title: Type of social support among homeless women: its impact on psychosocial resources, health and health behaviors, and use of health services.
abstract: BACKGROUND
  Information about whether specific types of support are associated with poor psychosocial profiles, health behaviors, and positive use of medical care is critical for identifying homeless women at highest risk for negative outcomes.
  
  
  OBJECTIVE
  This study aimed to examine the impact that various levels of support from substance users and nonusers have on homeless women's psychosocial profiles, health and health behaviors, and use of health services.
  
  
  METHODS
  This cross-sectional survey used a sample of 1,302 sheltered homeless women. Using controls for potential confounders, outcomes were compared across four mutually exclusive subgroups of women reporting support from substance users only (n = 58), substance nonusers only (n = 439), both users and nonusers (n = 136), and no one (n = 669). Structured and psychometrically sound instruments measured social support, substance use, self-esteem, coping, and psychological symptoms. Additional instruments measured sociodemographic characteristics, sexual risk behavior, health status, and use of health services.
  
  
  RESULTS
  As compared with those who have little or no support, women whose support included substance nonusers reported better psychosocial profiles and somewhat greater use of health services. Support from substance nonusers only was associated with better health behaviors and greater use of health services. Support from substance users only was essentially equivalent to not having support.
  
  
  CONCLUSIONS
  Modifying the social networks of homeless women appears to be associated with improved mental health outcomes, less risky health behaviors, and greater use of health services.
authors.affiliation: School of Nursing, University of California at Los Angeles, 90095-6918, USA. ayamath@sonnet.ucla.edu
authors.forename: A
authors.initials: A
authors.lastname: Nyamathi
authors.forename: B
authors.initials: B
authors.lastname: Leake
authors.forename: C
authors.initials: C
authors.lastname: Keenan
authors.forename: L
authors.initials: L
authors.lastname: Gelberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006703:Ill-Housed Persons; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D017533:Marital Status; D012649:Self Concept; D012934:Social Isolation; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology