Background:Recovery education centers (RECs) offer recovery supports through education rather than traditional health services. The Supporting Transitions and Recovery Learning Centre (STAR) in Toronto, Canada, is among the few that are internationally focused on individuals with histories of homelessness. Although research suggests that RECs positively impact participants, there is a paucity of rigorous studies and none address the engagement and impacts on homeless individuals.Aims:This protocol describes a realist-informed evaluation of STAR, specifically examining (1) if STAR participation is more effective in promoting 12-month recovery outcomes than participation in usual services for individuals experiencing housing instability and mental health challenges and (2) how STAR participation promotes recovery and other positive outcomes.Methods:This study uses a quasi-experimental mixed methods design. Personal empowerment (primary outcome) and recovery, housing stability, social functioning, health service use and quality of life (secondary outcomes) data were collected at baseline, and 6 and 12 months. Intervention group participants were recruited at the time of STAR registration while control group participants were recruited from community agencies serving this population after screening for age and histories of housing instability. Interviews and focus groups with service users and providers will identify the key intervention ingredients that support the process of recovery.Results:From January 2017 to July 2018, 92 individuals were recruited to each of the intervention and control groups. The groups were mostly similar at baseline; the intervention group’s total empowerment score was slightly higher than the control group’s ( M ( SD): 2.94 (0.23) vs 2.84 (0.28), p = .02), and so was the level of education. A subset of STAR participants ( n = 20) and nine service providers participated in the qualitative interviews and focus groups.Conclusion:This study will offer important new insights into the effectiveness of RECs, and expose how key REC ingredients support the process of recovery for people experiencing housing instability.

Background: Recovery Education Centres (RECs) are increasingly implemented to support the process of recovery for individuals experiencing mental health challenges. However, the evidence on key REC mechanisms and outcomes, particularly for diverse subpopulations or service delivery contexts is scant. This study identified mechanisms and outcomes of an REC focused on adults with mental health challenges transitioning from homelessness. Methods: Qualitative methods were used to explore in-depth the experiences of homeless and unstably housed participants experiencing mental health challenges in Toronto, Canada. Twenty service users participated in semistructured interviews between July 2017 and June 2018, six to 14 months following REC enrollment. A realist informed interview guide explored participants' perspectives on key REC mechanisms and outcomes. Interviews were audiorecorded, transcribed verbatim and analyzed using inductive thematic analysis. Investigator triangulation and member checking processes enhanced analytical rigour. Results: Participants perceived that program participation supported the process of recovery through several mechanisms: a judgment-free environment; supportive relationships, mutuality and role modelling; deconstruction of self-stigma; and reclaiming of one's power. Participants described several outcomes at the personal, interpersonal and social levels, including improvements in health and well-being; self-esteem, confidence and identity; sense of empowerment, control and personal responsibility; as well as improvements in interpersonal skills, pro-social behaviours and ability to self-advocate; and increased goal development and future orientation. Conclusions: Findings suggest RECs can support the process of recovery among people transitioning from homelessness and can successfully support subpopulations experiencing mental health challenges and social disadvantage.

examination of Canada's first REC for adults exiting homelessness can help guide program and policy development to better support this disadvantaged population.