The Quorum for Community-Driven Wellness Research: Guiding research that promotes health equity for people experiencing homelessness and living with chronic illnesses
The Health, Homelessness, & Criminal Justice (HHCJ) Lab is embedded within the Hennepin Healthcare Research Institute (HHRI), the research arm of the Hennepin Healthcare System (HHS). The HHCJ Lab conducts research that focuses on the complex drivers of health for people experiencing homelessness and/or criminal justice involvement. Within this context, the lab studies physical health, mental health, and substance use conditions and the overlapping systemic barriers to health, often driven by structural racism.
Further within the HHCJ Lab is The Quorum for Community-Driven Wellness Research, Quorum for short. “Quorum is a community-engaged research team made up of various knowledge-holders: community partners, research staff, housing partners, and community health workers.” This framework ensures “having the right people at the table to make meaningful decisions.” It functions to bridge the gap between community and institutional knowledge surrounding wellness research for community members experiencing homelessness.
Founded in 2015, Quorum aims to promote health equity for marginalized communities by guiding research for people with lived experiences of homelessness and chronic diseases such as heart disease, high cholesterol, high blood pressure, and diabetes. These individuals are often on public medical assistance through Minnesota’s Medicaid program, which is called Medical Assistance (MA).
The North Star for Quorum’s research is based on the principles of trust, mutual respect, shared knowledge, shared power, mutual benefit, and reflection. They are motivated to change harrowing statistics outlined in the Minnesota Homeless Mortality Report 2017-2021 that homeless people die at a rate of 3x higher than their housed peers. Quorum’s current research projects are Diabetes Homeless Medication Support (D-HOMES) and Cardiovascular Health Homeless Support (CV-HOMES).
Their pursuit of improved health care for people on Medicaid comes from a shared recognition of the competing priorities that often exist when faced with the work of taking care of one’s health and the logistical challenges of interfacing with health care, housing, and other systems. As the group observes, “It’s never just diabetes.”
D-HOMES
Among the millions of Americans who experience homelessness each year, thousands die prematurely from diabetes at a rate of 3 to 6 times higher than the general population. The D-HOMES tailormade program offers hope to change this by offering health coaching for those simultaneously experiencing homelessness and type 2 diabetes. Coaching is offered in English and Spanish for up to 10 one-on-one sessions over 12 weeks through psychology-based behavioral activation and by providing referrals to local housing, food, behavioral health, and related resources. The D-HOMES coaching study will measure the effectiveness of short-term coaching versus a single diabetes educational session, developing better blood sugar control, and improving psychological well-being.
CV-HOMES
Previously, Quorum primarily focused on those experiencing homelessness and type 2 diabetes, but they have now expanded their research to include cardiovascular health through the CV-HOMES program. CV-HOMES explores disproportionate rates of cardiovascular disease (CVD) among people of color experiencing homelessness. Like the D-HOMES program, it is a tailor-made behavioral health coaching program offered to those at high risk for CVD. Through this program, participants learn how to create better healthy habits that impact CVD health such as not smoking, prescription adherence, sleep hygiene, nutrition, and exercising.
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