PDF(Pubmed)
Abstract：
Homelessness, affecting over half a million Americans, significantly elevates the risks of mental and physical health issues, consequently diminishing life expectancy when compared with the general population. Homelessness is a critical public health issue, and efforts are needed to address lack of housing as a social determinant of health. Transitional housing (TH) programs emerge as vital interventions, offering a place to stay with various support services to facilitate the transition to permanent residency. Nearly half of the unhoused population in the country and over 90% in New York live in TH or shelters. Despite the high utilization rates of TH, engagement with support services and opportunities for improvement remain poorly understood. This study aimed to fill this gap by examining the factors influencing support service usage and opportunities for enhancement through semi-structured interviews with TH residents in New York City to capture their lived experiences and perspectives. Analysis of the interviews (n = 20) revealed five main factors affecting service engagement that aligned with constructs of the socioecological model: intrapersonal (self-efficacy, chronic health conditions, mental health), interpersonal (parenthood and well-being of children with special needs, individual staff interactions, and communication), institutional (bureaucratic challenges, administrative burden, and living facilities), community (social isolation and educational opportunity), and policy (challenge meeting basic needs and undocumented status). Recommendations for bridging service gaps primarily arose at the institutional and community levels, offering critical insights for administrators to tailor services more effectively to TH residents\' needs, thus contributing to the broader goal of advancing health equity among the unhoused.
摘要：
无家可归,影响了50多万美国人，显著提高了精神和身体健康问题的风险，因此，与普通人群相比，预期寿命缩短。无家可归是一个关键的公共卫生问题，并且需要努力解决缺乏住房作为健康的社会决定因素的问题。过渡性住房（TH）计划成为重要的干预措施，提供各种支持服务的住宿场所，以促进向永久居留权的过渡。该国近一半的无住房人口和纽约超过90％的人口居住在TH或庇护所。尽管TH的利用率很高，对支持服务的参与和改进机会仍然知之甚少。这项研究旨在通过对纽约市TH居民进行半结构化访谈来研究影响支持服务使用的因素和增强的机会，以捕捉他们的生活经历和观点，从而填补这一空白。对访谈的分析（n=20）揭示了影响服务参与的五个主要因素，这些因素与社会生态模型的构建相一致：内省（自我效能感，慢性健康状况,心理健康)，人际关系(有特殊需要的儿童的父母身份和福祉，个人员工互动，和通信)，制度(官僚挑战，行政负担,和生活设施)，社区(社会隔离和教育机会)，和政策(挑战满足基本需求和无证状态)。弥合服务差距的建议主要出现在机构和社区层面，为管理员提供关键见解，以更有效地根据TH居民的需求定制服务，从而有助于促进无住房者之间健康公平的更广泛目标。
