{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:38:30Z","timestamp":1787020710560,"version":"build-2736575974"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","award":["435-2016-0761"],"award-info":[{"award-number":["435-2016-0761"]}],"id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Health Qual Life Outcomes"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In health and social service evaluations, including research on homelessness, quality of Life (QOL) is often used as a key indicator of well-being among service users. However, no typology has been developed on changes in QOL over a 12-month period for a heterogenous sample of homeless individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cluster analysis was employed to identify a typology of change in QOL for 270 currently or formerly homeless individuals using emergency shelters, temporary housing (TH) and permanent housing (PH) services in Quebec (Canada). Participant interviews were conducted at baseline and 12\u00a0months later. An adapted Gelberg\u2013Andersen Model helped organize QOL-related sociodemographic, clinical, and service use variables into predisposing, needs, and enabling factors, respectively. Comparison analyses were performed to determine group differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four groups emerged from the analyses: (1) young women in stable-PH or improved housing status with moderately high needs and specialized ambulatory care service use, with improved QOL over 12\u00a0months; (2) middle-age to older men with stable housing status, few needs and low acute care service use, with most improvement in QOL over 12\u00a0months; (3) older individuals residing in stable-PH or improved housing status with very high needs and reduced QOL over 12\u00a0months; and (4) men in stable-TH or worse housing status, with high substance use disorder, using few specialized ambulatory care services and showing decline in QOL over 12\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings suggest that positive change in QOL over 12\u00a0months was mainly associated with fewer needs, and stability in housing status more than housing improvement. Specific recommendations, such as assertive community treatment and harm reduction programs, should be prioritized for individuals with high needs or poor housing status, and among those experiencing difficulties related to QOL, whereas individuals with more favourable profiles could be encouraged to maintain stable housing and use services proportional to their needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12955-021-01768-y","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T08:22:32Z","timestamp":1618993352000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Typology of changes in quality of life over 12\u00a0months among currently or formerly homeless individuals using different housing services in Quebec, Canada"],"prefix":"10.1186","volume":"19","author":[{"given":"Gesthika","family":"Kaltsidis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4743-8611","authenticated-orcid":false,"given":"Guy","family":"Grenier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhirong","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"L\u2019Esp\u00e9rance","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9e","family":"Fleury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"1768_CR1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.psychres.2005.07.002","volume":"137","author":"J Caron","year":"2005","unstructured":"Caron J, Mercier C, Diaz P, Martin A. Socio-demographic and clinical predictors of quality of life in patients with schizophrenia or schizo-affective disorder. Psychiatry Res. 2005;137:203\u201313.","journal-title":"Psychiatry Res"},{"key":"1768_CR2","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1192\/bjp.187.2.121","volume":"187","author":"M Ruggeri","year":"2005","unstructured":"Ruggeri M, Nos\u00e8 M, Bonetto C, Cristofalo D, Lasalvia A, Salvi G, Stefani B, Malchiodi F, Tansella M. Changes and predictors of change in objective and subjective quality of life: multiwave follow-up study in community psychiatric practice. Br J Psychiatry. 2005;187:121\u201330.","journal-title":"Br J Psychiatry"},{"key":"1768_CR3","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1177\/0020764008100801","volume":"56","author":"M Piat","year":"2010","unstructured":"Piat M, Sabetti J, Bloom D. The transformation of mental health services to a recovery-orientated system of care: Canadian decision maker perspectives. Int J Soc Psychiatry. 2010;56:168\u201377.","journal-title":"Int J Soc Psychiatry"},{"key":"1768_CR4","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s11205-012-9998-7","volume":"115","author":"AM Hubley","year":"2014","unstructured":"Hubley AM. Subjective quality of life among individuals who are homeless: a review of current knowledge. Soc Ind Res. 2014;115:509\u201324.","journal-title":"Soc Ind Res"},{"key":"1768_CR5","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12955-015-0346-x","volume":"13","author":"MJ Fleury","year":"2015","unstructured":"Fleury MJ, Grenier G, Bamvita JM. Predictive typology of subjective quality of life among participants with severe mental disorders after a five-year follow-up: a longitudinal two-step cluster analysis. Health Qual Life Outcomes. 2015;13:150.","journal-title":"Health Qual Life Outcomes"},{"key":"1768_CR6","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/NMD.0b013e3181924ad8","volume":"197","author":"TW Strine","year":"2009","unstructured":"Strine TW, Kroenke K, Dhingra S, Balluz LS, Gonzalez O, Berry JT, Mokdad AH. The associations between depression, health-related quality of life, social support, life satisfaction, and disability in community-dwelling US adults. J Nerv Ment Dis. 2009;197:61\u20134.","journal-title":"J Nerv Ment Dis"},{"key":"1768_CR7","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s00038-011-0283-3","volume":"56","author":"SW Hwang","year":"2011","unstructured":"Hwang SW, Aubry T, Palepu A, Farrell S, Nisenbaum R, Hubley AM, Klodawsky F, Gogosis E, Hay E, Pidlubny S, et al. The health and housing in transition study: a longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities. Int J Public Health. 2011;56:609\u201323.","journal-title":"Int J Public Health"},{"key":"1768_CR8","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1001\/archgenpsychiatry.2010.56","volume":"67","author":"TP Gilmer","year":"2010","unstructured":"Gilmer TP, Stefancic A, Ettner SL, Manning WG, Tsemberis S. Effect of full-service partnerships on homelessness, use and costs of mental health services, and quality of life among adults with serious mental illness. Arch Gen Psychiatry. 2010;67:645\u201352.","journal-title":"Arch Gen Psychiatry"},{"key":"1768_CR9","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1176\/ps.2008.59.3.268","volume":"59","author":"MJ O'Connell","year":"2008","unstructured":"O\u2019Connell MJ, Kasprow W, Rosenheck RA. Rates and risk factors for homelessness after successful housing in a sample of formerly homeless veterans. Psychiatr Serv. 2008;59:268\u201375.","journal-title":"Psychiatr Serv"},{"key":"1768_CR10","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1037\/a0023189","volume":"8","author":"J Tsai","year":"2011","unstructured":"Tsai J, Kasprow W, Rosenheck R. Exiting homelessness without a voucher: a comparison of independently housed and other homeless veterans. Psychol Serv. 2011;8:114\u201322.","journal-title":"Psychol Serv"},{"key":"1768_CR11","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.2105\/AJPH.2005.063321","volume":"95","author":"CL Caton","year":"2005","unstructured":"Caton CL, Dominguez B, Schanzer B, Hasin DS, Shrout PE, Felix A, McQuistion H, Opler LA, Hsu E. Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults. Am J Public Health. 2005;95:1753\u20139.","journal-title":"Am J Public Health"},{"key":"1768_CR12","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s001270170029","volume":"36","author":"J Wolf","year":"2001","unstructured":"Wolf J, Burnam A, Koegel P, Sullivan G, Morton S. Changes in subjective quality of life among homeless adults who obtain housing: a prospective examination. Soc Psychiatry Psychiatr Epidemiol. 2001;36:391\u20138.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"1768_CR13","doi-asserted-by":"publisher","first-page":"e342","DOI":"10.1016\/S2468-2667(20)30055-4","volume":"5","author":"T Aubry","year":"2020","unstructured":"Aubry T, Bloch G, Brcic V, Saad A, Magwood O, Abdalla T, Alkhateeb Q, Xie E, Mathew C, Hannigan T, et al. Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review. Lancet Public Health. 2020;5:e342\u201360.","journal-title":"Lancet Public Health"},{"key":"1768_CR14","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s11205-012-9998-7","volume":"115","author":"AM Hubley","year":"2014","unstructured":"Hubley AM, Russell LB, Palepu A, Hwang SW. Subjective quality of life among individuals who are homeless: a review of current knowledge. Soc Inc Res. 2014;115:509\u201324.","journal-title":"Soc Inc Res."},{"key":"1768_CR15","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1177\/0020764011419056","volume":"58","author":"AG van der Plas","year":"2012","unstructured":"van der Plas AG, Hoek HW, van Hoeken D, Valencia E, van Hemert AM. Perceptions of quality of life and disability in homeless persons with schizophrenia and persons with schizophrenia living in non-institutional housing. Int J Soc Psychiatry. 2012;58:629\u201334.","journal-title":"Int J Soc Psychiatry"},{"key":"1768_CR16","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1007\/s11524-011-9592-3","volume":"88","author":"SW Hwang","year":"2011","unstructured":"Hwang SW, Gogosis E, Chambers C, Dunn JR, Hoch JS, Aubry T. Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program. J Urban Health. 2011;88:1076\u201390.","journal-title":"J Urban Health"},{"key":"1768_CR17","doi-asserted-by":"publisher","first-page":"651","DOI":"10.2105\/AJPH.94.4.651","volume":"94","author":"S Tsemberis","year":"2004","unstructured":"Tsemberis S, Gulcur L, Nakae M. Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. Am J Public Health. 2004;94:651\u20136.","journal-title":"Am J Public Health"},{"key":"1768_CR18","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3389\/fpsyt.2019.00010","volume":"10","author":"L Gentil","year":"2019","unstructured":"Gentil L, Grenier G, Bamvita JM, Dorvil H, Fleury MJ. Profiles of quality of life in a homeless population. Front Psychiatry. 2019;10:10.","journal-title":"Front Psychiatry"},{"key":"1768_CR19","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s10597-018-0340-y","volume":"55","author":"J Caron","year":"2019","unstructured":"Caron J, Cargo M, Daniel M, Liu A. Predictors of quality of life in Montreal, Canada: a longitudinal study. Community Ment Health J. 2019;55:189\u2013201.","journal-title":"Community Ment Health J"},{"key":"1768_CR20","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s10597-007-9114-7","volume":"44","author":"SH Chan","year":"2008","unstructured":"Chan SH, Yeung FK. Path models of quality of life among people with schizophrenia living in the community in Hong Kong. Community Ment Health J. 2008;44:97\u2013112.","journal-title":"Community Ment Health J"},{"key":"1768_CR21","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1007\/s00127-013-0719-6","volume":"48","author":"M Patterson","year":"2013","unstructured":"Patterson M, Moniruzzaman A, Palepu A, Zabkiewicz D, Frankish CJ, Krausz M, Somers JM. Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1245\u201359.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"1768_CR22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1007\/s10464-011-9444-z","volume":"49","author":"T Aubry","year":"2012","unstructured":"Aubry T, Klodawsky F, Coulombe D. Comparing the housing trajectories of different classes within a diverse homeless population. Am J Community Psychol. 2012;49:142\u201355.","journal-title":"Am J Community Psychol"},{"key":"1768_CR23","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1177\/0706743716645302","volume":"62","author":"CE Adair","year":"2017","unstructured":"Adair CE, Streiner DL, Barnhart R, Kopp B, Veldhuizen S, Patterson M, Aubry T, Lavoie J, Sareen J, LeBlanc SR, Goering P. Outcome trajectories among homeless individuals with mental disorders in a multisite randomised controlled trial of housing first. Can J Psychiatry. 2017;62:30\u20139.","journal-title":"Can J Psychiatry"},{"key":"1768_CR24","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.socscimed.2016.02.004","volume":"153","author":"CT Lee","year":"2016","unstructured":"Lee CT, Guzman D, Ponath C, Tieu L, Riley E, Kushel M. Residential patterns in older homeless adults: results of a cluster analysis. Soc Sci Med. 2016;153:131\u201340.","journal-title":"Soc Sci Med"},{"key":"1768_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10511482.2007.9521591","volume":"8","author":"D Culhane","year":"2007","unstructured":"Culhane D, Metraux S, Park JM, Schretzman M, Valente J. Testing a typology of family homelessness based on patterns of public shelter utilization in four US jurisdictions: implications for policy and program planning. Hous Policy Debate. 2007;8:1\u201328.","journal-title":"Hous Policy Debate"},{"key":"1768_CR26","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s10464-005-1888-6","volume":"35","author":"M Munoz","year":"2005","unstructured":"Munoz M, Panadero S, Santos EP, Quiroga MA. Role of stressful life events in homelessness: an intragroup analysis. Am J Community Psychol. 2005;35:35\u201347.","journal-title":"Am J Community Psychol"},{"key":"1768_CR27","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1353\/hpu.2011.0081","volume":"22","author":"J Tsai","year":"2011","unstructured":"Tsai J, Edens EL, Rosenheck RA. A typology of childhood problems among chronically homeless adults and its association with housing and clinical outcomes. J Health Care Poor Underserved. 2011;22:853\u201370.","journal-title":"J Health Care Poor Underserved"},{"key":"1768_CR28","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1353\/hpu.0.0040","volume":"19","author":"G Goldstein","year":"2008","unstructured":"Goldstein G, Luther JF, Jacoby AM, Haas GL, Gordon AJ. A taxonomy of medical comorbidity for veterans who are homeless. J Health Care Poor Underserved. 2008;19:991\u20131005.","journal-title":"J Health Care Poor Underserved"},{"key":"1768_CR29","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s10488-009-0206-2","volume":"36","author":"JP Bonin","year":"2009","unstructured":"Bonin JP, Fournier L, Blais R. A typology of mentally disordered users of resources for homeless people: towards better planning of mental health services. Adm Policy Ment Health. 2009;36:223\u201335.","journal-title":"Adm Policy Ment Health"},{"key":"1768_CR30","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1080\/08964289.2018.1447905","volume":"45","author":"L Garey","year":"2019","unstructured":"Garey L, Reitzel LR, Neisler J, Kendzor DE, Zvolensky MJ, Neighbors C, Hernandez DC, Businelle MS. Health-related quality of life among homeless smokers: risk and protective factors of latent class membership. Behav Med. 2019;45:40\u201351.","journal-title":"Behav Med"},{"key":"1768_CR31","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.ssresearch.2011.12.011","volume":"41","author":"LA Kort-Butler","year":"2012","unstructured":"Kort-Butler LA, Tyler KA. A cluster analysis of service utilization and incarceration among homeless youth. Soc Sci Res. 2012;41:612\u201323.","journal-title":"Soc Sci Res"},{"key":"1768_CR32","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/S0140-6736(14)61132-6","volume":"384","author":"S Fazel","year":"2014","unstructured":"Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014;384:1529\u201340.","journal-title":"Lancet"},{"key":"1768_CR33","first-page":"1273","volume":"34","author":"L Gelberg","year":"2000","unstructured":"Gelberg L, Andersen RM, Leake BD. The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv Res. 2000;34:1273\u2013302.","journal-title":"Health Serv Res"},{"key":"1768_CR34","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1037\/ser0000119","volume":"14","author":"S Gabrielian","year":"2017","unstructured":"Gabrielian S, Hamilton AB, Alexandrino A, Hellemann G, Young AS. \u201cThey\u2019re homeless in a home\u201d: retaining homeless-experienced consumers in supported housing. Psychol Serv. 2017;14:154\u201366.","journal-title":"Psychol Serv"},{"key":"1768_CR35","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1177\/1359105307080612","volume":"12","author":"JA Stein","year":"2007","unstructured":"Stein JA, Andersen R, Gelberg L. Applying the Gelberg\u2013Andersen behavioral model for vulnerable populations to health services utilization in homeless women. J Health Psychol. 2007;12:791\u2013804.","journal-title":"J Health Psychol"},{"key":"1768_CR36","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/hsc.12834","volume":"28","author":"L Gentil","year":"2019","unstructured":"Gentil L, Grenier G, Bamvita JM, Fleury MJ. Satisfaction with health and community services among homeless and formerly homeless individuals in Quebec, Canada. Health Soc Care Community. 2019;28:22\u201333.","journal-title":"Health Soc Care Community"},{"key":"1768_CR37","doi-asserted-by":"publisher","first-page":"195","DOI":"10.7202\/032422ar","volume":"22","author":"J Caron","year":"1997","unstructured":"Caron J, Mercier C. Tempier R [Validation of satisfaction with life domains scale in Quebec]. Sante Ment Que. 1997;22:195\u2013217.","journal-title":"Sante Ment Que"},{"key":"1768_CR38","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/0149-7189(82)90059-3","volume":"5","author":"F Baker","year":"1982","unstructured":"Baker F, Intagliata J. Quality of life in the evaluation of community support systems. Eval Program Plann. 1982;5:69\u201379.","journal-title":"Eval Program Plann"},{"key":"1768_CR39","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.psychres.2014.07.072","volume":"220","author":"BF Henwood","year":"2014","unstructured":"Henwood BF, Matejkowski J, Stefancic A, Lukens JM. Quality of life after housing first for adults with serious mental illness who have experienced chronic homelessness. Psychiatry Res. 2014;220:549\u201355.","journal-title":"Psychiatry Res"},{"key":"1768_CR40","unstructured":"Statistics Canada Canadian community health survey\u2014mental health and well-being\u2014T1.2. Ottawa: Statistics Canada; 2002."},{"issue":"Suppl 20","key":"1768_CR41","first-page":"22","volume":"59","author":"DV Sheehan","year":"1998","unstructured":"Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22\u201333 (quiz 34-57).","journal-title":"J Clin Psychiatry"},{"key":"1768_CR42","doi-asserted-by":"publisher","first-page":"423","DOI":"10.15288\/jsa.1995.56.423","volume":"56","author":"MJ Bohn","year":"1995","unstructured":"Bohn MJ, Babor TF, Kranzler HR. The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings. J Stud Alcohol. 1995;56:423\u201332.","journal-title":"J Stud Alcohol"},{"key":"1768_CR43","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/0306-4603(82)90005-3","volume":"7","author":"HA Skinner","year":"1982","unstructured":"Skinner HA. The drug abuse screening test. Addict Behav. 1982;7:363\u201371.","journal-title":"Addict Behav"},{"key":"1768_CR44","doi-asserted-by":"publisher","first-page":"815","DOI":"10.2471\/BLT.09.067231","volume":"88","author":"TB Ust\u00fcn","year":"2010","unstructured":"Ust\u00fcn TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, Saxena S, von Korff M, Pull C, Project WNJ. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ. 2010;88:815\u201323.","journal-title":"Bull World Health Organ"},{"key":"1768_CR45","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1177\/070674370505001002","volume":"50","author":"R Gravel","year":"2005","unstructured":"Gravel R, Beland Y. The Canadian Community Health Survey: mental health and well-being. Can J Psychiatry. 2005;50:573\u20139.","journal-title":"Can J Psychiatry"},{"key":"1768_CR46","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.jsp.2009.10.001","volume":"48","author":"AN Baraldi","year":"2010","unstructured":"Baraldi AN, Enders CK. An introduction to modern missing data analyses. J Sch Psychol. 2010;48:5\u201337.","journal-title":"J Sch Psychol"},{"key":"1768_CR47","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/1476-072X-8-54","volume":"8","author":"JD Hibbert","year":"2009","unstructured":"Hibbert JD, Liese AD, Lawson A, Porter DE, Puett RC, Standiford D, Liu L, Dabelea D. Evaluating geographic imputation approaches for zip code level data: an application to a study of pediatric diabetes. Int J Health Geogr. 2009;8:54.","journal-title":"Int J Health Geogr"},{"key":"1768_CR48","doi-asserted-by":"publisher","first-page":"100","DOI":"10.2307\/2346830","volume":"28","author":"JA Hartigan","year":"1979","unstructured":"Hartigan JA, Wong MA. A k-means clustering algorithm. Appl Stat. 1979;28:100\u20138.","journal-title":"Appl Stat"},{"key":"1768_CR49","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1080\/01621459.1957.10501411","volume":"52","author":"DR Cox","year":"1957","unstructured":"Cox DR. Note on grouping. J Am Stat Assoc. 1957;52:543\u20137.","journal-title":"J Am Stat Assoc"},{"key":"1768_CR50","unstructured":"Ali B, Massmoudi Y: K-means clustering based on gower similarity coefficient: a comparative study. In 5th International conference on modeling, simulation and applied optimization (ICMSAO); Hammamet, Tunisia; 2013."},{"key":"1768_CR51","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1176\/appi.ps.201400167","volume":"66","author":"T Aubry","year":"2015","unstructured":"Aubry T, Tsemberis S, Adair CE, Veldhuizen S, Streiner D, Latimer E, Sareen J, Patterson M, McGarvey K, Kopp B, et al. One-year outcomes of a randomized controlled trial of housing first with ACT in five Canadian cities. Psychiatr Serv. 2015;66:463\u20139.","journal-title":"Psychiatr Serv"},{"key":"1768_CR52","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2105\/AJPH.2011.300320","volume":"102","author":"S Tsemberis","year":"2012","unstructured":"Tsemberis S, Kent D, Respress C. Housing stability and recovery among chronically homeless persons with co-occuring disorders in Washington, DC. Am J Public Health. 2012;102:13\u20136.","journal-title":"Am J Public Health"},{"key":"1768_CR53","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/1472-6963-14-167","volume":"14","author":"V Stergiopoulos","year":"2014","unstructured":"Stergiopoulos V, Gozdzik A, O\u2019Campo P, Holtby AR, Jeyaratnam J, Tsemberis S. Housing first: exploring participants\u2019 early support needs. BMC Health Serv Res. 2014;14:167.","journal-title":"BMC Health Serv Res"},{"key":"1768_CR54","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1176\/ps.51.1.116","volume":"51","author":"JA Lam","year":"2000","unstructured":"Lam JA, Rosenheck RA. Correlates of improvement in quality of life among homeless persons with serious mental illness. Psychiatr Serv. 2000;51:116\u20138.","journal-title":"Psychiatr Serv"},{"key":"1768_CR55","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s11205-013-0302-2","volume":"116","author":"AM Gadermann","year":"2014","unstructured":"Gadermann AM, Hubley AM, Russell LB, Palepu A. Subjective health-related quality of life in homeless and vulnerably housed individuals and its relationship with self-reported physical and mental health status. Soc Indic Res. 2014;116:341\u201352.","journal-title":"Soc Indic Res"},{"key":"1768_CR56","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1080\/15504263.2017.1319586","volume":"13","author":"RA Cherner","year":"2017","unstructured":"Cherner RA, Aubry T, Sylvestre J, Boyd R, Pettey D. Housing first for adults with problematic substance use. J Dual Diagn. 2017;13:219\u201329.","journal-title":"J Dual Diagn"},{"key":"1768_CR57","first-page":"120","volume":"46","author":"C Schwartz","year":"2009","unstructured":"Schwartz C, Gronemann OC. The contribution of self-efficacy, social support and participation in the community to predicting loneliness among persons with schizophrenia living in supported residences. Isr J Psychiatry Relat Sci. 2009;46:120\u20139.","journal-title":"Isr J Psychiatry Relat Sci"},{"key":"1768_CR58","doi-asserted-by":"publisher","first-page":"e241","DOI":"10.1111\/hsc.12505","volume":"26","author":"M Bower","year":"2018","unstructured":"Bower M, Conroy E, Perz J. Australian homeless persons\u2019 experiences of social connectedness, isolation and loneliness. Health Soc Care Community. 2018;26:e241\u20138.","journal-title":"Health Soc Care Community"},{"key":"1768_CR59","unstructured":"Council. NHCftH: disability, employment and homelessness. 2011 Policy Statement; 2011."},{"key":"1768_CR60","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.cpr.2017.10.012","volume":"66","author":"RK McHugh","year":"2018","unstructured":"McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev. 2018;66:12\u201323.","journal-title":"Clin Psychol Rev"},{"key":"1768_CR61","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.whi.2016.12.011","volume":"27","author":"H Winetrobe","year":"2017","unstructured":"Winetrobe H, Wenzel S, Rhoades H, Henwood B, Rice E, Harris T. Differences in health and social support between homeless men and women entering permanent supportive housing. Womens Health Issues. 2017;27:286\u201393.","journal-title":"Womens Health Issues"},{"key":"1768_CR62","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1177\/2150131914556122","volume":"6","author":"BM White","year":"2015","unstructured":"White BM, Newman SD. Access to primary care services among the homeless: a synthesis of the literature using the equity of access to medical care framework. J Prim Care Community Health. 2015;6:77\u201387.","journal-title":"J Prim Care Community Health"},{"key":"1768_CR63","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1001\/jama.285.2.200","volume":"285","author":"MB Kushel","year":"2001","unstructured":"Kushel MB, Vittinghoff E, Haas JS. Factors associated with the health care utilization of homeless persons. JAMA. 2001;285:200\u20136.","journal-title":"JAMA"},{"key":"1768_CR64","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.drugalcdep.2015.06.033","volume":"154","author":"KK O'Brien","year":"2015","unstructured":"O\u2019Brien KK, Schuttke A, Alhakeem A, Donnelly-Swift E, Keogh C, O\u2019Carroll A, O\u2019Sullivan K, Galvin R, Fahey T. Health, perceived quality of life and health services use among homeless illicit drug users. Drug Alcohol Depend. 2015;154:139\u201345.","journal-title":"Drug Alcohol Depend"},{"issue":"Suppl 2","key":"1768_CR65","doi-asserted-by":"publisher","first-page":"S294","DOI":"10.2105\/AJPH.2013.301369","volume":"103","author":"SW Hwang","year":"2013","unstructured":"Hwang SW, Chambers C, Chiu S, Katic M, Kiss A, Redelmeier DA, Levinson W. A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance. Am J Public Health. 2013;103(Suppl 2):S294-301.","journal-title":"Am J Public Health"}],"container-title":["Health and Quality of Life Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-021-01768-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12955-021-01768-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-021-01768-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T09:21:52Z","timestamp":1618996912000},"score":1,"resource":{"primary":{"URL":"https:\/\/hqlo.biomedcentral.com\/articles\/10.1186\/s12955-021-01768-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,21]]},"references-count":65,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1768"],"URL":"https:\/\/doi.org\/10.1186\/s12955-021-01768-y","relation":{},"ISSN":["1477-7525"],"issn-type":[{"value":"1477-7525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,21]]},"assertion":[{"value":"4 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The public health ethics committee of the Douglas MH University Institute evaluated and approved the study. Written informed consent was obtained from all participants at the beginning of the interviews.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declared no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"128"}}