title: Constructing and identifying predictors of frailty among homeless adults—a latent variable structural equations model approach.
abstract: Homeless urbanites are a heterogeneous population with unique health and social service needs. The study examined situational, behavioral, health-related and resource indicators in terms of their direct impact on frailty, hypothesized as a latent variable. Using structural equation modeling (SEM), a model was tested with 150 homeless men and women, ages 40–73, from three homeless day center drop-in sites on Skid Row and one residential drug treatment (RDT) facility that works with homeless parolees and probationers. In bivariate analyses with the latent construct frailty, months homeless (p < 0.01), female gender (p < 0.05), education (p < 0.05), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), health care utilization (p < 0.01), and falls (p < 0.001) were significantly associated with frailty. In the final path model, significant predictors of frailty included educational attainment (p < 0.01), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), and falls (p < 0.01). These findings will serve as a foundation for future nurse-led, community-based initiatives that focus on key predictors of frailty among the homeless and the development of interventions.
authors: Benissa E
authors: BE
authors: Salem
authors: Adeline
authors: A
authors: Nyamathi
authors: Mary-Lynn
authors: ML
authors: Brecht
authors: Linda R
authors: LR
authors: Phillips
authors: Janet C
authors: JC
authors: Mentes
authors: Catherine
authors: C
authors: Sarkisian
authors: Judith A
authors: JA
authors: Stein
mesh_terms: D000328:Adult; D000368:Aged; D004522:Educational Status; D005260:Female; D016330:Frail Elderly; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D020380:Needs Assessment; D011237:Predictive Value of Tests; D012947:Social Work; D014505:Urban Population; D035862:Vulnerable Populations