Protocol - Perceptions of Housing Insecurity
The AHC HRSN screening tool assesses the current living situation, including perception of stability, as well as decency and safety, with two items.
If someone chooses the underlined answers, they might have an unmet health-related social need.
- What is your living situation today?
- [ ] I have a steady place to live
- [ ] I have a place to live today, but I am worried about losing it in the future
- [ ] I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter,living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park)
- Think about the place you live. Do you have problems with any of the following?
CHOOSE ALL THAT APPLY
- [ ] Pests such as bugs, ants, or mice
- [ ] Mold
- [ ] Lead paint or pipes
- [ ] Lack of heat
- [ ] Oven or stove not working
- [ ] Smoke detectors missing or not working
- [ ] Water leaks
- [ ] None of the above
Underlined answer options indicate positive responses for the associated health-related social need.
Item 1: The second answer option is intended to identify beneficiaries who are at risk of losing their housing for any reason, including inability to pay a mortgage or rent. The third answer option is intended to identify beneficiaries who are homeless. Selecting either option 2 or option 3 would indicate that the beneficiary has a housing need for the purposes of the AHC Model.
Item 2: Selecting any answer option other than “none of the above”would indicate that the beneficiary has a housing need for the purposes of the AHC Model.
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.
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.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Adults aged 18 or older
The AHC HRSN screening tool is validated and freely available.
|caDSR Common Data Elements (CDE)||Perceptions of Housing Insecurity||12114273||CDE Browser|
Process and Review
Protocol Name from Source
The Accountable Health Communities (AHC) Health-Related Social Needs (HRSN) Screening Tool
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
Nuruzzaman, N., Broadwin, M., Kourouma, K., & Olson, D. P. (2015). Making the social determinants of health a routine part of medical care. Journal of Healthcare for the Poor and Underserved, 26(2), 321-327. https://doi.org/10.1353/hpu.2015.0036
Broaddus-Shea, E. T., Fife Duarte, K., Jantz, K., Reno, J., Connelly, L., & Nederveld, A. (2022). Implementing health-related social needs screening in western Colorado primary care practices: Qualitative research to inform improved communication with patients. Health & Social Care in the Community. Advance online publication. https://doi.org/10.1111/hsc.13752
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
Holcomb, J., Highfield, L., Ferguson, G. M., & Morgan, R. O. (2022). Association of social needs and healthcare utilization among Medicare and Medicaid beneficiaries in the Accountable Health Communities Model. Journal of General Internal Medicine. Advance online publication. https://doi.org/10.1007/s11606-022-07403-w
National Association of Community Health Centers, Association of Asian Pacific Community Health Organizations, and their partners. (2017). The Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE). Available at https://prapare.org
O'Gurek, D. T., & Henke, C. (2018). A practical approach to screening for social determinants of health. Family Practice Management, 25(3), 7-12.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
Perceptions of Housing Insecurity
December 14, 2022
This measure captures an individual’s perception about how secure and stable the housing situation is.
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. Housing insecurity is associated with increased exposure to health and safety risks like vermin and mold.
perceptions of housing insecurity, Housing, instability, housing insecurity, living situation, address, hotel, shelter, environment, home, house, residence, neighborhood built environment
|Protocol ID||Protocol Name|
|281401||Perceptions of Housing Insecurity|
There are no publications listed for this protocol.