Food insecurity results from unreliable access to affordable and nutritious food. Homeless adults are particularly vulnerable to both food insecurity and problematic alcohol use. The current study examined the link between problematic alcohol use and food insecurity among homeless adults. Participants (N = 528; 62.7% men; M_age = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Problematic alcohol use was measured using the Alcohol Quantity and Frequency Questionnaire and the Patient Health Questionnaire. The latter used DSM-IV diagnostic criteria to assess probable alcohol use dependence/abuse. Heavy drinking was considered >7 drinks (women) and >14 drinks (men) per week. Food insecurity was measured with the USDA Food Security Scale-Short Form. The link between alcohol problems and food insecurity was examined with logistic regression analyses controlling for sex, age, education, income, and months homeless. Overall, 28.4% of the sample had probable alcohol dependence, 25% were heavy drinkers, and 78.4% were food insecure. Probable alcohol dependence and heavy drinking were correlated at 0.53 (p < 0.001). Results indicated that heavy drinking (OR = 2.12, CI_.95 = 1.21, 3.73) and probable alcohol dependence/abuse (OR = 2.72, CI_.95 = 1.55, 4.77) were each associated with increased odds of food insecurity. Food insecurity and problematic alcohol use are major issues among homeless populations; this study suggests they are associated. Future research is needed to shed light on potential causal mechanisms and on whether alcohol may take precedence over eating or food purchases.

Traditionally, intrapersonal characteristics (distress tolerance) and interpersonal characteristics (social support) have been studied separately rather than simultaneously. In the current study, we address this gap by simultaneously examining these characteristics as potential indirect associations linking established urban stress–depression and urban stress–Post-Traumatic Stress Disorder (PTSD) relationships. Adults experiencing homelessness were recruited from six homeless shelters in Oklahoma City (n = 567). Participants self-reported urban life stress (Urban Life Stress Scale), distress tolerance (Distress Tolerance Scale), social support (Interpersonal Support Evaluation List 12), major depressive disorder (Patient Health Questionnaire-8), and PTSD symptoms (Primary Care Post-Traumatic Stress Disorder screener). Covariate-adjusted structural equation models indicated a significant indirect effect of distress tolerance on the urban stress–depression (b = 0.101, 95% CI = 0.061, 0.147) and urban stress–PTSD (b = 0.065, 95% CI = 0.023, 0.112) relationships. Additionally, a significant indirect effect of social support on the urban stress–depression (b = 0.091, 95% CI = 0.053, 0.133) and urban stress-PTSD relationships (b = 0.043, 95% CI = 0.006, 0.082) was evident. Further, both the urban stress–depression (b = 0.022, 95% CI = 0.011, 0.037) and urban stress–PTSD relationships (b = 0.014, 95% CI = 0.005, 0.026) were associated indirectly through social support to distress tolerance. Interventions that aim to increase social support may also increase distress tolerance skills and indirectly reduce depressive and PTSD symptoms in the context of urban stress among adults experiencing homelessness.

The county-wide lockdowns that were implemented due to the COVID-19 pandemic resulted in some in-person qualitative research studies needing to be transitioned online using a video conferencing platform. However, evaluating the feasibility of transitioning an ongoing qualitative research study focused on low-income, racial/ethnic minorities had not been performed. Orsmond and Cohn’s feasibility framework was used to evaluate this study in three primary areas: recruitment capability, data collection procedures, and evaluation of relevant resources. Recruitment efforts for the in-person focus groups (January–March 2020) and online focus groups (March–April 2020), along with data collection procedures, were measured through various counts. To gauge the resources needed to transition a study from in-person to online, the administrative capacity, the space, technology, and funds necessary to support the research study were recorded. Sample characteristics were extracted from administrative and survey data. To estimate the differences in the sample characteristics, recruitment efforts and the length of the focus groups before and during the lockdown, independent sample t-tests, or proportion tests were conducted. The sociodemographic characteristics of participants pre-lockdown and during the lockdown were similar between the two groups with most participants identifying as female, Black, single, unemployed. The average number of participants recruited, confirmed, and attended per focus group, along with the total number of contact attempts remained similar before and during the lockdown. The length of the focus groups before and during the lockdown also remained similar. The in-person focus groups did require more financial resources for their successful execution than the online focus groups. It is feasible to sustain a research study focused on low-income, racial/ethnic minorities by transitioning the study from in-person to online using a video conferencing platform. This approach should be considered from the onset of qualitative research studies to increase reach to low-income, racial/ethnic minorities.