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Constructing and identifying predictors of frailty among homeless adults-A latent variable structural equations model approach

  • Author(s): Salem, BE
  • Nyamathi, A
  • Brecht, ML
  • Phillips, LR
  • Mentes, JC
  • Sarkisian, C
  • Stein, JA
  • et al.
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. © 2013 Elsevier Ireland Ltd.

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