Pilot Implementation of a Nutrition-Focused Community-Health-Worker Intervention among Formerly Chronically Homeless Adults in Permanent Supportive Housing

Jane E. Hamilton (), Diana C. Guevara, Sara F. Steinfeld, Raina Jose, Farrah Hmaidan, Sarah Simmons, Calvin W. Wong, Clara Smith, Eva Thibaudeau-Graczyk and Shreela V. Sharma
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Jane E. Hamilton: McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX 77030, USA
Diana C. Guevara: McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX 77030, USA
Sara F. Steinfeld: McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX 77030, USA
Raina Jose: Bread of Life, Inc., Houston, TX 77002, USA
Farrah Hmaidan: Bread of Life, Inc., Houston, TX 77002, USA
Sarah Simmons: Bread of Life, Inc., Houston, TX 77002, USA
Calvin W. Wong: McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX 77030, USA
Clara Smith: Bread of Life, Inc., Houston, TX 77002, USA
Eva Thibaudeau-Graczyk: Temenos, CDC, Houston, TX 77003, USA
Shreela V. Sharma: McGovern Medical School, The University of Texas Health Science Center Houston, Houston, TX 77030, USA

IJERPH, 2024, vol. 21, issue 1, 1-16

Abstract: Food insecurity is a known health equity threat for formerly chronically homeless populations even after they transition into permanent housing. This project utilized a human-centered design methodology to plan and implement a nutrition-focused community-health-worker (CHW) intervention in permanent supportive housing (PSH). The project aimed to increase access to healthy foods, improve nutritional literacy, healthy cooking/eating practices, and build community/social connectedness among 140 PSH residents. Validated food-security screening conducted by CHWs identified low or very low food security among 64% of 83 residents who completed the baseline survey, which is similar to rates found in a previous study among formerly homeless populations placed in PSH. Major themes identified through an analysis of resident feedback include (1) lack of needed kitchenware/appliances for food preparation, (2) knowledge gaps on how to purchase and prepare healthier food, (3) positive perceptions of healthy food options, (4) expanded preferences for healthy, easy-to-prepare foods, (5) regaining cooking skills lost during homelessness, (6) positive experiences participating in group activities, (7) community re-entry, and (8) resident ownership. Preliminary findings suggest the use of a human-centered design methodology for planning and implementing this multi-level CHW intervention helped reduce food insecurity, engaged participants in learning and adopting healthy and safe cooking and eating practices, and fostered social connectedness and feelings of community among formerly chronically homeless PSH residents.

Keywords: food insecurity; homelessness; permanent supportive housing; program planning/implementation to address social determinants of health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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