Development of Sarcopenia Management Systems for Former Homeless Older Adults Residing in Supportive Housing: Mixed Methods Study

This is the authors' abstract. We don't add key points for this paper.

Background: Former homeless older adults represent a highly vulnerable population facing substantial community health challenges, including an elevated risk of sarcopenia due to compounded health and social disadvantages. Developing a context-specific management system is crucial for enhancing early detection, prevention, and care within supportive housing settings. Objective: This study aimed to develop and evaluate the feasibility of a sarcopenia management system for former homeless older adults in Thailand. Methods: mixed methods design was used, consisting of three phases: (1) development, (2) implementation, and (3) preliminary evaluation testing. The development phase engaged 18 stakeholders and 32 focus group participants (former homeless older adults and staff) through 2 rounds of consultation. The system was subsequently implemented and preliminarily evaluated for feasibility, perceived quality, perceived benefits, and user satisfaction. Results: Through qualitative methods and a systematic review, a context-specific sarcopenia management system was developed for former homeless older adults. The system comprised five core components screening, classification, management, follow-up, evaluation and was integrated into routine care processes involving multidisciplinary staff and homeless volunteers within a supportive housing setting. The system was subsequently implemented and preliminarily tested among 116 former homeless older adults living in a supportive housing facility in Thailand. Preliminary findings indicated good feasibility and acceptability of the system. The perceived quality of the system achieved a mean score of 2.6 (SD 0.48), while perceived benefits were rated at 3.8 (SD 0.40). Overall satisfaction with system use and implementation processes achieved mean scores of 2.8 (SD 0.41) and 2.72 (SD 0.79), respectively, indicating high user satisfaction. Conclusions: This study presents the first context-sensitive sarcopenia management system specifically developed for former homeless older adults in supportive housing in Thailand. The system was well accepted and shows promise for strengthening early detection, prevention, and management of sarcopenia in community-based housing settings.