Family-assisted Housing for Older Homeless Adults

为老年无家可归者提供家庭援助的住房

• 批准号: 9134564
• 负责人: Kelly Ray Knight
• 金额: $ 32.35万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9134564
• 关键词: Address; Adult; Affect; Age; Aging; Belief; Case Manager; Chronic; Code; Communities; Complex; County; Data; Data Analyses; Elderly; Enrollment; Epidemiologist; Ethnography; Failure; Family; Family member; Funding; General Population; Health; Healthcare; Home environment; Home visitation; Homelessness; House Call; Housing; Impaired cognition; Individual; Interdisciplinary Study; Intervention; Interview; Lawyers; Learning; Life; Link; Loneliness; Longitudinal Studies; Low income; Medicaid; Medical; Methodology; Modeling; Outcome; Parents; Participant; Personal Satisfaction; Policies; Policy Maker; Population; Population Intervention; Principal Investigator; Provider; Qualitative Methods; Research Personnel; Risk; Sampling; Science; Services; Site; Social Problems; Social isolation; Visit; Work; aged; base; cohort; community based service; cost; disability; ethnographic method; experience; functional disability; informant; member; mortality; prevent; programs; social; success; supported housing; theories; willingness; working group

 DESCRIPTION (provided by applicant): The proposed study will use qualitative methods to understand barriers to and facilitators of re-housing older homeless adults (aged 50 and older) with members of their family. The proportion of homeless adults age 50 and older has grown at a rate exceeding the general population for the past two decades. Despite extensive evidence demonstrating the severe deleterious effects of homelessness on health, gaps exist in identifying housing strategies for older homeless adults. The NIA funded R01, "Aging among the homeless: geriatric conditions, health and healthcare outcomes," (AG041860, PI Kushel) a longitudinal study of 350 older homeless adults, will serve as the parent study to the proposed project. In the Aging Homeless Study, a large proportion of older homeless adults have frequent and on-going contact with family members; approximately one-third were temporarily housed with family for a week or longer in the prior six months, most homeless participants expressed a willingness to live with family and a belief that their family members would allow them. This combination of temporary housing with family and willingness to continue has raised questions as to whether steps could be taken to make these temporary housing situations permanent. Existing interventions to promote older individuals' ability to thrive in the community bolster social ties, as loneliness and social isolation are associated with higher rates of chronic medical conditions, cognitive decline, and mortality. The proposed project will examine whether re-housing with family members is an effective means to promote re-housing and support older homeless adults' existing social ties. We propose to adapt the social-ecological model to address the following specific aims: Aim 1: To understand the factors influencing older homeless adults' ability to live with housed family members from the perspective of both older homeless adults and their family members. Aim 2: To understand the factors influencing older homeless adults' ability to live with housed family members from the perspective of key programmatic and policy stakeholders. Aim 3: To develop a toolkit addressing the barriers and facilitators to housing older homeless adults with family members for clinicians, homeless services providers, low-income housing program leaders and policy makers. To address Aims 1 and 2, we will conduct one-to-one qualitative interviews with a purposive sample of older homeless adults enrolled in the parent study, their family members, and service providers and policy stakeholders. We will conduct ethnographic participant observation in family members' home environments. Qualitative data will be transcribed, coded and analyzed using grounded theory methodologies by the multidisciplinary research team, consisting of an internationally recognized researcher of health for homeless populations (Principal Investigator), a medical anthropologist (Principal Investigator), and an epidemiologist with expertise in transitional science (Co-investigator). For Aim 3, we will synthesize study data and develop the toolkit to provide guidance about re-housing older homeless adults with family members.

 描述（由申请人提供）：拟议的研究将使用定性方法来了解重新安置无家可归的老年人（50岁及以上）及其家庭成员的障碍和促进因素。在过去二十年中，50岁及以上无家可归成年人的比例增长速度超过了总人口。尽管有大量证据表明无家可归对健康造成严重的有害影响，但在为无家可归的老年人确定住房战略方面存在差距。NIA资助的R 01，“无家可归者的老龄化：老年病状况，健康和医疗保健结果”（AG 041860，PI Kushel），一项对350名无家可归的老年人的纵向研究，将作为拟议项目的母研究。在老龄化无家可归者研究中，很大一部分无家可归的老年人与家庭成员有频繁和持续的联系;大约三分之一的人在过去六个月内暂时与家人住在一起一周或更长时间，大多数无家可归的参与者表示愿意与家人住在一起，并相信他们的家庭成员会允许他们。这种临时住房与家庭和愿意继续居住的情况结合在一起，引起了人们的疑问，即是否可以采取步骤使这些临时住房情况永久化。现有的促进老年人在社区中茁壮成长的干预措施加强了社会联系，因为孤独和社会孤立与更高的慢性疾病发病率有关。 认知能力下降和死亡率。这项拟议计划会研究与家人安置是否促进安置和支持无家可归长者现有社会联系的有效方法。我们建议适应社会生态模型，以解决以下具体目标：目标1：了解影响老年无家可归的成年人的能力，从老年无家可归的成年人和他们的家庭成员的角度与居住的家庭成员生活的因素。目标二：从主要方案和政策利益攸关方的角度了解影响无家可归的老年人与有住房的家庭成员一起生活的能力的因素。目标3：为临床医生、无家可归者服务提供者、低收入住房方案负责人和政策制定者开发一个工具包，解决无家可归的老年人与家庭成员一起住房的障碍和促进因素。为了解决目标1和2，我们将进行一对一的定性访谈，有目的的样本参加父母研究的无家可归的老年人，他们的家庭成员，服务提供者和政策利益相关者。我们将在家庭成员的家庭环境中进行民族志参与观察。定性数据将由多学科研究小组使用扎根理论方法进行转录，编码和分析，该研究小组由国际公认的无家可归人口健康研究人员（主要研究者），医学人类学家（主要研究者）和具有过渡科学专业知识的流行病学家（共同研究者）组成。就目的3而言，我们会综合研究数据，并开发工具包，为无家可归的长者与家人安置提供指引。