1. Quality of Life for Men who Attend a Day Shelter Compared to Transitional Housing Team Quality Comparison Ellen Drzymala, Shannon Melchior, Tawnee Cain, Kelsey Bigham, Kristen Tam, & Steph Hayden Washington University School of Medicine Program in Occupational Therapy

2. Introduction The Problem 600,000 homeless people in the U.S. Negative impact on occupational performance Impact on quality of life Day program vs. transitional housing

3. Purpose The purpose of this study was to observe the quality of life among men who live in permanent housing, transitional housing and those who attend a day shelter.

4. Hypothesis In St. Louis, individuals living in permanent or transitional housing will have a greater quality of life compared to those attending day shelters.

5. Methods Subjects: Day shelter Transitional housing Permanent housing Development: Altered assessment WHOQOL Data Collection: Administration of written assessment at each of the locations Outcome measures: Self- perceived quality of life

6. Descriptive Statistics Table 1. Sample Characteristics GroupNMean Age ± SD Permanent1243.4 ± 11.9 Labre1242.4 ± 12.2 The Bridge436.8 ± 15.2 Table 2. WHOQOL Score Distribution GroupMean Score ± SDMinMax Permanent64.3 ± 4.85671 Labre57.9 ± 11.73275 The Bridge39.8 ± 3.83645

7. Statistical Data Analysis Kruskal Wallis Analysis Non-parametric Small sample size Cannot assume a normal distribution Interval data Mann- Whitney U Analysis Non-parametric Detects significance

8. Results Table 3. Comparison of QOL among Housing Groups GroupNMean Rank Permanent*1218.9 Labre*1213.7 The Bridge43.6 * Significantly different than The Bridge p<0.05

9. Results Table 3. Comparison of QOL among Housing Groups GroupNMean Rank Permanent*1218.9 Labre*1213.7 The Bridge43.6 * Significantly different than The Bridge p<0.05

10. Results Table 3. Comparison of QOL among Housing Groups GroupNMean Rank Permanent*1218.9 Labre*1213.7 The Bridge43.6 * Significantly different than The Bridge p<0.05

11. Statistical Insight Difficulty recruiting appropriate sample size Incentives failed to motivate participants Demographic information collection Sensitive topic

12. Comparison to Previous Literature Few studies Wolf et al. (2001): transitional housing yielded higher life satisfaction Bebout et al. (1997): improved QOL in stable housing Lack of literature on day programs and quality of life

13. Adding to the Body of Knowledge Data from our study suggest that individuals who reside in transitional housing enjoy a higher quality of life than those attending day shelters.

14. Clinical Implications & Future Work Informs policy makers and program designers Potential area for OT practice Quality of Life Was OT intervention an influential factor in high QOL at the Labre center?

15. Limitations Small & unequal sample sizes Possible untruthful answers Due to environment, laziness, etc. Social desirability bias Limited knowledge of sample demographics Lack of rapport Non-standardized assessment

16. Conclusion & Summary Programs for homeless individuals should utilize a transitional housing format as opposed to a day-shelter design. More research Generalize (other locations; different models) Fill gaps caused by limitations

17. Questions?

18. References Chard, G., Faulkner, T., Chugg, A. (2009). Exploring occupation and its meaning among homeless men. British Journal of Occupational Therapy, 72(3), 116-124. Hubley, A.M., Russel, L.B., Palepu, A., Hwang, S.W. (2012). Subjective quality of life among individuals who are homeless: A review of current knowledge. Social Indicators Research Journal Morrison, D.S.(2009).Homelessness as an independent risk factor for mortality:results from a retrospective cohort study.International Journal of Epidemiology. (38). p. 877-883 National Alliance to End Homelessness. (2012). The state of homelessness in America 2012. Washington, DC: Homelessness Research Institute. Whiteford, G. (2000). Occupational deprivation: Global challenge in the new millennium. British Journal of Occupational Therapy 63(5), 200-204. Wilcock, A.A. (2005). Relationship of occupations to health and well-being. In C.H. Christiansen, C.M. Baum and J. Bass-Haugen (Eds.) Occupational Therapy: Performance, Participation and Well-Being. 3rd edition. Thorofare, NJ: Slack, Inc. Williams, J. I. (2000). Ready, step, stop: Reflections on assessing quality of life and the WHOQOL-100 (U.S. version). Journal of Clinical Epidemiology, 53(I), 13-17.