Journal of Urban Health

, Volume 87, Issue 3, pp 365–380 | Cite as

Mobile Phone Technology: A New Paradigm for the Prevention, Treatment, and Research of the Non-sheltered “Street” Homeless?

  • Karin M. Eyrich-GargEmail author


Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one’s social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or “clean time”), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population.


Homeless Technology Cell phone Mobile phone Social support Prevention Treatment Intervention Aftercare Methods 



The author would like to thank Temple University for the study leave and grant-in-aid supporting this work, Ms. Misty Sparks at the Bethesda Project Café for supplying space for interviewing, Mr. Jacob Bowling and Ms. Tarissa Sweat for assistance with interviewing, Ms. Julie Denlinger for assistance with data entry, Drs. Nick Garg and Cheryl Hyde for reviewing prior versions of this manuscript, and the 100 men and women who graciously volunteered to participate in this research study. A prior version of these findings was presented at the 100th Annual Meeting of the American Psychopathological Association in New York City on March 4, 2010.


  1. 1.
    Ramin B, Svoboda T. Health of the homeless and climate change. J Urban Health. 2009; 86(4): 654–664.CrossRefPubMedGoogle Scholar
  2. 2.
    Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA. 2000; 283(16): 2152–2157.CrossRefPubMedGoogle Scholar
  3. 3.
    Lee TC, Hanlon JG, Ben-David J, et al. Risk factors for cardiovascular disease in homeless adults. Circulation. 2005; 111: 2629–2635.CrossRefPubMedGoogle Scholar
  4. 4.
    Snyder LD, Eisner MD. Obstructive lung disease among the urban homeless. Chest. 2005; 125: 1719–1725.CrossRefGoogle Scholar
  5. 5.
    Hwang SW, Kirst MJ, Chiu S, et al. Multidimensional social support and the health of homeless individuals. J Urban Health. 2009; 86(5): 791–803.CrossRefPubMedGoogle Scholar
  6. 6.
    Harris Interactive. Cell phone usage continues to increase. The Harris Poll #36. Accessed 3 Nov 2009.
  7. 7.
    In US, SMS Text Messaging Tops Mobile Phone Calling. Accessed 12 Feb 2010.
  8. 8.
    Horrigan, J. Mobile access to data and information, March 2008. Accessed 12 Feb 2010.
  9. 9.
    Office of Community Planning and Development. The 2008 Annual Homeless Assessment Report to Congress. US Department of Housing and Urban Development; 2009.Google Scholar
  10. 10.
    Shelton KH, Taylor PJ, Bonner A, Van den Bree M. Risk factors for homelessness: evidence from a population-based study. Psychiatr Serv. 2009; 60(4): 465–472.CrossRefPubMedGoogle Scholar
  11. 11.
    Freedman MJ, Lester KM, McNamara C, Milby JB, Schumacher JE. Cell phones for ecological momentary assessment with cocaine-addicted homeless patients in treatment. J Subst Abuse Treat. 2006; 30: 105–111.CrossRefPubMedGoogle Scholar
  12. 12.
    Cottler LB, Compton WM, Abdallah AB, et al. Peer-delivered interventions reduce HIV risk behaviors among out-of-treatment drug abusers. Public Health Rep. 1998; 113(Supp 1): 31–41.PubMedGoogle Scholar
  13. 13.
    North CS, Eyrich KM, Pollio DE, Cottler LB, Spitznagel EL. The homeless supplement to the diagnostic interview schedule: test–retest analyses. Int J Method Psych. 2004; 13(3): 184–191.CrossRefGoogle Scholar
  14. 14.
    McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the Addiction Severity Index. J Subst Abuse Treat. 1992; 9(3): 199–213.CrossRefPubMedGoogle Scholar
  15. 15.
    Argeriou M, McCarty D, Mulvey K, Daley M. Use of the addiction severity index with homeless substance abusers. J Subst Abuse Treat. 1994; 11(4): 359–365.CrossRefPubMedGoogle Scholar
  16. 16.
    Zanis DA, McLellan AT, Cnaan RA, Randall M. Reliability and validity of the Addiction Severity Index with a homeless sample. J Subst Abuse Treat. 1994; 11(6): 541–548.CrossRefPubMedGoogle Scholar
  17. 17.
    Patton MQ. Qualitative Research & Evaluation Methods. 3rd ed. Thousand Oaks: Sage Publications; 2002.Google Scholar
  18. 18.
    Strauss A, Corbin J. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 2nd ed. London: Sage; 1998.Google Scholar
  19. 19.
    Sullivan NP. Cell phones provide significant economic gains for low-income American households: A review of the literature and data from two new surveys. Accessed 3 Nov 2009.
  20. 20.
    Dietz TL, Wright JD. Age and gender differences and predictors of victimization of the older homeless. J Elder Abuse Negl. 2005; 17(1): 37–60.CrossRefPubMedGoogle Scholar
  21. 21.
    Kramer CB, Gibran NS, Heimbach DM, Rivara FP, Klein MB. Assault and substance abuse characterize burn injuries in homeless patients. J Burn Care Res. 2008; 29: 461–467.CrossRefPubMedGoogle Scholar
  22. 22.
    Wenzel SL, Tucker JS, Hambarsoomian K, Elliott MN. Toward a more comprehensive understanding of violence against impoverished women. J Interpers Violence. 2006; 21: 820–839.CrossRefPubMedGoogle Scholar
  23. 23.
    Eyrich KM, Pollio DE, North CS. An exploration of alienation and replacement theories of social support in homelessness. Soc Work Res. 2003; 27(4): 222–231.Google Scholar
  24. 24.
    Fischer PJ, Shapiro S, Breakey WR, Anthony JC, Kramer M. Mental health and social characteristics of the homeless: a survey of mission users. Am J Public Health. 1986; 76(5): 519–524.CrossRefPubMedGoogle Scholar
  25. 25.
    Solarz A, Bogat GA. When social support fails: the homeless. J Community Psychol. 1990; 18(1): 79–96.CrossRefGoogle Scholar
  26. 26.
    Tischler V, Rademeyer A, Vostanis P. Mothers experiencing homelessness: mental health, support, and social care needs. Health Soc Care Community. 2007; 15(3): 246–253.PubMedCrossRefGoogle Scholar
  27. 27.
    Zugazaga CB. Understanding social support of the homeless: a comparison of single men, single women, and women with children. Fam Soc. 2008; 89(3): 447–455.Google Scholar
  28. 28.
    Stein JA, Dixon EL, Nyamathi AM. Effects of psychosocial and situational variables on substance abuse among homeless adults. Psychol Addict Behav. 2008; 22(3): 410–416.CrossRefPubMedGoogle Scholar
  29. 29.
    Chayko M. The portable community: envisioning and examining mobile social connectedness. Int J Web Based Communities. 2007; 3(4): 373–385.CrossRefGoogle Scholar
  30. 30.
    Rheingold H. Smart Mobs: The Next Social Revolution. Cambridge, MA: Perseus Publishing; 2002.Google Scholar
  31. 31.
    Leung CS, Ho MM, Gundlapalli AV, Hwang SW. Homelessness and the response to emerging infectious disease outbreaks: lessons from SARS. J Urban Health. 2008; 85(3): 402–410.CrossRefPubMedGoogle Scholar
  32. 32.
    Vlahov D, Coady MH, Ompad DC, Galea S. Strategies for improving influenza immunization rates among hard-to-reach populations. J Urban Health. 2007; 84(4): 615–631.CrossRefPubMedGoogle Scholar
  33. 33.
    Kuntsche E, Robert B. Short message service (SMS) technology in alcohol research—a feasibility study. Alcohol Alcoholism. 2009; 44(4): 423–428.CrossRefGoogle Scholar
  34. 34.
    Ybarra ML, Bull SS. Current trends in internet- and cell phone-based HIV prevention and intervention programs. Current HIV/AIDS Reports. 2007; 4: 201–207.CrossRefPubMedGoogle Scholar
  35. 35.
    Brendryen H, Kraft P. Happy ending: a randomized controlled trial of a digital multi-media smoking cessation intervention. Addiction. 2008; 103: 478–484.CrossRefPubMedGoogle Scholar
  36. 36.
    Obermayer JL, Riley WT, Asif O, Jean-Mary J. College smoking-cessation using cell phone text messaging. J Am Coll Health. 2004; 53(2): 71–78.CrossRefPubMedGoogle Scholar
  37. 37.
    Miloh T, Annunziato R, Arnon R, et al. Improved adherence and outcomes for pediatric liver transplant recipients by using text messaging. Pediatrics. 2009; 124(5): 844–850.CrossRefGoogle Scholar
  38. 38.
    Haller DM, Sanci LA, Patton GC, Sawyer SM. Text message communication in primary care research: a randomized controlled trial. Fam Pract. 2009; 26: 325–330.CrossRefPubMedGoogle Scholar

Copyright information

© The New York Academy of Medicine 2010

Authors and Affiliations

  1. 1.School of Social Work, College of Health Professions and Social WorkTemple UniversityPhiladelphiaUSA
  2. 2.Department of Public Health, College of Health Professions and Social WorkTemple UniversityPhiladelphiaUSA
  3. 3.Department of Geography and Urban Studies, College of Liberal ArtsTemple UniversityPhiladelphiaUSA

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