TY - JOUR
T1 - Food security among individuals experiencing homelessness and mental illness in the at Home/Chez Soi Trial
AU - O'Campo, Patricia
AU - Hwang, Stephen W.
AU - Gozdzik, Agnes
AU - Schuler, Andreé
AU - Kaufman-Shriqui, Vered
AU - Poremski, Daniel
AU - Lazgare, Luis Ivan Palma
AU - Distasio, Jino
AU - Belbraouet, Slimane
AU - Addorisio, Sindi
N1 - Publisher Copyright:
© 2017 The Authors.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objective Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. Design At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Setting Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Subjects Homeless adults with mental illness (n 2148). Results Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Conclusions Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.
AB - Objective Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. Design At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Setting Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Subjects Homeless adults with mental illness (n 2148). Results Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Conclusions Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.
KW - Food security
KW - Homelessness
KW - Mental health
KW - Randomized trial
UR - http://www.scopus.com/inward/record.url?scp=85020086806&partnerID=8YFLogxK
U2 - 10.1017/S1368980017000489
DO - 10.1017/S1368980017000489
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C2 - 28560947
AN - SCOPUS:85020086806
SN - 1368-9800
VL - 20
SP - 2023
EP - 2033
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 11
ER -