Increases in social support co-occur with decreases in depressive symptoms and substance use problems among adults in permanent supportive housing: an 18-month longitudinal study

Zhengqi Tan,Eun-Young Mun,Uyen-Sa D T Nguyen,Scott T Walters

doi:10.1186/s40359-020-00507-0

Zhengqi Tan, Eun-Young Mun + Show 2 more

Open Access

https://doi.org/10.1186/s40359-020-00507-0

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Abstract

BackgroundSocial support is a well-known protective factor against depressive symptoms and substance use problems, but very few studies have examined its protective effects among residents of permanent supportive housing (PSH), a housing program for people with a history of chronic homelessness. We utilized unconditional latent growth curve models (LGCMs) and parallel process growth models to describe univariate trajectories of social support, depressive symptoms, and substance use problems and to examine their longitudinal associations in a large sample of adults residing in PSH.MethodsParticipants were 653 adult PSH residents in North Texas (56% female; 57% Black; mean age: 51 years) who participated in a monthly health coaching program from 2014 to 2017. Their health behaviors were assessed at baseline and tracked every six months at three follow-up visits.ResultsUnconditional LGCMs indicated that over time, social support increased, whereas depressive symptoms and substance use problems decreased. However, their rates of change slowed over time. Further, in parallel process growth models, we found that at baseline, individuals with greater social support tended to have less severe depressive symptoms and substance use problems (coefficients: − 0.67, p < 0.01; − 0.52, p < 0.01, respectively). Individuals with a faster increase in social support tended to have steeper rates of reduction in both depressive symptoms (coefficient: − 0.99, p < 0.01) and substance use problems (coefficient: − 0.98, p < 0.01), respectively.ConclusionsThis study suggests that plausibly, increases in social support, though slowing over time, still positively impact depressive symptoms and substance use problems among PSH residents. Future PSH programs could emphasize social support as an early component as it may contribute to clients’ overall health.

Highlights

People who are homeless are at higher risk for health problems, such as malnutrition, stress, communicable diseases, and violence [1]
We subsequently modeled the parallel trajectories [44, 45] of social support and depressive symptoms, and the parallel trajectories of social support and substance use problems in two separate, bivariate longitudinal analyses [46] to examine the relationships of the parameters from one trajectory with those from the other trajectory [47]
All measurement models were fitted following the structure of the measurement tool for that health behavior

Summary

Introduction

People who are homeless are at higher risk for health problems, such as malnutrition, stress, communicable diseases, and violence [1]. Some evidence suggests that social support is negatively associated with both depressive symptoms and substance use problems among people who are homeless [7,8,9,10,11,12]. Few studies have examined the longitudinal associations of social support with either depressive symptoms or substance use problems among PSH residents with a history of homelessness. Social support is a well-known protective factor against depressive symptoms and substance use problems, but very few studies have examined its protective effects among residents of permanent supportive housing (PSH), a housing program for people with a history of chronic homelessness. We utilized unconditional latent growth curve models (LGCMs) and parallel process growth models to describe univariate trajectories of social support, depressive symptoms, and substance use problems and to examine their longitudinal associations in a large sample of adults residing in PSH

Methods

Results

Discussion

Conclusion