Background and Significance: People experiencing homelessness (PEH) have an increased risk of contracting the novel coronavirus (COVID-19) and are at a higher risk of COVID-19-related hospitalization and death due to increased vulnerability and known comorbidities. Consequently, the recent pandemic has made housing for PEH a top priority. Permanent supportive housing (PSH) programs that provide access to living and support services are the most effective approach for serving PSH, but it is not known what type of PSH programs can best address COVID-19-related risk.
Study Aims: This study aims to test the comparative effectiveness of place-based PSH (PB-PSH) and scattered-site PSH (SS-PSH) on PEH quality of life and whether COVID-19 related health behaviors act as a mediator in this relationship. In addition, this study aims to learn PEH adherence to social distancing guidelines and provider perspectives on challenges of implementing and sustaining COVID-19 related prevention practices and care in PSH.
Design – Natural Observational Experiment: cohort and qualitative
Population – 600 persons experiencing homelessness (PEH) who are placed into either place-based public supportive housing (PB-PSH) or into scattered site public supportive housing (SS-PSH) in Los Angeles County, and 32 providers of PSH.
Interventions/Comparators – Place-based PSH (PB-PSH) that provide site-based housing only for persons with a history of homelessness, mental illness, and/or substance abuse with support services delivered onsite. Scattered-site PSH (SS-PSH) provide housing in existing private-market rental units and support services are delivered using mobile case managers or teams.
Outcomes – Primary: Life satisfaction, quality of physical health, mental health, social health, and environmental health; Secondary: COVID-19 prevention practices, healthcare utilization
Timeframe – 6-month follow-up for primary outcomes