A Longitudinal Study Among Permanent Supportive Housing Residents: Increase in Social Support Co-Occurring with Decrease in Depressive Symptoms and Substance Use Problems

Purpose: 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 examined whether perceived social support improves when provided with regular health coaching visits and whether improved social support is associated with reduced depressive symptoms and substance use problems among this underserved population. Methods:Participants 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. We assessed their health behaviors at baseline and three follow-up visits for up to 18 months. We used latent growth curve models to capture changes over time and parallel process growth models to examine the associations between the trajectories of social support and the trajectories of each health measure. Results:PSH residents showed improved social support, and decreased depressive symptoms and substance use problems over time. In addition, individuals with greater needs at baseline tended to improve faster, although their improvements slowed over time. Further, those who improved in social support tended to show reduced depressive symptoms (coefficient: –0.67, p< 0.01) and substance use problems (coefficient: –0.52, p< 0.01). Conclusions:This study suggests that increases in social support may positively impact depressive symptoms and substance use problems among PSH residents. Future housing programs could emphasize social support as an early component. Supported by Medicaid1115Waiver & R01AA019511.