guided the search process. The search included qualitative, quantitative, review, and mixed-method research studies published in English between 2000 and 2024. Two reviewers screened papers for eligibility by title, abstract, and full text. Result: A total of 11,475 papers were screened, with 57 papers from various countries included in the review. Indicators of intellectual disability were identified in three settings: (1) educational settings (preschool, primary, and secondary schools); (2) social care services, including homeless and community services; and (3) criminal services, such as courts, probation, and prisons, highlighting the wide applicability of findings. These indicators were linked to “experiences”, “behaviours”, “challenges”, and “observations”. Conclusion: This review emphasised the importance of early diagnosis by adopting appropriate assessment tools, which require national screening policies. It also highlighted the essential role of professionals working in intellectual disability services in identifying and supporting undiagnosed individuals, particularly within high-risk populations. Implication: The review’s findings will guide policy, practice, and research recommendations for enhancing the early identification of people with intellectual disabilities. Full article

This study uses a public health approach to identify the comorbid risk factors and protective factors that influence the likelihood of an officer-involved shooting (OIS). Methods: We analyzed 7.5 years of hospital inpatient data obtained from the state of Texas. The OIS subjects (n = 177) were civilians who were shot during a legal intervention involving law enforcement. The control group (n = 33,539) included persons who were hospitalized due to injuries from a car accident. Logistic regression models were used to identify the predictors of an OIS incident. The data included information on chronic diseases, vulnerable population status, health insurance, mental health diagnoses, substance use disorders, and recent trauma. Results: About one-fourth (24.3%) of OIS subjects had a diagnosed mental illness, compared to 8.4% of control subjects (p < 0.001). Factors that greatly increased the risk for an OIS included the following: schizophrenia (AOR = 2.7; CI: 1.6, 4.6), methamphetamine use disorder (AOR = 3.5; CI: 2.2, 5.5), and recent family bereavement (AOR = 8.5; CI: 1.8, 39.6). Six subjects (3.4%) were persons experiencing homelessness (PEH). Protective factors that lowered the risk for an OIS included commercial health insurance (AOR = 0.27; CI: 0.17, 0.45) and Medicaid insurance (AOR = 0.61; CI: 0.11, 0.93). Conclusions: These findings underscore the preventable nature of many OIS incidents, especially those that involve untreated mental illness, homelessness, substance use disorders, and recent trauma. Addressing the root causes of these incidents will likely require interdisciplinary collaboration among law enforcement, public health agencies, and social services. Full article

Background/Objectives: The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. Methods: A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. Results: The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group. Full article

The increasing prevalence of emergency room (ER) visits for mental health concerns presents a significant challenge for healthcare systems. This study aimed to analyze the socio-demographic and clinical characteristics associated with frequent users of psychiatric consultations in the ER of Maggiore della Carità University Hospital in Novara, Italy. A retrospective observational study was conducted over a six-year period (2017–2022), including all psychiatric consultations recorded in a hospital database. Frequent users were defined as individuals undergoing at least three psychiatric consultations in the ER within a year. Univariable and multivariable logistic models were employed to identify significant socio-demographic and clinical predictors of frequent use. Of the 1565 individuals who received psychiatric consultations in the ER, 92 (5.88%) were identified as frequent users. Factors associated with higher ER utilization included being unmarried (aOR 1.35, 95% CI 1.02–1.79), younger age (aOR 1.32, 95% CI 1.02–1.72), homelessness, diagnosis of schizophrenia, substance use disorder (aOR 1.49, 95% CI 1.06–2.09), and ongoing psychopharmacological treatment (aOR 1.56, 95% CI 1.12–2.18). These findings highlight the need for targeted interventions to improve care continuity and community-based support for individuals at risk of frequent ER visits for psychiatric reasons. Full article

Background/Objectives: Possible sarcopenia and malnutrition are critical public health concerns among older adults, particularly in vulnerable populations such as those with a history of homelessness. However, limited evidence exists on the nutritional status and muscle health of this group in Thailand. Methods: This study aimed to assess the nutritional status of formerly homeless older adults residing in supportive housing in Thailand and examine its association with possible sarcopenia. A cross-sectional study was conducted among 116 participants aged 50 years and older. Sociodemographic information was collected using a structured questionnaire. Nutritional status was then assessed using the Mini Nutritional Assessment short form (MNA-SF) and body mass index (BMI). Possible sarcopenia was determined based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, including low calf circumference, reduced handgrip strength, and/or low gait speed. Data were analyzed using descriptive statistics and logistic regression. Results: Of all participants, 66.4% were male, with a mean age of 59.14 years (SD = 7.791). A total of 78.4% were identified as having possible sarcopenia. Univariate analysis revealed significant associations between possible sarcopenia and malnutrition (OR = 6.111, 95% CI = 2.104–17.750), low BMI (OR = 16.784, 95% CI = 3.729–75.535), and waist circumference (OR = 0.129, 95% CI = 0.049–0.342). Multivariate logistic regression indicated that malnutrition (OR = 3.429, 95% CI = 1.093–10.763) and low BMI (OR = 11.732, 95% CI = 2.523–54.567) were significant predictors of possible sarcopenia, collectively explaining 33.8% of the variance. Conclusions: The findings underscore a high prevalence of possible sarcopenia among formerly homeless older adults in supportive housing in Thailand and highlight poor nutritional status, particularly low BMI and malnutrition, as a key contributing factor. These results emphasize the importance of early nutritional screening and interventions to prevent or delay sarcopenia in this vulnerable population. Full article

(1) Background: Housing instability is a public health issue in both developed and developing countries. This exploratory pilot study examines executive functioning (EF) and the history of acquired brain injury (ABI) in youth and young adults experiencing homelessness (YYEH). (2) Methods: Twenty-three YYEH (ages 18–25; 48% male) were recruited from a drop-in center in Central Ohio. The Ohio State University TBI Identification Method (OSU TBI-ID+ABI) was used to screen for exposure to ABI. Outcomes were measured using the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A) and the NIH Toolbox Cognitive Battery. (3) Results: Eighty-seven percent of participants reported a lifetime history of ABI, including traumatic brain injury or hypoxic-anoxic brain injury. Overall, participants did not present with elevated EF scores on outcome measures. Those with multiple lifetime ABIs (n = 16) had significantly higher scores than those with a single ABI (n = 4), representing poorer EF, on shift, self-monitor, task monitor, and the Global Executive Composite of the BRIEF-A. There was no evidence of significant differences between participants on outcome measures based on injury mechanism. (4) Conclusions: In this pilot sample, those with multiple reported ABIs demonstrated decreased EF performance, and these differences were noted in specific areas of EF. To ensure YYEH have access to services, resource support and intervention providers should consider the cognitive profiles of the youth they serve. Full article