Improving Lives of Most Vulnerable: The Relationship between Diet, Physical Activity, and Quality of Life among Permanent Supportive Housing Residents

Background: Chronic homelessness is a complex public health concern in the United States. People experiencing chronic homelessness are much more likely to suffer from mental illness and substance use, and to be overweight or obese (Tsai & Rosenheck, 2013; Tsemberis, Kent, & Respress, 2012). Housing First is an approach to place people who are chronically homeless into Permanent Supportive Housing (PSH) (Rog el at., 2014). There is clear evidence PSH programs increase housing retention and, reduce healthcare and criminal justice costs (Tsemberis & Eisenberg, 2014; McLaughlin, 2010). However, becoming housed does not necessarily improve a person’s overall quality of life (QOL) (Wolf et al., 2001). Improvement in diet and physical activity may be one way to improve QOL among vulnerable populations (Blissmer et al., 2006). However, this association has not been explored among PSH residents. The purpose of this study was to explore the patterns of change and relationship between diet, physical activity and QOL among PSH residents enrolled in a health coaching program. Method: We used data collected during baseline and follow up interviews from m.chat – a health coaching program for PSH residents in Fort Worth. The program utilizes motivational interviewing and wellness incentives to help people achieve health goals. Specifically, we examined demographic characteristics, diet, physical activity and overall QOL from 230 participants enrolled in the m.chat program. Paired t-test and mixed model analysis was performed utilizing SPSS software. Results: We found a significant improvement in the total QOL scores from baseline to follow-up. A random intercept model showed a positive association between change in diet and the improvement in QOL. Physical activity was not significantly related to improved QOL; however, there was large variation in the physical activity data. Conclusion: This study is the first to look at changes in QOL among PSH residents enrolled in a health coaching program. Interventions that encourage diet and physical activity may improve overall QOL among PSH residents.