An Exploratory Factor Analysis of the Adult Needs and Strengths Assessment Among of Sample of Homeless Individuals with Co-Occurring Mental Health and Substance Use Disorders

Background and Purpose: Homelessness has been a perennial public health concern in the US. Consequently, federal and state-funded programs have supported various programs aimed at helping individuals experiencing homelessness. The Texas Health and Human Services Commission (HHSC) funded Healthy Communities Collaborative (HCC) program provides support for a particularly at-risk group— individuals experiencing homelessness with mental illness or co-occurring mental health and substance use disorders. Following routine administration of the Adult Needs and Strengths Assessment (ANSA) to HCC participants, this study aimed to explore the underlying factor structure of the ANSA instrument and to better understand the utility of the ANSA for individuals experiencing homelessness and co-occurring mental health and substance use disorders.

Methods: This study used data from the ANSA who participated in the HCC program (N=6755). Exploratory factor analysis (EFA) was conducted using principal component analysis with Varimax (orthogonal) rotation.

Results: Factor analysis of the 22-items indicated a 6-factor structure (internal consistency; α = 0. 57-0.70), with eigenvalues above 1, accounting for 54.28% of the total variance: personal recovery, externalizing behaviors, self-sufficiency, trauma and stress, and substance use risks.

Conclusions and Implications: Study findings from EFA indicate preliminary results showing that the ANSA has acceptable validity (construct) and reliability. Therefore, the ANSA offers those involved in the assessment of homeless individuals with co-occurring disorders with a usable instrument. However, poor to good internal consistency indicates that the ANSA assessment may be best used in conjunction with other tools more suited to the homelessness experience. Further evaluation is needed for better understanding and application of the instrument.