People who are homeless have high incidence and prevalence of physical illnesses that are further exacerbated by co-occurring serious mental illnesses. African Americans are disproportionately affected by homelessness with as many as 50 percent of homeless people being African American. In Illinois, the homeless population is increasing and expected to rise 5 percent. In Chicago from 2006-2010, shelter use rose 28.4 percent and those unsheltered surged to 40.4 percent. One neighborhood especially hard hit is the Edgewater-Uptown area with among the highest rate of homeless people with co-occurring mental illness in the country. Although integrated care programs have been proposed and developed for this population, they have limited impact in part because they have not fully incorporated the voice of the homeless in development and implementation. Hence, we propose a community based participatory research (CBPR) project meant to target the health care needs of African Americans who are homeless with serious mental illness. A preliminary needs assessment with the group has helped to direct this proposal. We will establish a Community Advisory Board (CAB) comprised of African Americans with lived experience and co-chaired by the co-PIs including an African American with lived experience. The CAB will have control over all aspects of this proposal. To define the problem, we will conduct qualitative interviews of people with lived experience and other stakeholders and then cross-validate this information with a second group in a quantitative survey. The CAB will use this information to design an intervention using an integrated care model. Feasibility, acceptability, and impact of the intervention will then be tested in a pilot evaluation. Outcomes will include assessments of perceived availability, program satisfaction, physical and mental health, and quality of life with longitudinal design (e.g., baseline, midpoint, and follow-up).
(See Instructions): African Americans who are homeless with serious mental illness suffer a catastrophic level of morbidity and mortality. Through community based participatory research, we will identify specific health concerns of this population in Chicago's Edgewater-Uptown neighborhood and develop an integration meant to promote integrated care therein. The project will also include a pilot investigation of the acceptability and impact of thi intervention.