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. 2024 Jun;66(6):999-1007.
doi: 10.1016/j.amepre.2024.01.018. Epub 2024 Feb 3.

Predicting Homelessness Among Transitioning U.S. Army Soldiers

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Predicting Homelessness Among Transitioning U.S. Army Soldiers

Jack Tsai et al. Am J Prev Med. 2024 Jun.

Abstract

Introduction: This study develops a practical method to triage Army transitioning service members (TSMs) at highest risk of homelessness to target a preventive intervention.

Methods: The sample included 4,790 soldiers from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) who participated in 1 of 3 Army STARRS 2011-2014 baseline surveys followed by the third wave of the STARRS-LS online panel surveys (2020-2022). Two machine learning models were trained: a Stage-1 model that used administrative predictors and geospatial data available for all TSMs at discharge to identify high-risk TSMs for initial outreach; and a Stage-2 model estimated in the high-risk subsample that used self-reported survey data to help determine highest risk based on additional information collected from high-risk TSMs once they are contacted. The outcome in both models was homelessness within 12 months after leaving active service.

Results: Twelve-month prevalence of post-transition homelessness was 5.0% (SE=0.5). The Stage-1 model identified 30% of high-risk TSMs who accounted for 52% of homelessness. The Stage-2 model identified 10% of all TSMs (i.e., 33% of high-risk TSMs) who accounted for 35% of all homelessness (i.e., 63% of the homeless among high-risk TSMs).

Conclusions: Machine learning can help target outreach and assessment of TSMs for homeless prevention interventions.

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Figures

Figure 1.
Figure 1.. SHAP values and bee swarm plots from the Stage-1 Random Forest model predicting homelessness
Note: The mean absolute value SHAP for all predictors was 0.058531. SHAP values were derived from a Random Forest prediction model. Abbreviations: SHAP, Shapley Additive Explanations aThe predictors include 6 geospatial variables and 4 VADIR (Veterans Affairs/Department of Defense Identity Repository) variables.

References

    1. Tsai J, Pietrzak RH, Szymkowiak D. The problem of veteran homelessness: An update for the new decade. Am J Prev Med. 2021;60(6):774–780. 10.1016/j.amepre.2020.12.012. - DOI - PubMed
    1. Tsai J Homelessness Among U.S. Veterans: Critical Perspectives. New York, NY: Oxford University Press; 2018.
    1. Tsai J, Rosenheck RA. Risk factors for homelessness among U.S. Veterans. Epidemiol Rev. 2015;37(1):177–195. 10.1093/epirev/mxu004. - DOI - PMC - PubMed
    1. Balshem H, Christensen V, Tuepker A. A critical review of the literature regarding homelessness among veterans. VA-ESP Project #05–225. https://www.hsrd.research.va.gov/publications/esp/homelessness.pdf. Accessed June 26, 2023. - PubMed
    1. Sousa TD, Andrichik A, Cuellar M, Marson J, Prestera E, Rush K. The 2022 Annual Homelessness Assessment Report (AHAR) to Congress. https://www.huduser.gov/portal/sites/default/files/pdf/2022-ahar-part-1.pdf. Accessed September 5, 2023.

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