Individual agency, community capacity building, and chronic illness care: Using participatory methods to implement the Stanford Chronic Disease Self Management Program in a Housing First program

Pathways to Housing is a program that ends homelessness for people with psychiatric disability by providing access to permanent, independent housing, along with comprehensive, community-based support and treatment services. Once housed, individuals are in a position to address numerous chronic health conditions that are often newly recognized. A critical component of chronic illness care is self-management support. While there is evidence of the efficacy of standard chronic disease self-management programs across socio-economic and education levels, their applicability for individuals with experiences of both chronic homelessness and serious mental illness is unknown. Earlier research from our program suggests that these individuals have unique health support needs stemming from complexities associated with 1) making the transition from homelessness to permanent supportive housing and 2) co-occurring substance use. This presentation will describe a pilot implementation of the Stanford Chronic Disease Self Management Program (CDSMP) at Pathways to Housing using community-based participatory research methodology, which includes both consumer and clinician researchers on the study team. The specific aims of the project were to examine: (1) the impact of collaborative inquiry into health program development on critical agency; (2) whether CDSMP is experienced as a valuable intervention from the perspective of Housing First tenants; (3) what health related outcomes, if any, improve for consumer investigators as a result of both health program participation and its evaluation. Measured quantitative and qualitative outcomes in the domains of personal agency, health, functioning, self-efficacy, and community capacity building will be discussed.