Protocol - Housing Instability Due to Affordability

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a “don’t know” response is provided.

Equipment Needs

The PhenX Working Group acknowledges these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements

Requirement Category	Required
Major equipment	No
Specialized training	No
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	No

Mode of Administration

Interviewer-administered questionnaire

Lifestage

Adult

Participants

Adults aged 18 or older

Selection Rationale

The U.S. Centers of Disease Control and Prevention (CDC) BRFSS Social Context: Housing Affordability screening item is an established, well-validated, interviewer-administered Likert-style response question used frequently as an indicator of housing insecurity.

Language

English, Spanish

Standards

Standard	Name	ID	Source

Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

CDC Behavioral Risk Factor Surveillance System (BRFSS) Survey

Source

Centers of Disease Control and Prevention. (2015). Behavioral Risk Factor Surveillance System (BRFSS), 2015. Washington, DC. Question number: Social Context, #1-2.

General References

Billioux, A., Verlander, K., Anthony, S., & Alley, D. (2017). Standardized screening for health-related social needs in clinical settings: the accountable health communities screening tool. [Discussion paper]. NAM Perspectives. National Academy of Medicine. https://doi.org/10.31478/201705b

O'Gurek, D. T., & Henke, C. (2018). A practical approach to screening for social determinants of health. Family Practice Management, 25(3), 7-12.

Aratani, Y., Chau, M., Wight, V. R., & Addy, S. (2011). Rent burden, housing subsidies and the well-being of children and youth. National Center for Children in Poverty. Available from https://www.nccp.org/publication/rent-burden-housing-subsidies-and-the-well-being-of-children-and-youth/

Bushman, G., & Mehdipanah, R. (2022). Housing and health inequities during COVID-19: findings from the national Household Pulse Survey. Journal of epidemiology and community health, 76(2), 121–127. https://doi.org/10.1136/jech-2021-216764

Protocol ID

281201

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX281201_Housing_Instability_Affordability_Rent_Own_Home
	PX281201010000	Do you own or rent your home?	N/A
PX281201_Housing_Instability_Affordability_Worry_Stress_Past_12_Months_Have_Enough_Money
	PX281201020000	How often in the past 12 months would you more say you were worried or stressed about having enough money to pay your rent/mortgage? Would you say--- show less	N/A

Individual Social Determinants of Health

Measure Name

Housing Instability Due to Affordability

Release Date

December 14, 2022

Definition

This measure evaluates how secure and stable housing is for an individual, with an emphasis on stability, safety, and low burden to the resident.

Purpose

Stable housing indicates that it does not incur significant burden and stress, including financial, physical, and emotional, to its occupants. Stable housing implies that the occupant has a sense of affordability, stability, and safety within their housing situation. A lack of stable housing, including homelessness, is associated with increased risk of symptoms of chronic disease, as well as odds of disease such as diabetes and depression.

Keywords

Housing, instability, housing insecurity, affordability, worry, living situation, address, shelter, environment, home, house, rent, mortgage, residence, Behavioral Risk Factor Surveillance System, BRFSS, Centers for Disease Control and Prevention, CDC, neighborhood built environment

Measure Protocols

Protocol ID	Protocol Name
281201	Housing Instability Due to Affordability

Publications

Bart, T. A., et al. (2023) Measurement invariance of commonly used psychosis-screening scales in US Spanish- and English-speaking Hispanic participants. Psychological Assessment. 2023 April; 35(4): 300-310. doi: 10.1037/pas0001207

Purvis, R. S., et al. (2021) Trusted Sources of COVID-19 Vaccine Information among Hesitant Adopters in the United States. Vaccines. 2021 December; 9(12): 1418. doi: 10.3390/vaccines9121418