Investigating Health Risk Environments in Housing Programs for Young Adults: Protocol for a Geographically Explicit Ecological Momentary Assessment Study.

Benjamin F Henwood,Danielle R Madden,Genevieve F Dunton,Stephen S Intille,Eric Rice,Harmony Rhoades,Brian Redline,Sara Semborski,Qu Tang,Eldin Dzubur

doi:10.2196/12112

Abstract

BackgroundYoung adults who experience homelessness are exposed to environments that contribute to risk behavior. However, few studies have examined how access to housing may affect the health risk behaviors of young adults experiencing homelessness.ObjectiveThis paper describes the Log My Life study that uses an innovative, mixed-methods approach based on geographically explicit ecological momentary assessment (EMA) through cell phone technology to understand the risk environment of young adults who have either enrolled in housing programs or are currently homeless.MethodsFor the quantitative arm, study participants age 18-27 respond to momentary surveys via a smartphone app that collects geospatial information repeatedly during a 1-week period. Both EMAs (up to 8 per day) and daily diaries are prompted to explore within-day and daily variations in emotional affect, context, and health risk behavior, while also capturing infrequent risk behaviors such as sex in exchange for goods or services. For the qualitative arm, a purposive subsample of participants who indicated engaging in risky behaviors are asked to complete an in-depth qualitative interview using an interactive, personalized geospatial map rendering of EMA responses.ResultsRecruitment began in June of 2017. To date, 170 participants enrolled in the study. Compliance with EMA and daily diary surveys was generally high. In-depth qualitative follow-ups have been conducted with 15 participants. We expect to recruit 50 additional participants and complete analyses by September of 2019.ConclusionsMixing the quantitative and qualitative arms in this study will provide a more complete understanding of differences in risk environments between homeless and housed young adults. Furthermore, this approach can improve recall bias and enhance ecological validity.International Registered Report Identifier (IRRID)DERR1-10.2196/12112

Highlights

BackgroundRisk environment has been defined as the space—whether social or physical—in which factors external to a person interact to increase the chances of certain health risk behaviors [1,2,3]
There has been limited investigation of young adults with a history of homelessness who have enrolled in housing programs [14] or differences in the risk environment between those experiencing homelessness and those who have moved into housing programs
The Log My Life (LML) study seeks to fill this gap in the literature by developing an innovative, mixed-methods approach using geographically explicit ecological momentary assessments (GEMA) to understand the risk environment of young adults who have either enrolled in housing programs or are currently experiencing homelessness

Summary

Introduction

BackgroundRisk environment has been defined as the space—whether social or physical—in which factors external to a person interact to increase the chances of certain health risk behaviors [1,2,3]. Methods: For the quantitative arm, study participants age 18-27 respond to momentary surveys via a smartphone app that collects geospatial information repeatedly during a 1-week period Both EMAs (up to 8 per day) and daily diaries are prompted to explore within-day and daily variations in emotional affect, context, and health risk behavior, while capturing infrequent risk behaviors such as sex in exchange for goods or services. Conclusions: Mixing the quantitative and qualitative arms in this study will provide a more complete understanding of differences in risk environments between homeless and housed young adults. This approach can improve recall bias and enhance ecological validity.

Objectives

Methods

Results

Discussion

Conclusion