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mHealth Technology to Connect and Empower People Experiencing Homelessness to Improve Health and Social Need Outcomes

Award Number: R18HS027750
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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PROJECT SUMMARY/ABSTRACT People experiencing homelessness (PEH) are at exceptionally high risk of frequent emergency department (ED) and hospital use, poor functional outcomes, and increased morbidity and mortality from poorly managed chronic health conditions and complex social needs. Significant deficiencies in continuity of care and poor communication between PEH and health and social services providers contribute to these bleak long-term outcomes. Evidence-based interventions of particular promise for reducing ED and hospital utilization and improving health outcomes and meeting social needs involve: 1) providing care in the community to overcome barriers including transportation and fear of stigmatization; 2) coordination of care transitions following ED or hospital discharge to improve access to needed community supports and reduce the risk of readmission; and 3) using mHealth technology to link PEH with appropriate community-based health and social services. This project will build on evidence from two feasibility studies in order to integrate and test a mHealth intervention, comprised of global positioning system technology and text messaging components, into a community setting to connect PEH with a community-based case manager and healthcare and social services. Our hypothesis is that integrating the mHealth intervention into an established, trusted navigation center for PEH will mitigate barriers to care and gaps in the care continuum resulting in decreased ED and hospital use and improved health outcomes and attainment of social needs. Our specific aims are to: 1) refine the existing mHealth intervention and implementation strategy using a community-based participatory research approach; 2) conduct a stratified RCT to compare a mHealth intervention with usual care community-based case management to examine the impact on healthcare utilization (primary outcome), medication adherence, social support, psychological distress and social needs attainment (secondary outcomes) in PEH; and 3) identify and understand factors from PEH and stakeholder perspectives that impact sustainability of the mHealth intervention. The project will be conducted in four phases. During phase one, we will refine the intervention (Aim 1) by eliciting feedback from PEH, key informants, and our community advisory board before conducting a usability test of the refined mHealth intervention. Phase two will consist of the RCT (Aim 2) to compare the efficacy of the mHealth intervention to a usual care control group. Phase three will identify factors to facilitate sustainability of the mHealth intervention (Aim 3) using stakeholder interviews. Phase four will consist of data analysis, triangulation of findings, and dissemination. This study is significant and innovative for several reasons: targets an AHRQ understudied group with complex needs and use of high cost services at a critical transition point; is based in a community-based navigation center instead of a traditional health or social services setting; and recognizes the need for end-user engagement in design.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $382,691 )
2023	2023	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR	AUSTIN	TX	78712	TRAVIS	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	5/31/2023	NON-COMPETING CONTINUATION	$382,691
														Subtotal = $382,691

Issue Date FY: 2022 ( Subtotal = $397,429 )
2022	2022	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR	AUSTIN	TX	78712	TRAVIS	USA	Research on Healthcare Costs, Quality and Outcomes	001	3	6/3/2022	NON-COMPETING CONTINUATION	$397,429
2022	2021	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR MN 13	AUSTIN	TX	78712	TRAVIS	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	10/19/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $397,429

Issue Date FY: 2021 ( Subtotal = $396,025 )
2021	2021	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR MN 13	AUSTIN	TX	78712	TRAVIS	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	6/16/2021	NON-COMPETING CONTINUATION	$396,025
														Subtotal = $396,025

Issue Date FY: 2020 ( Subtotal = $395,062 )
2020	2020	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR MN 13	AUSTIN	TX	78712	TRAVIS	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	9/1/2020	NEW	$395,062
2020	2020	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR MN 13	AUSTIN	TX	78712	TRAVIS	USA	Research on Healthcare Costs, Quality and Outcomes	001	1	9/9/2020	NEW	$0
														Subtotal = $395,062

Grand Total All Awards = $1,571,207

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mHealth Technology to Connect and Empower People Experiencing Homelessness to Improve Health and Social Need Outcomes

Award Number: R18HS027750

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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