Health-Related Quality of Life Among Homeless Smokers: Risk and Protective Factors of Latent Class Membership

ABSTRACT

Health-related quality of life (HRQoL) is a multidimensional assessment of well-being and health status. Most work in this area assumes that HRQoL is a homogenous construct; however, it is possible HRQoL subgroups may exist. The purpose of the study was to characterize common classes of HRQoL among adult, homeless smokers, a particularly vulnerable group of the larger population, and to evaluate risk and protective factors of HRQoL class membership. Homeless smokers (N = 456; 65.1% male; M_age = 43.19 years [SD = 11.77]) completed self-report measures of sociodemographics, smoking characteristics, anxiety sensitivity, stress, social support, and the Center for Disease Control (CDC) four-item HRQoL measure. A latent class analysis was conducted for HRQoL. Multinomial regression models were used to simultaneously test correlates of class membership. A three-class solution, consisting of poor HRQoL, moderate HRQoL, and excellent HRQoL, demonstrated superior fit. Correlates of class membership included sex, age, lifetime months of being homeless, smoking characteristics, anxiety sensitivity, stress, and social support. The current findings provide novel evidence for three distinct classes of HRQoL among homeless smokers. Results suggest that older smokers with greater emotional distress, as evidenced by greater anxiety sensitivity, greater stress, and less social support, may be particularly vulnerable to poorer HRQoL.

KEYWORDS:

• health related quality of life
• latent class analysis
• homeless
• smokers
• socioeconomically disadvantaged
• tobacco use

Compliance with ethical standards

Disclosure of potential conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individuals participating in the study.

Notes

¹ In post-hoc analyses with the ASI-3 subscales, only the ASI-3 Cognitive subscale differentiated class membership between the poor and excellent HRQoL classes and the moderate and excellent HRQoL classes in the multinomial regression model.

Additional information

Funding

Funding for this research was primarily provided by the Oklahoma Tobacco Research Center at the University of Oklahoma Health Sciences Center (to MSB), with additional support from the University of Houston (to LRR and JN). This study was also supported by funding from the American Cancer Society grant MRSGT-12-114-01-CPPB (to MSB). Work on this manuscript was supported, in part, by funding from the National Institute on Drug Abuse through award F31DA043390-01 (to LG).