Link2Care: Homeless Care Management App

Sponsor

University of Oklahoma (Other)

Overall Status

Recruiting

CT.gov ID

NCT03399500

Collaborator

The University of Texas Health Science Center, Houston (Other), National Institutes of Health (NIH) (NIH), National Institute on Minority Health and Health Disparities (NIMHD) (NIH)

432

Enrollment

Locations

Arms

48.1

Anticipated Duration (Months)

216

Patients Per Site

4.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

There is a significant revolving door of incarceration among homeless adults, a population with substantial health disparities. Homeless adults who receive the professional coordination of individualized care (i.e., case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be re-incarcerated. The proposed study will use mobile technology to address these barriers and fill gaps in the understanding of the causes of the revolving door of homeless incarceration. This research represents a step toward integrated service connection and healthcare service provision for one of the most underserved, high need, and understudied populations in the United States. Smart phone apps that increase the use of available healthcare services and identify predictors of key outcomes (e.g., homelessness, re-arrest, medication compliance) could be used to reach hard to reach populations with histories of significant and persistent health disparities (e.g., homeless adults).

Condition or Disease	Intervention/Treatment	Phase
Substance Use Disorders Mental Health Impairment Health Behavior Adherence, Patient	Behavioral: In-Person Case Management at Homeless Recovery Program Behavioral: Unlimited Smartphone Behavioral: Smartphone Based Case Management (SPCM) app	Phase 3

Study Design

Study Type:

Interventional

Anticipated Enrollment :

432 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

m-Health to Increase Service Utilization in Recently Incarcerated Homeless Adults

Actual Study Start Date :

Apr 27, 2018

Anticipated Primary Completion Date :

May 1, 2022

Anticipated Study Completion Date :

May 1, 2022

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Usual Case Management (UCM) Group receives standard case management at the shelter	Behavioral: In-Person Case Management at Homeless Recovery Program In-Person Case Management at Homeless Recovery Program
Experimental: UCM + Smartphone Group receives standard case management and an unlimited smartphone	Behavioral: In-Person Case Management at Homeless Recovery Program In-Person Case Management at Homeless Recovery Program Behavioral: Unlimited Smartphone Smartphone with unlimited calls, texts, and data plan
Experimental: Smartphone Based Case Management (SPCM) Group receives standard case management and an unlimited smartphone with the SPCM app	Behavioral: In-Person Case Management at Homeless Recovery Program In-Person Case Management at Homeless Recovery Program Behavioral: Unlimited Smartphone Smartphone with unlimited calls, texts, and data plan Behavioral: Smartphone Based Case Management (SPCM) app Smartphone Based Case Management app

Arm

Intervention/Treatment

Active Comparator: Usual Case Management (UCM)

Group receives standard case management at the shelter

Behavioral: In-Person Case Management at Homeless Recovery Program

In-Person Case Management at Homeless Recovery Program

Experimental: UCM + Smartphone

Group receives standard case management and an unlimited smartphone

Behavioral: In-Person Case Management at Homeless Recovery Program

In-Person Case Management at Homeless Recovery Program

Behavioral: Unlimited Smartphone

Smartphone with unlimited calls, texts, and data plan

Experimental: Smartphone Based Case Management (SPCM)

Group receives standard case management and an unlimited smartphone with the SPCM app

Behavioral: In-Person Case Management at Homeless Recovery Program

In-Person Case Management at Homeless Recovery Program

Behavioral: Unlimited Smartphone

Smartphone with unlimited calls, texts, and data plan

Behavioral: Smartphone Based Case Management (SPCM) app

Smartphone Based Case Management app

Outcome Measures

Primary Outcome Measures

Number of case management sessions completed [6-month follow-up]
Total number of sessions completed between the randomization visit and 6-month follow-up

Secondary Outcome Measures

Number of homeless nights [6 months]
Total number of self-reported homeless nights (via Timeline Follow Back Procedures)
Number of arrests [12 months]
Total number of times each participant is booked into Dallas County Jail (using jail arrest records)
Alcohol use [6 months]
Number of days of alcohol use (via Timeline Follow Back procedures)
Drug use [6 months]
Number of days of drug use (via Timeline Follow Back procedures)

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

released from Dallas County Jail in the past month
plan to reside in the Dallas area for the next year
enrolled in The Bridge Homeless Recovery Program
willing and able to attend the baseline visit, randomization visit, and the 1, 3, and 6-month follow-up visits
score ≥ 4 on the REALM-SF indicating > 6th grade English literacy level
score >24 on the Mini-Mental State Exam indicating no substantial cognitive impairment.

Exclusion Criteria

Cannot read English
Under the age of 18

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	University of Oklahoma Health Sciences Center - OTRC	Oklahoma City	Oklahoma	United States	73104
2	UTHealth School of Public Health	Dallas	Texas	United States	75390

Sponsors and Collaborators

University of Oklahoma
The University of Texas Health Science Center, Houston
National Institutes of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)

Investigators

Principal Investigator: Michael S Businelle, Ph.D., University of Oklahoma
Principal Investigator: Jennifer M Reingle, Ph.D., UTHealth School of Public Health