Jack Tsai
Dados Biográficos
| ID | 4073292 |
|---|---|
| NOME | Jack Tsai |
| PRENOMES | Jack |
| SOBRENOME | Tsai |
| ASSINATURA | TSAI J |
| AFILIAÇÕES | Yale University |
| VERIFICADO | Não |
| TOTAL DE OBRAS | 46 |
| TOTAL DE CITAÇÕES | 96 |
| TOTAL COMO AUTOR | 46 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 7 |
Identifying predictors of housing distress in later life
Objectives Housing insecurity is increasingly prevalent among older adults in the US, yet the factors that contribute to housing-related distress in this population remain inadequately understood. This study examined how changes in a comprehensive set of physical health, health behaviors, psychosocial, and economic factors are associated with subsequent housing distress, and explored differences by military veteran status. Methods We analyzed thr…
Healthcare Mobility among United States Military Veterans with Experience of Housing Instability
Housing instability, generally, is associated with a lack of access to care. The present study explores healthcare mobility among Veterans experiencing housing instability to identify the magnitude of this phenomenon and whether it is associated with certain patient characteristics or needs. The sample included 486,675 Veterans with 4 or more healthcare visits during the year following identification of homelessness. Analyses compared (a) baselin…
Spiritual Supports for Formerly Unhoused US Veterans
Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability
In this study, federal prevention solutions to homelessness were associated with improved health outcomes and lower inpatient costs, which should inform national policy debates within and beyond the VA
Housing distress and subsequent health and well-being among older adults
Housing insecurity is increasing among older adults in the U.S., yet the impact of housing-related distress on health and well-being in this population is understudied. This study uses three waves of prospective data from a national sample of U.S. adults aged 50+ years (Health and Retirement Study, N = 12,998) to examine associations between housing distress and 35 indicators of physical, behavioral, and psychosocial health and well-being four ye…
Development of the Homeless Assistance Safety Perceptions (Hasp) Inventory
Screening for Major Depression and Alcohol Use Disorder in Laundromats As a New Setting for Community- Based Engagement and Intervention
The mediating role of social support in associations between childhood adversity, military sexual trauma, and homelessness in a nationally representative sample of US veterans
Among veterans, availability of social support and histories of military sexual trauma (MST) and/or adverse childhood experiences (ACEs) are particularly salient correlates of homelessness. Using path analyses, we investigated whether social support (i.e., interpersonal social support and community integration) would at least partially account for the relationships of MST and ACEs with any lifetime homelessness in a large, nationally representati…
First Decade of Supportive Services for Veteran Families Program and Homelessness, 2012–2022
As homelessness remains an urgent public health crisis in the United States, specific programs in the US Department of Veterans Affairs (VA) system may serve as a roadmap for addressing it. We examine lessons learned from the first decade (2012–2022) of the Supportive Services for Veteran Families (SSVF) program, a cornerstone in the VA continuum of homeless services aimed at both preventing homelessness among those at risk and providing rapid re…
Performance of the Elixhauser Comorbidity Index in Predicting Mortality Among a National US Sample of Hospitalized Homeless Adults
BACKGROUND: The Elixhauser Comorbidity Index (ECI) is widely used, but its performance in homeless populations has not been evaluated. OBJECTIVES: Using a national sample of inpatients, this study compared homeless and nonhomeless inpatients on common clinical diagnoses and evaluated ECI performance in predicting mortality among homeless inpatients. RESEARCH DESIGN: A retrospective study was conducted using 2019 National Inpatient Sample (NIS) da…
Applying Concepts of Successful Aging in Measuring and Promoting Whole Person Health
Countries around the world have large aging adult populations. There is wide public health concern about the health and well-being of aging adults, and a movement to transform healthcare systems to become age-friendly. The concept of “successful aging” recognizes the importance of aging and expands the goal beyond the absence of disease to functioning and well-being. In this perspective, we discuss aging as a part of life that should be considere…
Socioeconomic Correlates of Suicidal Ideation in Military Veterans
Homelessness and Contact with the Criminal Legal System among U.S. Combat Veterans
A notable proportion of criminal legal system (CLS)-involved combat veterans have a history of homelessness. However, knowledge regarding the relationship between homelessness and CLS involvement among combat veterans is largely based on descriptive studies, and potential mechanisms linking homelessness to CLS involvement are largely unknown. Using data from the 2019-2020 National Health and Resilience in Veterans Study ( n = 1,353), this study e…
Service use and barriers to care among homeless veterans
The objective of this study was to examine type of services U.S. veterans seek when they experience homelessness, characteristics associated with service use, and reasons for not using services. Data from a 2021 nationally representative survey of 1004 low-income U.S. veterans were analyzed with descriptive and multivariable analyses. One-quarter of low-income U.S. veterans with experiences of homelessness reported using homeless services while t…
Returns to Homelessness
Co-occurring Medical Multimorbidity, Mental Illness, and Substance Use Disorders Among Older Criminal Legal System-Involved Veterans
BACKGROUND: Older veterans involved in the criminal legal system (CLS) may have patterns of multimorbidity that place them at risk for poor health outcomes. OBJECTIVES: To estimate the prevalence of medical multimorbidity (≥2 chronic medical diseases), substance use disorders (SUDs), and mental illness among CLS-involved veterans aged 50 and older. RESEARCH DESIGN: Using Veterans Health Administration health records, we estimated the prevalence o…
Evictions and tenant‐landlord relationships during the 2020–2021 eviction moratorium in the US
This study provisionally examined the effects of the US eviction moratorium instituted in response to the Coronavirus Disease 2019 (COVID‐19) pandemic. Three waves of data collected May 2020–April 2021 from a nationally representative sample of middle‐ and low‐income US tenants ( n = 3393 in Wave 1, n = 1311 in Wave 2, and 814 in Wave 3) were analyzed. Across three waves, 4.3% of tenants reported experiencing an eviction during the moratorium and…
The Annual Homeless Point-in-Time Count
The point-in-time (PIT) homeless count conducted annually in communities across the United States is a major metric reported to the federal government that has a number of limitations. With the PIT count in 2021 being optional because of the COVID-19 pandemic and potential increases in homeless-related needs in the aftermath of the pandemic, there are opportunities for renewed efforts to improve how the United States enumerates homelessness, dete…
Change in housing environment and residential satisfaction following exit from permanent supportive housing
Moving On initiatives (MOIs) transition stable permanent supportive housing (PSH) residents into mainstream housing without embedded services. While this approach frees up PSH for homeless individuals in need, open questions remain regarding MOI recipients' long-term outcomes. This exploratory study examines how housing environment and residential satisfaction, potential predictors of housing retention, change from PSH to mainstream housing. Subj…
Estimation of Utility Values for Computing Quality-adjusted Life Years Associated With Homelessness
BACKGROUND: There is a lack of data-driven evidence about the burden of homelessness, and lack of a holistic measure of effectiveness for evaluating interventions targeting homelessness. Quality-adjusted life years (QALYs) can help holistically capture the burden of homelessness, and facilitate the valuation and comparison of interventions designed to address homelessness. OBJECTIVE: This study estimated utility values required to compute the QAL…
Multimorbidity and Social Drivers of Homelessness and Health
This introduction describes the impetus and context for this special issue on multimorbidity in homeless populations. The guest editors begin the introduction by describing the problem of homelessness which has been exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. The editors then describe the content of this special issue, which includes original research examining special populations such as homeless youth, aging populations, an…
Financial Strain, Mental Illness, and Homelessness
BACKGROUND: Research indicates that adults with severe mental illness have lower income and employment than adults without severe mental illness. Further, mental illness has been identified as a risk factor for homelessness. However, little research has investigated the interrelationships between financial strain, mental illness, and homelessness. It is unknown whether or to what extent financial strain mediates the association between mental ill…
Preventing Suicide Among Homeless Veterans
Rates of death by suicide among Veterans remain high, with age- and sex-adjusted rates 1.5 times higher for Veterans than non-Veteran adults.1 This risk is especially pronounced among Veterans experiencing homelessness, who have particularly high rates of suicidal ideation and suicidal self-directed violence.2 This likely relates to the presence of multiple risk factors, including extreme poverty and lack of housing; loneliness and limited social…
Covid-19
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is infecting people throughout the world. It is probable that coronavirus disease (COVID-19) will be transmitted to people experiencing homelessness, which will become a major problem in particular in North America where there are sizable populations of people experiencing homelessness in nearly every metropolitan city in the USA and Canada. In the USA, more than 500 000 people were rep…
Is the Housing First Model Effective? Different Evidence for Different Outcomes
Is the Housing First Model Effective? Different Evidence for Different Outcomes Jack Tsai PhD Affiliation Jack Tsai is with the National Center on Homelessness Among Veterans, US Department of Veterans Affairs Central Office; the School of Public Health, University of Texas Health Science Center at Houston; and the Department of Psychiatry, Yale University, New Haven, CT.CopyRightCorrespondence should be sent to Jack Tsai, PhD, Campus Dean and Pr…
Housing Preferences and Choices Among Adults with Mental Illness and Substance Use Disorders
When Health Insurance Is Not a Factor
Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medi…
Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns
Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class so…
Is the Housing First Model Effective? Different Evidence for Different Outcomes
Is the Housing First Model Effective? Different Evidence for Different Outcomes Jack Tsai PhD Affiliation Jack Tsai is with the National Center on Homelessness Among Veterans, US Department of Veterans Affairs Central Office; the School of Public Health, University of Texas Health Science Center at Houston; and the Department of Psychiatry, Yale University, New Haven, CT.CopyRightCorrespondence should be sent to Jack Tsai, PhD, Campus Dean and Pr…
Conceptualizing Social Integration Among Formerly Homeless Adults With Severe Mental Illness
The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well‐studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors related to social integration, (b) examine the association between clinical symptoms and social integration…
Longitudinal Association of Therapeutic Alliance and Clinical Outcomes in Supported Housing for Chronically Homeless Adults
Housing Satisfaction Among Chronically Homeless Adults
Uninsured Veterans Who Will Need to Obtain Insurance Coverage Under the Patient Protection and Affordable Care Act
Objectives. We examined the number and clinical needs of uninsured veterans, including those who will be eligible for the Medicaid expansion and health insurance exchanges in 2014. Methods. We analyzed weighted data for 8710 veterans from the 2010 National Survey of Veterans, classifying it by veterans’ age, income, household size, and insurance status. Results. Of 22 million veterans, about 7%, or more than 1.5 million, were uninsured and will n…
A Geographic Analysis of Chronically Homeless Adults Before and After Enrollment in a Multi‐Site Supported Housing Initiative
The current study examined the community characteristics and migration of chronically homeless adults before and after entry into a multi-site supported housing initiative. A total of 394 participants were geocoded at baseline and 12-month follow up. Data from geographic information systems indicate that the median distance participants traveled from their last residence to their residence 1 year after program entry was 4.6 miles and 12% of parti…
Impact of Health Insurance Status and a Diagnosis of Serious Mental Illness on Whether Chronically Homeless Individuals Engage in Primary Care
Objectives. We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. Methods. We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary …
Service use and barriers to care among homeless veterans
The objective of this study was to examine type of services U.S. veterans seek when they experience homelessness, characteristics associated with service use, and reasons for not using services. Data from a 2021 nationally representative survey of 1004 low-income U.S. veterans were analyzed with descriptive and multivariable analyses. One-quarter of low-income U.S. veterans with experiences of homelessness reported using homeless services while t…
A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska
This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff cond…
Asian American and Pacific Islander Military Veterans in the United States
Objectives. We (1) compared use of various health services nationally between Asian American and Pacific Islander (AA/PI) veterans and veterans of other racial/ethnic groups and (2) specifically compared perceived barriers and stigma related to mental health services. Methods. Using bivariate and multivariable statistics, we analyzed a population-weighted sample of 8315 veterans from the 2010 National Survey of Veterans and a random sample of 567…
Integrated dual disorders treatment
Mental health programs are increasingly combining evidence‐based practices to provide comprehensive services. Individuals with complex services needs, such as those dually diagnosed with mental illness and substance use disorders, are at high risk for numerous negative outcomes and may benefit from such comprehensive programs. This report describes the process and outcomes of a program that formally integrated assertive community treatment, suppo…
Evictions and tenant‐landlord relationships during the 2020–2021 eviction moratorium in the US
This study provisionally examined the effects of the US eviction moratorium instituted in response to the Coronavirus Disease 2019 (COVID‐19) pandemic. Three waves of data collected May 2020–April 2021 from a nationally representative sample of middle‐ and low‐income US tenants ( n = 3393 in Wave 1, n = 1311 in Wave 2, and 814 in Wave 3) were analyzed. Across three waves, 4.3% of tenants reported experiencing an eviction during the moratorium and…
The Annual Homeless Point-in-Time Count
The point-in-time (PIT) homeless count conducted annually in communities across the United States is a major metric reported to the federal government that has a number of limitations. With the PIT count in 2021 being optional because of the COVID-19 pandemic and potential increases in homeless-related needs in the aftermath of the pandemic, there are opportunities for renewed efforts to improve how the United States enumerates homelessness, dete…
Civil Legal Services and Medical-Legal Partnerships Needed by the Homeless Population
Objectives. To examine civil legal needs among people experiencing homelessness and the extent to which medical-legal partnerships exist in homeless service sites, which promote the integration of civil legal aid professionals into health care settings. Methods. We surveyed a national sample of 48 homeless service sites across 26 states in November 2015. The survey asked about needs, attitudes, and practices related to civil legal issues, includi…
Integrated dual disorders treatment
Mental health programs are increasingly combining evidence‐based practices to provide comprehensive services. Individuals with complex services needs, such as those dually diagnosed with mental illness and substance use disorders, are at high risk for numerous negative outcomes and may benefit from such comprehensive programs. This report describes the process and outcomes of a program that formally integrated assertive community treatment, suppo…
Housing Preferences and Choices Among Adults with Mental Illness and Substance Use Disorders
A Geographic Analysis of Chronically Homeless Adults Before and After Enrollment in a Multi‐Site Supported Housing Initiative
The current study examined the community characteristics and migration of chronically homeless adults before and after entry into a multi-site supported housing initiative. A total of 394 participants were geocoded at baseline and 12-month follow up. Data from geographic information systems indicate that the median distance participants traveled from their last residence to their residence 1 year after program entry was 4.6 miles and 12% of parti…
Housing arrangements among a national sample of adults with chronic schizophrenia living in the United States
There has been no recent national description of where and with whom people with chronic mental illness reside. Using data from the Clinical Antipsychotic Trials of Intervention Effectiveness, the living arrangements of 1,446 clients with schizophrenia from 57 sites throughout the United States were characterized over 1 year. At baseline, 46% of participants were living with family members and loved ones, 5% were living with other nonrelatives, 1…
Housing Satisfaction Among Chronically Homeless Adults
Do Faith-Based Residential Care Services Affect the Religious Faith and Clinical Outcomes of Homeless Veterans
Does Housing Chronically Homeless Adults Lead to Social Integration?
OBJECTIVE: Supported housing programs have been successful in helping homeless adults obtain housing. This study examined whether improvements in social integration occur after clients obtain supported housing. METHODS: Measures of social integration were examined for 550 chronically homeless adults with mental illness who participated in the 11-site Collaborative Initiative to Help End Chronic Homelessness. Social integration was conceptualized …
Conceptualizing Social Integration Among Formerly Homeless Adults With Severe Mental Illness
The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well‐studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors related to social integration, (b) examine the association between clinical symptoms and social integration…
Impact of Health Insurance Status and a Diagnosis of Serious Mental Illness on Whether Chronically Homeless Individuals Engage in Primary Care
Objectives. We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. Methods. We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary …
Longitudinal Association of Therapeutic Alliance and Clinical Outcomes in Supported Housing for Chronically Homeless Adults
When Health Insurance Is Not a Factor
Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medi…
Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns
Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class so…
Childhood antecedents of incarceration and criminal justice involvement among homeless veterans
Although criminal justice involvement and incarceration are common problems for homeless veterans, few studies have examined childhood risk factors for criminal justice involvement among veterans. This study examined the association between three types of childhood problems, family instability, conduct disorder behaviors, and childhood abuse, and criminal justice involvement and incarceration in adulthood. Data from 1,161 homeless veterans across…
Uninsured Veterans Who Will Need to Obtain Insurance Coverage Under the Patient Protection and Affordable Care Act
Objectives. We examined the number and clinical needs of uninsured veterans, including those who will be eligible for the Medicaid expansion and health insurance exchanges in 2014. Methods. We analyzed weighted data for 8710 veterans from the 2010 National Survey of Veterans, classifying it by veterans’ age, income, household size, and insurance status. Results. Of 22 million veterans, about 7%, or more than 1.5 million, were uninsured and will n…
Asian American and Pacific Islander Military Veterans in the United States
Objectives. We (1) compared use of various health services nationally between Asian American and Pacific Islander (AA/PI) veterans and veterans of other racial/ethnic groups and (2) specifically compared perceived barriers and stigma related to mental health services. Methods. Using bivariate and multivariable statistics, we analyzed a population-weighted sample of 8315 veterans from the 2010 National Survey of Veterans and a random sample of 567…
A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska
This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff cond…
Perspectives
Characteristics of urban male homeless veterans and non-veterans in Omaha, Nebraska
The current study examined differences between urban homeless veterans and non-veterans on sociodemographics, housing, clinical characteristics, and psychosocial factors. We recruited a sample of 196 homeless men (101 veterans, 95 non-veterans) from the Omaha, Nebraska metropolitan area. Structured interviews were conducted by research staff. The results showed that the two groups were similar in most respects, though there were several notable d…
Civil Legal Services and Medical-Legal Partnerships Needed by the Homeless Population
Objectives. To examine civil legal needs among people experiencing homelessness and the extent to which medical-legal partnerships exist in homeless service sites, which promote the integration of civil legal aid professionals into health care settings. Methods. We surveyed a national sample of 48 homeless service sites across 26 states in November 2015. The survey asked about needs, attitudes, and practices related to civil legal issues, includi…
Where’s My Choice?” An Examination of Veteran and Provider Experiences With Hepatitis C Treatment Through the Veteran Affairs Choice Program
BACKGROUND: The Department of Veterans Affairs (VA) is the country's largest provider for chronic hepatitis C virus (HCV) infection. The VA created the Choice Program, which allows eligible veterans to seek care from community providers, who are reimbursed by the VA. OBJECTIVES: This study aimed to examine perspectives and experiences with the VA Choice Program among veteran patients and their HCV providers. RESEARCH DESIGN: Qualitative study bas…
Improving VHA’s Approach to Community Care
Yakovchenko, Vera MPH, MS*; Gifford, Allen L. MD†,‡; Matthews, Kameron L. MD, JD§; Greenstone, Clinton L. MD§,∥,¶; Tsai, Jack PhD#,**; McInnes, D. Keith ScD, MSc*,† Author Information
Covid-19
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is infecting people throughout the world. It is probable that coronavirus disease (COVID-19) will be transmitted to people experiencing homelessness, which will become a major problem in particular in North America where there are sizable populations of people experiencing homelessness in nearly every metropolitan city in the USA and Canada. In the USA, more than 500 000 people were rep…
Is the Housing First Model Effective? Different Evidence for Different Outcomes
Is the Housing First Model Effective? Different Evidence for Different Outcomes Jack Tsai PhD Affiliation Jack Tsai is with the National Center on Homelessness Among Veterans, US Department of Veterans Affairs Central Office; the School of Public Health, University of Texas Health Science Center at Houston; and the Department of Psychiatry, Yale University, New Haven, CT.CopyRightCorrespondence should be sent to Jack Tsai, PhD, Campus Dean and Pr…
Change in housing environment and residential satisfaction following exit from permanent supportive housing
Moving On initiatives (MOIs) transition stable permanent supportive housing (PSH) residents into mainstream housing without embedded services. While this approach frees up PSH for homeless individuals in need, open questions remain regarding MOI recipients' long-term outcomes. This exploratory study examines how housing environment and residential satisfaction, potential predictors of housing retention, change from PSH to mainstream housing. Subj…
Estimation of Utility Values for Computing Quality-adjusted Life Years Associated With Homelessness
BACKGROUND: There is a lack of data-driven evidence about the burden of homelessness, and lack of a holistic measure of effectiveness for evaluating interventions targeting homelessness. Quality-adjusted life years (QALYs) can help holistically capture the burden of homelessness, and facilitate the valuation and comparison of interventions designed to address homelessness. OBJECTIVE: This study estimated utility values required to compute the QAL…
Homelessness and Social Issues (36 obras) · Medicine (36 obras) · Psychiatry (25 obras) · Psychology (21 obras) · Gerontology (17 obras) · Gerontology (17 obras) · Environmental health (15 obras) · Mental health (15 obras) · Health care (12 obras) · Veterans Affairs (11 obras)