A Systematic Review and Meta-Analysis of the Prevalence of Post-Traumatic Stress Disorder among Homeless People

Ayano, Getinet; Solomon, Melat; Tsegay, Light; Yohannes, Kalkidan; Abraha, Mebratu

doi:10.1007/s11126-020-09746-1

Cited by 34 publications

(23 citation statements)

References 56 publications

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“…For PEH, the pooled SARS-Cov-2 prevalence estimate was 29·49% (95% Confidence Interval, 95%CI=16·44%-42·55%, I 2 =97·79%, p=0·00) in the context of outbreak situations. As a sensitivity analysis, we removed an outlier that could reflect a super-spreading event (Imbert et al, 22 67·33%, 95%CI=59·48%-74·32%), resulting in a pooled prevalence of 23·32% (95%CI=12·12%-34·53%, I 2 =96·79%, p=0·00). For baseline estimation, the pooled prevalence was 2·14% (95%CI=1·02%-3·27%, I 2 =83·80%, p=0·00) (figure 2).…”

Section: Resultsmentioning

confidence: 96%

“…As a sensitivity analysis, we removed an outlier that could reflect a super-spreading event (Imbert et al, 22 67·33%, 95%CI=59·48%-74·32%), resulting in a pooled prevalence of 23·32% (95%CI=12·12%-34·53%, I 2 =96·79%, p=0·00). For baseline estimation, the pooled prevalence was 2·14% (95%CI=1·02%-3·27%, I 2 =83·80%, p=0·00) (figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…For staff members, the random-effect meta-analysis resulted in a pooled prevalence of 15·18% (95%CI=8·95%-21·42%, I 2 =65·76%, p=0·02) during an outbreak situation and 1·72% (95%CI=0·31%-3·12%)) for baseline estimation (figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…Summarizing the quantitative cross-sectional studies, all articles had a clear population by study design as a majority were conducted in homeless shelters, stated clear research objectives and, if reporting on prevalence, used PCR testing. Yet, few studies explicitly stated if data collection was conducted during a suspected outbreak situation or with the aim to provide baseline estimates and only 2 studies engaged in follow-up testing, one after 1 week 1 and one after 3-4 weeks 2 to investigate the full extent of a potential outbreak. As expected from studies conducted at an early stage of the pandemic, the majority of results are descriptive in nature.…”

Section: Supplementary Materialsmentioning

confidence: 99%

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SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

Mohsenpour

Bozorgmehr

Rohleder

et al. 2021

Preprint

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Background: People experiencing homelessness (PEH) may be at particular risk for COVID19. We synthesised the evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of targeted strategies for infection prevention and control (IPC). Methods: Systematic review of articles, reports and grey-literature indexed in electronic databases (EMBASE, WHO-Covid19, Web of Science), pre-print repositories, institutional websites, and handsearching. Empirical papers of any study design addressing Covid-19 in PEH or homeless shelters' staff in English were included. (PROSPERO 2020 CRD42020187033) Findings: Of 194 publications, 13 studies were included (two modelling, ten observational and one qualitative study). All were conducted in high-income countries. Random-effect meta-analysis of prevalence estimates yields a baseline SARS-Cov-2 prevalence of 2.14% (95% Confidence-Interval, 95%CI=1.02-3.27) in PEH and 1.72 % (95%CI=0.31-3.12) in staff. In outbreaks, the pooled prevalence increases to 29.49% (95%CI=16.44-29.55) in PEH and 15.18% (95%CI=8.95-21.42) in staff. Main IPC strategies were universal and rapid testing, expansion of non-congregate housing support, and individual measures in shelters (bed spacing, limited staff rotation). Interpretation: Up to 30% PEH and 17% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found on health-related outcomes or health effects of NPI. An overview and evaluation of IPC strategies for PEH, including a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems is needed. Qualitative studies may serve to voice PEH experiences and guide future evaluations and IPC strategies. Funding: No source of funding.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Supplementary Materialsmentioning

confidence: 99%

See 2 more Smart Citations

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

Mohsenpour

Bozorgmehr

Rohleder

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Homelessness is associated with mental health problems [1,2], infectious diseases [3], cardiovascular and respiratory diseases, and several long-term conditions (e.g., asthma, COPD, epilepsy) [4]. People experiencing homelessness (PEH) are a diverse group categorized according to their living situation: (a) Rooflessness, people without shelter sleeping rough in the streets or in public spaces, (b) houselessness, with accommodation of temporary nature, (c) living in insecure housing, shaped by threats of insecure tenancy, eviction or domestic violence, and (d) living in inadequate housing, e.g.…”

Section: Introductionmentioning

confidence: 99%

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background: People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). Methods: Systematic review of articles, indexed in electronic databases (EMBASE, WHOÀ ÀCovid19, Web of Science), institutional websites and the Norwegian Institute of Public Health's live map of COVID-19 evidence, and published from December 1st, 2019, to March 3rd, 2021. Empirical papers of any study design addressing Covid-19 and health(-related) outcomes in PEH or shelters' staff were included. (PROSPERO-2020-CRD42020187033) Findings: Of 536 publications, 37 studies were included (two modelling, 31 observational, four qualitative studies). Random-effect meta-analysis yields a baseline SARS-Cov-2 prevalence of 232% (95% Confidence-Interval, 95%CI=130À334) in PEH and 155% (95%CI=079À231) in staff. In outbreaks, the pooled prevalence increases to 3159% (95%CI=2048À4271) in PEH and 1480% (95%CI=1073À1887) in staff. Main IPC strategies were universal rapid testing, expansion of non-congregate housing, and in-shelter measures (bed spacing, limited staff rotation, reduction in number of residents). Interpretation: 32% of PEH and 15% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found quantifying health-related outcomes of NPI. Overview and evaluation of IPC strategies for PEH, a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems are needed. Qualitative studies may serve to voice PEH and shelter staff experiences, and guide future evaluations and IPC strategies.

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“Halfway Independent”: Experiences of formerly homeless adults living in permanent supportive housing

Pilla

Park‐Taylor

2021

Journal Community Psychology

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Permanent supportive housing (PSH), which combines affordable public housing with social services, has become the dominant model in the United States for providing housing to formerly homeless people. PSH has been effective in reducing re‐entry to homelessness, yet has shown limited evidence of improving formerly homeless individuals' mental health and quality of life. This study aimed to understand the lived experiences of formerly homeless adults' adjustment to tenancy in PSH, with a focus on how living in PSH has affected their meaningful activity and social engagement. Based on a phenomenological approach, a thematic analysis was conducted using semi‐structured interviews with 17 individuals living in three PSH buildings in New York City. Results suggested that PSH was beneficial in fulfilling formerly homeless individual's basic needs and facilitating lifestyle improvements, yet many were dissatisfied with their living conditions and lacked meaningful activity, social integration, and community belongingness. These issues were found to develop in large part as a result of formerly homeless individuals' disharmonious relationships within the social context of PSH, consisting of staff members, other residents, and people in the surrounding community. The effects of the COVID‐19 pandemic and implications for PSH social services are discussed.

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A Systematic Review and Meta-Analysis of the Prevalence of Post-Traumatic Stress Disorder among Homeless People

Cited by 34 publications

References 56 publications

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

“Halfway Independent”: Experiences of formerly homeless adults living in permanent supportive housing

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