The house is a machine for everything: the role of the built environment in group homes during the COVID-19 pandemic

N M Oreskovic; K Donelan; S J Bartels; C Chau; K E Irwin; D Krane; J H Levison; C Michael; H Trieu; B G Skotko

doi:10.1016/j.puhe.2023.08.012

The house is a machine for everything: the role of the built environment in group homes during the COVID-19 pandemic

Public Health. 2023 Nov:224:20-25. doi: 10.1016/j.puhe.2023.08.012. Epub 2023 Sep 9.

Authors

N M Oreskovic¹, K Donelan², S J Bartels³, C Chau⁴, K E Irwin⁵, D Krane⁴, J H Levison⁶, C Michael⁷, H Trieu⁴, B G Skotko⁸

Affiliations

¹ Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA. Electronic address: noreskovic@mgh.harvard.edu.
² The Mongan Institute, Massachusetts General Hospital, Boston, MA, USA; Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
³ The Mongan Institute, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁴ The Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
⁵ Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
⁶ Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; The Mongan Institute, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁷ Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
⁸ Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.

PMID: 37696198
DOI: 10.1016/j.puhe.2023.08.012

Abstract

Objectives: Individuals living in group homes during the COVID-19 pandemic faced unique challenges and health risks related to living in shared spaces. This study aimed to assess the experiences of living and working in a group home during the pandemic and to explore the role of the built environment.

Study design and methods: We conducted longitudinal working groups with group home residents with intellectual and developmental disabilities and serious mental illness, group home staff, and families/caregivers of residents from December 2020 through December 2022. Common themes highlighting ways in which group home residents, staff, and caregivers perceived the built environment to impact living in a group home during the COVID-19 pandemic were identified.

Results: Resonant themes centered around increased risk of COVID-19 infection, ad hoc spatial adaptations for infection control, space-related challenges due to isolation and quarantine requirements, and limited access to public spaces.

Conclusion: Group home residents and staff experienced multiple health and wellness challenges during the COVID-19 pandemic related to their surrounding built environment. Mechanisms to engage group home residents in modifications of their built environment may improve the effectiveness of infection control policies while acknowledging individual autonomy.

Keywords: Built environment; COVID-19; Group home; Intellectual disability; Serious mental illness.

MeSH terms

Built Environment* / statistics & numerical data
COVID-19* / epidemiology
COVID-19* / prevention & control
Caregivers / psychology
Caregivers / statistics & numerical data
Female
Group Homes*
Humans
Infection Control / methods
Infection Control / organization & administration
Longitudinal Studies
Male
Mental Disorders / epidemiology
Pandemics / prevention & control
Quarantine / psychology
SARS-CoV-2