Evaluating the impact of PHLHousing+ on reducing health disparities

评估 PHLHousing 对减少健康差距的影响

• 批准号: 10835178
• 负责人: BENJAMIN S ABELLA
• 金额: $ 36.56万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10835178
• 关键词: 16 year old; Accident and Emergency department; Address; Adult; Affective; Age; Area; Authorization documentation; Behavior; Black race; COVID-19 pandemic; Censuses; Child; Cities; Competence; Control Groups; Crime; Data; Dimensions; Disease; Economics; Education; Effectiveness; Electronic Health Record; Eligibility Determination; Emergency Situation; Emergency department visit; Emotional; Evaluation; Exposure to; Family Sizes; Future; Goals; Health; Health Promotion; Home; Hospitalization; Hospitals; Household; Household Heads; Housing; Income; Injury; Link; Low income; Marketing; Measures; Medical; Mental Health; Minority Groups; Modeling; Molds; Moods; Neighborhoods; Neurodevelopmental Problem; Outcome; Pathway interactions; Patient Self-Report; Pennsylvania; Philadelphia; Police; Policies; Positioning Attribute; Problem behavior; Property; Psyche structure; Random Allocation; Randomized; Randomized, Controlled Trials; Reduce health disparities; Respondent; Risk; Role; Sampling; Section 8; Secure; Security; Surveys; Testing; Time; Translating; Trauma; U.S. Department of Housing and Urban Development; Waiting Lists; Woman; World Health Organization; anxiety symptoms; authority; coronavirus disease; depressive symptoms; experience; experimental study; health disparity; health equity; hospital utilization; indexing; minority health disparity; novel; pandemic disease; participant retention; payment; perceived stress; physical conditioning; programs; reduce symptoms; social health determinants; socioeconomics; voucher

The objective of the PHLHousing+ Evaluation is to test whether unconditional, monthly cash payments made directly to tenants increases housing security and thereby reduces health disparities for low-income renters who, in the city of Philadelphia, are disproportionately Black. This objective is aligned with the strategic aim of NINR to understand which pandemic-era housing policies would best be continued to advance health equity. The PHLHousing+ Evaluation comprises three groups, all of whom earn below 50% area median income and have at least one child under the age of 16 years living at home: 270 households who receive monthly cash payments in lieu of a rental voucher (Cash group), 225 households who are eligible for (or currently using) a rental voucher (Voucher group), and 789 households on the Philadelphia Housing Authority (PHA) waitlist who will not be offered a rental voucher for the foreseeable future because of their randomized position on the waitlist (Control group). Of the 1,284 households in the study, 82.5% are headed by single women and 82.8% are Black. There are 2,678 children in the sample, ranging in age from 1 to 19 years (median = 10, IQR = 5- 15). Monthly cash payments range from $89 to $2079, with a median payment of $881; payments vary based on household income, family size, and fair market rent. Households in the Cash group will receive monthly payments for 2.5 years. All three groups are surveyed every six months for three years via an online survey; the first wave of surveys was deployed in August 2022. Existing surveys include measures of self-reported mental and physical health and hospital utilization for adults and children. We propose to extend these data in three ways: (1) by extracting electronic health record (EHR) data on emergency department (ED) visits and hospital admissions linked to our survey respondents; (2) by administering brief, monthly surveys that will increase participant retention between biannual surveys and will measure mood and health-promoting behaviors that might be pathways by which PHLHousing+ promotes positive health outcomes; and (3) by linking household addresses with census-based data on neighborhood opportunity and Philadelphia Police Department crime data. Aim 1 is to test whether rental assistance (Cash + Voucher vs. Control) or type of assistance (Cash vs. Voucher) is associated with self-reported mental and physical health and with affective volatility and health-promoting behaviors. Aim 2 is to test whether the availability or type of rental assistance is associated with ED use or hospital admissions as recorded in EHR, specifically for problems that are disproportionately associated with housing insecurity (e.g., mental health problems). Aim 3 is to test whether availability or type of rental assistance is associated with exposure to housing problems (e.g., pests, mold), access to neighborhood opportunity, or exposure to crime. Study findings will have immediate implications for the City of Philadelphia's model for providing housing assistance, will inform efforts to establish similar programs in other cities, and will inform federal approaches to rental assistance.

Phlhooding+评估的目的是测试是否进行无条件的每月现金支付 直接向租户提高住房安全，从而减少了低收入房客的健康差异 在费城市，他的黑色不成比例。这个目标与战略目标保持一致 忍者了解哪种流行病政策最好继续促进健康公平。 Phlhooding+评估包括三个组，所有这些群体的收入低于50％的收入和 至少有一个16岁以下的孩子住在家里：270户每月现金的家庭 付款代替租金券（现金集团），有资格（或当前使用）的225个家庭 租赁代金券（代金券集团）和费城住房管理局（PHA）候补名单上的789个家庭 由于它们在可预见的未来，不会为他们提供租金券，因为它们在 候补名单（对照组）。在研究中的1,284户家庭中，有82.5％由单身女性领导，82.8％ 是黑色的。样本中有2,678名儿童，年龄从1至19岁不等（中值= 10，IQR = 5- 15）。每月现金付款从89美元到2079美元不等，中位支付为881美元；付款不同 关于家庭收入，家庭规模和公平的市场租金。现金组的家庭将每月接收 付款2。5年。通过在线调查，每六个月对这三个小组进行每六个月的调查； 第一波调查是在2022年8月进行的。现有的调查包括自我报告的措施 成人和儿童的身心健康和医院利用。我们建议将这些数据扩展到 三种方式：（1）通过提取急诊科（ED）访问的电子健康记录（EHR）数据 与我们的调查受访者有关的医院入院； （2）管理简短的每月调查 增加双年度调查之间的参与者保留率，并将衡量情绪和健康促进 可能是浮游+促进积极健康结果的途径的行为； （3） 将家庭地址与基于人口普查的邻里机会和费城警察的数据联系起来 部门犯罪数据。目标1是测试租金援助（现金 +凭证与控制）还是类型 援助（现金与代金券）与自我报告的心理和身体健康以及情感有关 波动和促进健康的行为。 AIM 2是测试可用性或类型的租赁援助是 与EHR中记录的ED使用或住院有关，特别是针对问题 与住房不安全感相关（例如，心理健康问题）。目标3是测试是否 租赁援助的可用性或类型与住房问题的暴露有关（例如，害虫，霉菌）， 获得邻里机会或暴露于犯罪的机会。研究结果将对 费城市提供住房援助的模式，将为建立类似的努力提供努力 在其他城市的计划，并将为联邦租赁援助提供信息。