A place to call home: study protocol for a longitudinal, mixed methods evaluation of two housing first adaptations in Sydney, Australia

Whittaker, Elizabeth; Swift, Wendy; Flatau, Paul; Dobbins, Timothy; Schollar‐Root, Olivia; Burns, Lucy

doi:10.1186/s12889-015-1700-y

Cited by 12 publications

(14 citation statements)

References 34 publications

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“…As an alternative to the use of scattered sites, congregate HF (i.e., where all accommodations in a building are reserved for program clients) has been implemented in the US [12; 13], Europe [14], and Australia [15:16]. HF in congregate format has produced effective clinical outcomes and cost savings with clients with histories of homelessness and alcohol dependence [17; 18] and has been hypothesized to offer advantages to participants with complex needs including substance dependence [19].…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial Examining Housing First in Congregate and Scattered Site Formats

et al. 2017

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ObjectiveNo previous experimental trials have investigated Housing First (HF) in both scattered site (SHF) and congregate (CHF) formats. We hypothesized that CHF and SHF would be associated with a greater percentage of time stably housed as well as superior health and psychosocial outcomes over 24 months compared to treatment as usual (TAU).MethodsInclusion criteria were homelessness, mental illness, and high need for support. Participants were randomised to SHF, CHF, or TAU. SHF consisted of market rental apartments with support provided by Assertive Community Treatment (ACT). CHF consisted of a single building with supports equivalent to ACT. TAU included existing services and supports.ResultsOf 800 people screened, 297 were randomly assigned to CHF (107), SHF (90), or TAU (100). The percentage of time in stable housing over 24 months was 26.3% in TAU (reference; 95% confidence interval (CI) = 20.5, 32.0), compared to 74.3% in CHF (95% CI = 69.3, 79.3, p<0.001) and 74.5% in SHF (95% CI = 69.2, 79.7, p<0.001). Secondary outcomes favoured CHF but not SHF compared to TAU.ConclusionHF in scattered and congregate formats is capable of achieving housing stability among people experiencing major mental illness and chronic homelessness. Only CHF was associated with improvement on select secondary outcomes.RegistrationCurrent Controlled Trials: ISRCTN57595077.

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Section: Introductionmentioning

confidence: 99%

A Randomized Trial Examining Housing First in Congregate and Scattered Site Formats

et al. 2017

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“…The 63 participants were similar in socio‐demographic composition to all individuals within the two Housing First programs in Sydney 6 . Most participants were male (81%) and Australian born (79%), and 16 per cent identified as Indigenous.…”

Section: Resultsmentioning

confidence: 91%

“…Full details of the study have been published elsewhere 6 . Briefly, the study utilised a longitudinal, quantitative design and was conducted in Sydney, Australia.…”

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confidence: 99%

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First examination of varying health outcomes of the chronically homeless according to Housing First configuration

Whittaker¹,

Dobbins²,

Swift

et al. 2017

Australian and New Zealand Journal of Public Health

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Objective: To determine whether two Housing First configurations (scattered site [SS] versus congregated site [CS]) are associated with different health-related outcomes. Methods:This ecological study employed a longitudinal, quantitative design to compare the outcomes from 63 individuals (SS: n=37; CS: n=26) in Sydney, Australia, over 12 months. Results:Both configurations showed similar improvements in quality of life and psychological distress. While recent use of substances remained stable across the two configurations over time, a marginally greater increase in the proportion of CS individuals injecting more than weekly was found. For health service utilisation, CS participants had notably higher service utilisation rates for mental health specialists and the emergency department for mental health reasons at follow-up than SS participants. Conclusion:Preliminary evidence of differential injecting and health service utilisation outcomes between configurations emerged within this small-scale study over the 12-month period.Implications for public health: Given the rapid expansion of both SS and CS Housing First configurations across Western countries and the indications from this initial study that outcomes may differ according to configuration, there remains a need for robust evaluative evidence on the efficacy of various supported housing models on long-term individual outcomes.

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“…Many investigators have examined prevention and intervention strategies for use with this vulnerable population [4][5][6][7][8][9]. Three barriers investigators often encounter when conducting longitudinal work with homeless or other marginalized populations are difficulty tracking participants, high rates of noshows for follow-up interviews, and high rates of loss to follow-up [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

How Feasible is Multiple Time Point Web-Based Data Collection with Individuals Experiencing Street Homelessness?

Eyrich‐Garg

Moss

2017

J Urban Health

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Three barriers investigators often encounter when conducting longitudinal work with homeless or other marginalized populations are difficulty tracking participants, high rates of no-shows for follow-up interviews, and high rates of loss to follow-up. Recent research has shown that homeless populations have substantial access to information technologies, including mobile devices and computers. These technologies have the potential both to make longitudinal data collection with homeless populations easier and to minimize some of these methodological challenges. This pilot study's purpose was to test whether individuals who were homeless and sleeping on the streets-the Bstreet homeless^-would answer questions remotely through a web-based data collection system at regular Bfollowup^intervals. We attempted to simulate longitudinal data collection in a condensed time period. Participants (N = 21) completed an in-person baseline interview. Each participant was given a remotely reloadable gift card. Subsequently, weekly for 8 weeks, participants were sent an email with a link to a SurveyMonkey questionnaire. Participants were given 48 h to complete each questionnaire. Data were collected about life on the streets, service use, community inclusion, substance use, and high-risk sexual behaviors. Ten dollars was remotely loaded onto each participant's gift card when they completed the questionnaire within the completion window. A substantial number of participants (67% of the total sample and 86% of the adjusted sample) completed at least seven out of the eight follow-up questionnaires. Most questionnaires were completed at public libraries, but several were completed at other types of locations (social service agencies, places of employment, relative/friend/acquaintance's domiciles, or via mobile phone). Although some of the questions were quite sensitive, very few participants skipped any questions. The only variables associated with questionnaire completion were frequency of computer use and education-both positive associations. This pilot study suggests that collecting longitudinal data online may be feasible with a subpopulation of persons experiencing homelessness. We suspect that participant follow-up rates using web-based data collection methods have the potential to exceed follow-up rates using traditional in-person interviews. If this population of persons experiencing street homelessness can be successful with this method of data collection, perhaps other disenfranchised, difficult-to-track, or difficult-to-reach populations could be followed using web-based data collection methods. Local governments are striving to decrease the Bdigital divide,^providing free or greatly discounted wi-fi connectivity as well as mobile computer lab access to low-income geographic areas. These actions, in combination with increased smart phone ownership, may permit vulnerable populations to connect and communicate with investigators.

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A place to call home: study protocol for a longitudinal, mixed methods evaluation of two housing first adaptations in Sydney, Australia

Cited by 12 publications

References 34 publications

A Randomized Trial Examining Housing First in Congregate and Scattered Site Formats

A Randomized Trial Examining Housing First in Congregate and Scattered Site Formats

First examination of varying health outcomes of the chronically homeless according to Housing First configuration

How Feasible is Multiple Time Point Web-Based Data Collection with Individuals Experiencing Street Homelessness?

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