{"id":{"repo_id":"texas","oai_identifier":"oai:repositories.lib.utexas.edu:2152/133823"},"canonical_url":"https://search.dev.ndltd.org/etd/texas/oai:repositories.lib.utexas.edu:2152/133823","repository":{"repo_id":"texas","name":"University of Texas","base_url":"https://repositories.lib.utexas.edu/server/oai/request"},"display":{"title":"Factors related to medication adherence among people experiencing homelessness","abstract":"This study used the Behavioral Model for Vulnerable Populations to evaluate the relationships between medication adherence and traditional and vulnerable predisposing, enabling, and need (PEN) factors among people experiencing homelessness (PEH). A cross-sectional survey was administered to 150 PEH at two Austin homeless service agencies. Participants were [at least symbol]18 years old, currently homeless, took [at least symbol]1 oral medication for a chronic condition, and used the healthcare system in the past six-month. The nine-item Hill-Bone Medication Adherence Scale (HBMAS) (1=All the time to 4=None of the time; range 9-36, higher scores = better adherence) measured medication adherence. The other items evaluated the independent variables categorized as traditional and vulnerable predisposing (i.e., age, gender, race, ethnicity, length of homelessness, substance use, alcohol use, psychological distress, and perceived discrimination in the healthcare system), enabling (i.e., insurance type, medication affordability, competing needs/priorities, access to reliable transportation, medication storage area, and provider discrimination because of housing situation), and need (i.e., number of medications and presence of disability) factors. Data analysis included descriptive and bivariate analyses and linear regression. Alpha level was <0.05. On average, participants were 49.0 (±10.8) years old and 5.0 (±6.0) years homeless. Most were male (72.0%), half were white, and 25% were Hispanic. Over half (56.7%) used the medical access program and 44.7% were prescribed [at least symbol]5 medications. About one-third had very easy access to reliable transportation and secure medication storage. Most of them (82.0%) had some type of disability; 67.3% and 56.3% used illegal substances and alcohol, respectively. HBMAS score was 29.6 (±6.4)/36, perceived healthcare system discrimination score was 20.1 (±8.7)/45, psychological distress score was 12.7 (+5.9)/24; and competing needs/priorities was 19.0 (±4.9)/28; higher scores = higher levels of construct being measured. Medication affordability was 7.6 (±3.7)/16; higher scores = poor medication affordability. The regression analysis showed that medication adherence decreases as participants’ psychological distress (higher scores = high levels of distress) and medication affordability rating (high scores = poor affordability) increases (p<0.05), while controlling for respective PEN factors. This information can help homeless healthcare and social services experts tailor PEH’s medication adherence counseling, particularly addressing PEH psychological distress and challenges in medication affordability.","abstract_html":"This study used the Behavioral Model for Vulnerable Populations to evaluate the relationships between medication adherence and traditional and vulnerable predisposing, enabling, and need (PEN) factors among people experiencing homelessness (PEH). A cross-sectional survey was administered to 150 PEH at two Austin homeless service agencies. Participants were [at least symbol]18 years old, currently homeless, took [at least symbol]1 oral medication for a chronic condition, and used the healthcare system in the past six-month. The nine-item Hill-Bone Medication Adherence Scale (HBMAS) (1=All the time to 4=None of the time; range 9-36, higher scores = better adherence) measured medication adherence. The other items evaluated the independent variables categorized as traditional and vulnerable predisposing (i.e., age, gender, race, ethnicity, length of homelessness, substance use, alcohol use, psychological distress, and perceived discrimination in the healthcare system), enabling (i.e., insurance type, medication affordability, competing needs/priorities, access to reliable transportation, medication storage area, and provider discrimination because of housing situation), and need (i.e., number of medications and presence of disability) factors. Data analysis included descriptive and bivariate analyses and linear regression. Alpha level was <0.05. On average, participants were 49.0 (±10.8) years old and 5.0 (±6.0) years homeless. Most were male (72.0%), half were white, and 25% were Hispanic. Over half (56.7%) used the medical access program and 44.7% were prescribed [at least symbol]5 medications. About one-third had very easy access to reliable transportation and secure medication storage. Most of them (82.0%) had some type of disability; 67.3% and 56.3% used illegal substances and alcohol, respectively. HBMAS score was 29.6 (±6.4)/36, perceived healthcare system discrimination score was 20.1 (±8.7)/45, psychological distress score was 12.7 (+5.9)/24; and competing needs/priorities was 19.0 (±4.9)/28; higher scores = higher levels of construct being measured. Medication affordability was 7.6 (±3.7)/16; higher scores = poor medication affordability. The regression analysis showed that medication adherence decreases as participants’ psychological distress (higher scores = high levels of distress) and medication affordability rating (high scores = poor affordability) increases (p<0.05), while controlling for respective PEN factors. This information can help homeless healthcare and social services experts tailor PEH’s medication adherence counseling, particularly addressing PEH psychological distress and challenges in medication affordability.","abstract_has_math":false,"creators":["Baffoe, James O."],"institution":"The University of Texas at Austin","degree_name":"Doctor of Philosophy","degree_level":null,"degree_discipline":"Pharmaceutical Sciences","degree_department":null,"school":null,"contributors":[],"advisors":["Moczygemba, Leticia R."],"committee_chairs":[],"committee_members":["Avanceña, Anton L.V.","Brown, Carolyn M.","Seales, Emily M."],"year":2025,"date_issued":"2025-05","date_published":"2025-05","updated_at":"2026-07-24T05:01:18Z","subjects":["Psychological distress","Homelessness","Medication adherence","Adherence","Affordability of medications","Medication affordability","People experiencing homelessness"],"languages":["English"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://doi.org/10.26153/tsw/61151"],"render_values":[{"text":"https://doi.org/10.26153/tsw/61151","href":"https://doi.org/10.26153/tsw/61151","code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/2152/133823","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Moczygemba, Leticia R."]},{"key":"dc:contributor.committeemember","label":"Committee Member","values":["Avanceña, Anton L.V.","Brown, Carolyn M.","Seales, Emily M."]},{"key":"dc:creator","label":"Author","values":["Baffoe, James O."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-08-13T18:57:23Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-05"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Pharmaceutical Sciences"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Texas at Austin"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Psychological distress","Homelessness","Medication adherence","Adherence","Affordability of medications","Medication affordability","People experiencing homelessness"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["English"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/2152/133823","https://doi.org/10.26153/tsw/61151"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["This study used the Behavioral Model for Vulnerable Populations to evaluate the relationships between medication adherence and traditional and vulnerable predisposing, enabling, and need (PEN) factors among people experiencing homelessness (PEH). A cross-sectional survey was administered to 150 PEH at two Austin homeless service agencies. Participants were [at least symbol]18 years old, currently homeless, took [at least symbol]1 oral medication for a chronic condition, and used the healthcare system in the past six-month. The nine-item Hill-Bone Medication Adherence Scale (HBMAS) (1=All the time to 4=None of the time; range 9-36, higher scores = better adherence) measured medication adherence. The other items evaluated the independent variables categorized as traditional and vulnerable predisposing (i.e., age, gender, race, ethnicity, length of homelessness, substance use, alcohol use, psychological distress, and perceived discrimination in the healthcare system), enabling (i.e., insurance type, medication affordability, competing needs/priorities, access to reliable transportation, medication storage area, and provider discrimination because of housing situation), and need (i.e., number of medications and presence of disability) factors. Data analysis included descriptive and bivariate analyses and linear regression. Alpha level was <0.05. On average, participants were 49.0 (±10.8) years old and 5.0 (±6.0) years homeless. Most were male (72.0%), half were white, and 25% were Hispanic. Over half (56.7%) used the medical access program and 44.7% were prescribed [at least symbol]5 medications. About one-third had very easy access to reliable transportation and secure medication storage. Most of them (82.0%) had some type of disability; 67.3% and 56.3% used illegal substances and alcohol, respectively. HBMAS score was 29.6 (±6.4)/36, perceived healthcare system discrimination score was 20.1 (±8.7)/45, psychological distress score was 12.7 (+5.9)/24; and competing needs/priorities was 19.0 (±4.9)/28; higher scores = higher levels of construct being measured. Medication affordability was 7.6 (±3.7)/16; higher scores = poor medication affordability. The regression analysis showed that medication adherence decreases as participants’ psychological distress (higher scores = high levels of distress) and medication affordability rating (high scores = poor affordability) increases (p<0.05), while controlling for respective PEN factors. This information can help homeless healthcare and social services experts tailor PEH’s medication adherence counseling, particularly addressing PEH psychological distress and challenges in medication affordability."]},{"key":"dc:format.mimetype","label":"Dc Format Mimetype","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Factors related to medication adherence among people experiencing homelessness"]}]}],"canonical_facts":{"dc:contributor.advisor":["Moczygemba, Leticia R."],"dc:contributor.committeemember":["Avanceña, Anton L.V.","Brown, Carolyn M.","Seales, Emily M."],"dc:creator":["Baffoe, James O."],"dc:date.accessioned":["2025-08-13T18:57:23Z"],"dc:date.issued":["2025-05"],"dc:description.abstract":["This study used the Behavioral Model for Vulnerable Populations to evaluate the relationships between medication adherence and traditional and vulnerable predisposing, enabling, and need (PEN) factors among people experiencing homelessness (PEH). A cross-sectional survey was administered to 150 PEH at two Austin homeless service agencies. Participants were [at least symbol]18 years old, currently homeless, took [at least symbol]1 oral medication for a chronic condition, and used the healthcare system in the past six-month. The nine-item Hill-Bone Medication Adherence Scale (HBMAS) (1=All the time to 4=None of the time; range 9-36, higher scores = better adherence) measured medication adherence. The other items evaluated the independent variables categorized as traditional and vulnerable predisposing (i.e., age, gender, race, ethnicity, length of homelessness, substance use, alcohol use, psychological distress, and perceived discrimination in the healthcare system), enabling (i.e., insurance type, medication affordability, competing needs/priorities, access to reliable transportation, medication storage area, and provider discrimination because of housing situation), and need (i.e., number of medications and presence of disability) factors. Data analysis included descriptive and bivariate analyses and linear regression. Alpha level was <0.05. On average, participants were 49.0 (±10.8) years old and 5.0 (±6.0) years homeless. Most were male (72.0%), half were white, and 25% were Hispanic. Over half (56.7%) used the medical access program and 44.7% were prescribed [at least symbol]5 medications. About one-third had very easy access to reliable transportation and secure medication storage. Most of them (82.0%) had some type of disability; 67.3% and 56.3% used illegal substances and alcohol, respectively. HBMAS score was 29.6 (±6.4)/36, perceived healthcare system discrimination score was 20.1 (±8.7)/45, psychological distress score was 12.7 (+5.9)/24; and competing needs/priorities was 19.0 (±4.9)/28; higher scores = higher levels of construct being measured. Medication affordability was 7.6 (±3.7)/16; higher scores = poor medication affordability. The regression analysis showed that medication adherence decreases as participants’ psychological distress (higher scores = high levels of distress) and medication affordability rating (high scores = poor affordability) increases (p<0.05), while controlling for respective PEN factors. This information can help homeless healthcare and social services experts tailor PEH’s medication adherence counseling, particularly addressing PEH psychological distress and challenges in medication affordability."],"dc:format.mimetype":["application/pdf"],"dc:identifier.uri":["https://hdl.handle.net/2152/133823","https://doi.org/10.26153/tsw/61151"],"dc:language.iso":["English"],"dc:subject":["Psychological distress","Homelessness","Medication adherence","Adherence","Affordability of medications","Medication affordability","People experiencing homelessness"],"dc:title":["Factors related to medication adherence among people experiencing homelessness"],"dc:type":["Thesis"],"thesis:degree_discipline":["Pharmaceutical Sciences"],"thesis:degree_name":["Doctor of Philosophy"],"thesis:institution_name":["The University of Texas at Austin"]},"updated_at":"2026-07-24T05:01:18Z"}