Homeless Care Management App

Phase 3

Completed

Conditions: Mental Health Impairment
Substance Use Disorders
Health Behavior
Adherence, Patient

Interventions: Behavioral: In-Person Case Management at Homeless Recovery Program
Behavioral: Unlimited Smartphone
Behavioral: Smartphone Based Case Management (SPCM) app

Brief Summary: There is a significant revolving door of incarceration among homeless adults, a population with substantial health disparities. Homeless adults who receive the professional coordination of individualized care (i.e., case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be re-incarcerated. The proposed study will use mobile technology to address these barriers and fill gaps in the understanding of the causes of the revolving door of homeless incarceration. This research represents a step toward integrated service connection and healthcare service provision for one of the most underserved, high need, and understudied populations in the United States. Smart phone apps that increase the use of available healthcare services and identify predictors of key outcomes (e.g., homelessness, re-arrest, medication compliance) could be used to reach hard to reach populations with histories of significant and persistent health disparities (e.g., homeless adults).

Recruitment & Eligibility

Inclusion Criteria

released from Dallas County Jail in the past month
plan to reside in the Dallas area for the next year
enrolled in The Bridge Homeless Recovery Program
willing and able to attend the baseline visit, randomization visit, and the 1, 3, and 6-month follow-up visits
score ≥ 4 on the REALM-SF indicating > 6th grade English literacy level
score >24 on the Mini-Mental State Exam indicating no substantial cognitive impairment.

Exclusion Criteria

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
Usual Case Management (UCM)	In-Person Case Management at Homeless Recovery Program	Group receives standard case management at the shelter
Smartphone Based Case Management (SPCM)	Smartphone Based Case Management (SPCM) app	Group receives standard case management and an unlimited smartphone with the SPCM app
UCM + Smartphone	In-Person Case Management at Homeless Recovery Program	Group receives standard case management and an unlimited smartphone
UCM + Smartphone	Unlimited Smartphone	Group receives standard case management and an unlimited smartphone
Smartphone Based Case Management (SPCM)	Unlimited Smartphone	Group receives standard case management and an unlimited smartphone with the SPCM app
Smartphone Based Case Management (SPCM)	In-Person Case Management at Homeless Recovery Program	Group receives standard case management and an unlimited smartphone with the SPCM app

Primary Outcome Measures

Name	Time	Method
Number of Case Management Sessions Completed	6-month follow-up	Total number of sessions completed between the randomization visit and 6-month follow-up

Secondary Outcome Measures

Name	Time	Method
Number of Homeless Nights	6 months	Total number of self-reported homeless nights over the 6 month study period (via Timeline Follow Back Procedures). Participants with any missing are excluded.
Number of Re-arrests	12 months	Total number of times each participant is booked into Dallas County Jail (using jail arrest records)
Alcohol Use	6 months	Number of days of alcohol use (via Timeline Follow Back procedures). Any participant that missed any of the follow-ups are missing.
Drug Use	6 months	Number of days of drug use (via Timeline Follow Back procedures). Any participant that missed any of the 3 follow-ups are missing.

Locations (2): UTHealth School of Public Health
🇺🇸
Dallas, Texas, United States
University of Oklahoma Health Sciences Center - OTRC
🇺🇸
Oklahoma City, Oklahoma, United States