Date of Degree

9-2015

Document Type

Dissertation

Degree Name

D.P.H.

Program

Public Health

Advisor(s)

Mary Clare Lennon

Subject Categories

Public Health

Keywords

Families; Homelessness; Mental Health; Substance Use; Trauma

Abstract

Homelessness is at historical levels in the United States and New York City has not been immune to this nationwide trend. Homeless populations are not only increasing in number but are remaining in the shelter for longer periods of time. Homelessness, itself has been shown to have negative consequences on mental health and physical health, but its effects are particularly significant for families with children who have greater needs and who are more susceptible to negative experiences at early ages that can have lifelong impact. Despite this recent data there has been very little to no research on the potential impact of the shelter environment on the mental or physical well-being of homeless families.

Thus, this dissertation research aims to fill this gap in the current literature by conducting a secondary analysis of the HIV Prevention Outreach for Parents and Early Adolescents (HOPE) study to test: 1) the association between three shelter related variables (i.e., time in the shelter, the perceived social environment of the shelter, and difficulty following shelter rules) and psychosocial outcomes for caregivers (i.e., mental health, parental stress, and substance use among caregivers), 2) the association between three shelter related variables (i.e., time in the shelter, the perceived social environment of the shelter, and difficulty following shelter rules) and psychosocial outcomes for youth (i.e., depressive symptoms, and substance use among caregivers), 3) the potential moderating effect of this perceived social environment of the shelter and difficulty following rules on the association between trauma and psychosocial outcomes for both youth residents and their caregivers. The sample for this research consisted of youth (ages 11 - 14) and their caregivers (n = 452) residing in 10 shelters in New York City. Hierarchical regressions were employed to test various models within the three aims of the study. In addition, sampling of residents within shelters and youth within families was accounted for in the analysis.

Results of the analysis conducted indicate that the length of time in the shelter was not significantly associated with psychosocial outcomes for youth and caregivers with two exceptions, namely caregiver mental health and parenting stress. Perception of the shelter environment was strongly associated with all psychosocial outcomes for caregivers and their youth, with the exception of caregiver substance use. Difficulty following shelter rules was significantly associated with all psychosocial outcomes for both youth and caregivers (although the youth substance use finding was counter to what was initially hypothesized). Trauma was also significantly associated with all psychosocial outcomes as well with the exception of parenting stress, and caregiver substance use. The findings from the third aim of the study revealed that his perceived social environment of the shelter did not prove to be a significant moderator of the association between trauma and psychosocial outcomes for youth and caregivers with the exception of youth substance use. Difficulty following rules was also not found to be as significant moderator with the exception of parenting stress and youth substance use. However both findings are counter-intuitive and discussed further in the concluding chapter. Thus, the findings support a more direct-effect relationship between the perceived social environment of the shelter and psychosocial outcomes as well as direct effects of difficulty following shelter rules and may also be indicative of a buffering effect. In addition, the findings of all three aims suggest an importance in the manner in which shelter is provided above and beyond providing a temporary residence.

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