Making choices: Increased choice opportunities are linked with better-perceived health among people experiencing homelessness

The aim of this study is to evaluate whether the level of perceived choice and the frequency of use of services is associated with the perceived health of people experiencing homelessness (PEH), accounting for the possible mediating role of resignation. A convenience sample was recruited by homeless services in the Municipality of a major Italian city. Data were collected with self-reported questionnaires from 43 people living on the street or shelters (self-identified as male = 83.7%; mean age = 52.7; SD = 12.2). Perceived choice and use of services were inserted as independent variables, resignation as the mediator, and perceived health as the outcome. A path analysis tested the hypothesized model, and the mediation was tested through the bootstrapping method. A higher level of perceived choice was associated with a lower sense of resignation that, in turn, was associated with better perceived general health. The frequency of service use was not significantly related to resignation. Choice is associated with increased control and autonomy and a reduced sense of resignation. Thus, transition is desirable on a service-level to person-centered, choice-oriented approaches.