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Results of a Peer Navigator Program to Address Chronic Illness Among Persons Experiencing Homelessness

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Abstract

People who are homeless disproportionately experience the burdens of chronic disease, have limited access to preventive care, and may be less trusting of healthcare agencies. The Collective Impact Project created and evaluated an innovative model designed to increase chronic disease screening and referral to healthcare and public health services. Trained Peer Navigators (PNs), who were paid staff with lived experiences similar to the clients served, were embedded in five agencies serving people experiencing homelessness or at risk for homelessness. Over two years, PNs engaged 1071 individuals. Of those, 823 were screened for chronic diseases and 429 were referred to healthcare services. Alongside screening and referrals, the project demonstrated the value of convening a coalition of community stakeholders, experts, and resources to identify service gaps and how PN functions might complement existing staffing roles. Project findings add to a growing literature documenting unique PN roles that potentially reduce health inequities.

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Abbreviations

COPD:

Chronic obstructive pulmonary disease

PL:

Peer liaison

PN:

Peer navigator

SWOT:

Strengths, Weaknesses, Opportunities, and Threats

References

  1. Centers for Disease Control and Prevention (2022). Leading causes of death. Retrieved December 20, 2022 from http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm.

  2. Baggett, T. P., Liauw, S. S., & Hwang, S. W. (2018). Cardiovascular disease and homelessness. Journal of the American College of Cardiology, 71(22), 2585–2597. https://doi.org/10.1016/j.jacc.2018.02.077.

    Article  PubMed  Google Scholar 

  3. Hwang, S. W. (2001). Homelessness and health. CMAJ: Canadian Medical Association Journal, 164(2), 229–233.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Rahimi, A. R., Spertus, J. A., Reid, K. J., Bernheim, S. M., & Krumholz, H. M. (2007). Financial barriers to health care and outcomes after acute myocardial infarction. Journal Of The American Medical Association, 297(10), 1063–1072. https://doi.org/10.1001/jama.297.10.1063.

    Article  CAS  PubMed  Google Scholar 

  5. Akinbami, L. J., & Liu, X. (2011). Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998–2009. (NCHS Data Brief, no. 63).(Vol 63, pp 1–8).

  6. Bingham, B. S., Facer, B., Ivey, C., & Osmundson, E. (2019). Cancer patients experiencing homelessness: What’s happening to them? Journal of Clinical Oncology, 37(15), e18153. https://doi.org/10.1200/JCO.2019.37.15_suppl.e18153

    Article  Google Scholar 

  7. O’Connell, J. J. (2005). Premature mortality in homeless populations: A review of the literature. National Health Care for the Homeless Council, Inc., Nashville, TN. Retrieved December 20, 2022 from http://sbdww.org/wp-content/uploads/2011/04/PrematureMortalityFinal.pdf.

  8. Abeyta, I. M., Tuitt, N. R., Byers, T. E., & Sauaia, A. (2012). Effect of community affluence on the association between individual socioeconomic status and cardiovascular disease risk factors, Colorado, 2007–2008. Preventing Chronic Disease, 9, E115. https://doi.org/10.5888/pcd9.110305.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Okuyemi, K. S., Goldade, K., Whembolua, G. L., Thomas, J. L., Eischen, S., Sewali, B., Guo, H., Connett, J. E., Grant, J., & Ahluwalia, J. S. (2013). Motivational interviewing to enhance nicotine patch treatment for smoking cessation among homeless smokers: a randomized controlled trial. Addiction, 108(6), 1136–1144. https://doi.org/10.1111/add.12140.

    Article  PubMed  PubMed Central  Google Scholar 

  10. National Health Care for the Homeless Council (2019). Homelessness & health: What’s the connection? Retrieved December 20, 2022 from https://nhchc.org/wp-content/uploads/2019/08/homelessness-and-health.pdf.

  11. National Law Center on Homelessness and Poverty (2014). Homelessness statistics. National Law Center on Homelessness and Poverty.

  12. Garg, A., Sandel, M., Dworkin, P. H., Kahn, R. S., & Zuckerman, B. (2012). From medical home to health neighborhood: transforming the medical home into a community-based health neighborhood. Journal of Pediatrics, 160(4), 535–536e531. https://doi.org/10.1016/j.jpeds.2012.01.001.

    Article  PubMed  Google Scholar 

  13. Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: assessing the evidence. Psychiatric Services, 65(4), 429–441. https://doi.org/10.1176/appi.ps.201300244.

    Article  PubMed  Google Scholar 

  14. Barker, S. L., & Maguire, N. (2017). Experts by experience: peer support and its use with the homeless. Community Mental Health Journal, 53(5), 598–612. https://doi.org/10.1007/s10597-017-0102-2.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bologna, M. J., & Pulice, R. T. (2011). Evaluation of a peer-run hospital diversion program: a descriptive study. American Journal of Psychiatric Rehabilitation, 14(4), 272–286. https://doi.org/10.1080/15487768.2011.622147.

    Article  Google Scholar 

  16. Corrigan, P. W. (2006). Impact of consumer-operated services on empowerment and recovery of people with psychiatric disabilities. Psychiatric Services, 57(10), 1493–1496. https://doi.org/10.1176/ps.2006.57.10.1493.

    Article  PubMed  Google Scholar 

  17. Corrigan, P. W., Sokol, K. A., & Rusch, N. (2013). The impact of self-stigma and mutual help programs on the quality of life of people with serious mental illnesses. Community Mental Health Journal, 49(1), 1–6. https://doi.org/10.1007/s10597-011-9445-2.

    Article  PubMed  Google Scholar 

  18. Sells, D., Davidson, L., Jewell, C., Falzer, P., & Rowe, M. (2006). The treatment relationship in peer-based and regular case management for clients with severe mental illness. Psychiatric Services, 57(8), 1179–1184. https://doi.org/10.1176/ps.2006.57.8.1179.

    Article  PubMed  Google Scholar 

  19. Sledge, W. H., Lawless, M., Sells, D., Wieland, M., O’Connell, M. J., & Davidson, L. (2011). Effectiveness of peer support in reducing readmissions of person with multiple psychiatric hospitalizations. Psychiatric Services, 62(5), 541–544. https://doi.org/10.1176/ps.62.5.pss6205_0541.

    Article  PubMed  Google Scholar 

  20. Whitley, E. M., Everhart, R. M., & Wright, R. A. (2006). Measuring return on investment of outreach by community health workers. Journal of Health Care for the Poor and Underserved, 17(1 Suppl), 6–15. https://doi.org/10.1353/hpu.2006.0015.

    Article  PubMed  Google Scholar 

  21. Chermack, T. J., & Kasshanna, B. K. (2007). The use and misuse of SWOT analysis and implications for HRD professionals. Human Resource Development International, 10(4), 383–399. https://doi.org/10.1080/13678860701718760.

    Article  Google Scholar 

  22. Cook, J. A., Copeland, M. E., Floyd, C. B., Jonikas, J. A., Hamilton, M. M., Razzano, L., Carter, T. M., Hudson, W. B., Grey, D. D., & Boyd, S. (2012). A randomized controlled trial of effects of Wellness Recovery Action Planning on depression, anxiety, and recovery. Psychiatric Services, 63(6), 541–547. https://doi.org/10.1176/appi.ps.201100125.

    Article  PubMed  Google Scholar 

  23. Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in healthcare: Helping patients change behavior. The Guildford Press.

    Google Scholar 

  24. Jego, M., Abcaya, J., Stefan, D. E., Calvet-Montredon, C., & Gentile, S. (2018). Improving health care management in primary care for homeless people: a literature review. International Journal of Environmental Research and Public Health, 15(2), 309. https://doi.org/10.3390/ijerph15020309.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fornaro, M., Dragioti, E., De Prisco, M., Billeci, M., Mondin, A. M., Calati, R., Smith, L., Hatcher, S., Kaluzienski, M., Fiedorowicz, J. G., Solmi, M., de Bartolomeis, A., & Carvalho, A. F. (2022). Homelessness and health-related outcomes: an umbrella review of observational studies and randomized controlled trials. BMC Medicine, 20(1), 224. https://doi.org/10.1186/s12916-022-02423-z.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kuhn, W., Bellinger, J., Stevens-Manser, S., & Kaufman, L. (2015). Integration of peer specialists working in mental health service settings. Community Mental Health Journal, 51(4), 453–458. https://doi.org/10.1007/s10597-015-9841-0.

    Article  PubMed  Google Scholar 

  27. Forbes, J., Pratt, C., & Cronise, R. (2022). Experiences of peer support specialists supervised by nonpeer supervisors. Psychiatric Rehabilitation Journal, 45(1), 54–60. https://doi.org/10.1037/prj0000475.

    Article  PubMed  Google Scholar 

  28. Ponka, D., Agbata, E., Kendall, C., Stergiopoulos, V., Mendonca, O., Magwood, O., Saad, A., Larson, B., Sun, A. H., Arya, N., Hannigan, T., Thavorn, K., Andermann, A., Tugwell, P., & Pottie, K. (2020). The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review. PLoS ONE, 15(4), e0230896. https://doi.org/10.1371/journal.pone.0230896

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Funding

This study was funded by the Colorado Department of Public Health and Environment.

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Authors and Affiliations

  1. Department of Psychiatry, University of Colorado Anschutz Medical Campus, MS F478, 1890 N Revere Ct, Aurora, CO, 80045, USA

    Derek H. Noland MPH, Chad D. Morris PhD, Ashley M. Kayser MS & Christine E. Garver-Apgar PhD

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  1. Derek H. Noland MPH
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  2. Chad D. Morris PhD
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  3. Ashley M. Kayser MS
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Correspondence to Derek H. Noland MPH.

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Conflict of interests

The authors have no relevant financial or non-financial interests to disclose.

Acknowledgements

The authors would like to recognize all the Coalition members and stakeholders for their invaluable contributions and support of this project. In particular, the experience and expertise of Metro Denver Homeless Initiative, Colorado Mental Wellness Network, Metro Community Provider Network, Denver Public Library, Homeless Outreach Providing Encouragement, Bridge House, and The Action Center. We would further like to thank the PNs, PL, and agency supervisors.

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Noland, D.H., Morris, C.D., Kayser, A.M. et al. Results of a Peer Navigator Program to Address Chronic Illness Among Persons Experiencing Homelessness. J Community Health 48, 606–615 (2023). https://doi.org/10.1007/s10900-023-01194-9

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