Lifestyle Factors and Depressive Symptoms Among Permanent Supportive Housing Residents

Abstract

Background: Depression is prevalent among low-income populations. Many lifestyle factors may influence depressive symptoms, including vegetable and fruit intake, physical activity, tobacco use, alcohol use, social support, and satisfaction with leisure activities. However, the influence of lifestyle factors on depressive symptoms among permanent supportive housing (PSH) residents is unclear. In addition, it is unclear if PSH residents with depressive symptoms are interested in working on lifestyle factors. Methods: A longitudinal analysis was conducted among 420 PSH residents participating in a technology-assisted health coaching program. Three timepoints were included, corresponding with the screening/baseline, six-month, and twelve-month assessment visits. The independent variables were total vegetable and fruit intake, physical activity, tobacco use, alcohol use, social support, and satisfaction with leisure activities. The dependent variable was depressive symptoms, measured by the 9-item Patient Health Questionnaire (PHQ-9). Covariates were race, sex, age, and visit. In addition, social support was examined as a potential effect modifier. Participants' interest in working on health areas was evaluated as well. Results: Moderate alcohol consumption predicted lower depressive symptoms compared with heavy alcohol consumption (b=-1.54, p=0.01). Additionally, the difference in depressive symptoms between non-consumers and heavy consumers of alcohol approached statistical significance with non-consumers of alcohol having less depressive symptoms than heavy consumers of alcohol (b = -.76, p = .07). High compared with low satisfaction with leisure activities (b=-0.83, p<0.0001) and high compared with low social support (b=-1.86, p<.0001) predicted lower depressive symptoms. Tobacco use was a marginally statistically significant predictor of depressive symptoms (b=0.92, p=0.05). Total vegetable and fruit intake and physical activity were not statistically significant predictors of depressive symptoms. Social support was not a statistically significant modifier of the effect of lifestyle factors on depressive symptoms. Participants with moderate, moderately severe, and severe depressive symptoms were most interested in working on diet, exercise, and substance use and least interested in working on social support and recreation/leisure activities. Conclusions: Alcohol use, tobacco use, social support, and satisfaction with leisure activities may influence depressive symptoms among PSH residents. However, participants may not be interested in working on social support and satisfaction with leisure activities. An ecological approach may be necessary to influence social support and satisfaction with leisure activities among PSH residents. Lifestyle interventions designed to reduce depressive symptoms among PSH residents should aim to increase PSH residents' social support and satisfaction with leisure activities.