Effectiveness of interventions targeting community integration among individuals with lived experiences of homelessness: A systematic review

Abstract

Community integration (CI) has been identified as a key outcome of programs designed to improve the lives of homeless and recently housed individuals (Gaetz, The State of Homelessness in Canada 2016, 2016). Although researchers have explored the extent to which Housing First (HF) impacts on social integration (Quilgars & Pleace, Soc. Incl., 4, 2016), little is known about the range and effectiveness of other interventions on CI more broadly. We conducted a systematic review of experimental studies using Joanna Briggs Institute (JBI) guidelines. Our search strategy was deployed in six databases: EMBASE,

Beyond behaviour: rethinking integration for people experiencing homelessness

“…This conceptual model has revolutionised the way of looking at integration from an ecological perspective. Several studies have tried to examine Wong and Solomon's (2002) theoretical framework empirically to understand the role of these factors in the integration of people experiencing homelessness and psychiatric disabilities (Marshall et al, 2020). Following Wong and Solomon (2002), we review literature on integration at nested ecological levels: housing environment (housing and neighbourhood), behavioural and support environment (social support) and personal factors (psychiatric symptoms).…”

A Multilevel Intervention Framework for Supporting People Experiencing Homelessness with Pets

“…Implementation of a Housing First approach to housing policy has implications for pet owners experiencing homelessness. The impacts of pet ownership on outcomes in Housing First have not been fully investigated, though pets have been linked to greater community integration [ 77 , 78 ] and lack of integration remains an issue for Housing First tenants [ 79 , 80 , 81 ]. The intervention’s approach is also highly congruent with the needs of pet owners.…”

Finding home: Community integration experiences of formerly homeless women with problematic substance use in Housing First

“…Housing First is an evidence‐based intervention that promotes greater housing stability among people who have experienced homelessness. Nonetheless, there has only been mixed evidence that it promotes greater community integration in this population (Marshall et al, 2020). This qualitative study adds to the existing evidence base by providing a window into the experiences of community integration among women in a Housing First program who have had histories of homelessness and substance use problems.…”

“…Whereas Housing First is a starting point, addressing broader societal structures that restrict community integration is required (Quilgars & Pleace, 2016). Further, psychosocial interventions and access to other support services, such as employment, education, volunteering, and leisure supports, have been shown to have more promising effects on community integration and could be scaled up as adjuncts to Housing First (Marshall et al, 2020). That some of the women foresaw themselves moving to other neighborhoods show the value of portable support in the form of intensive case management, and in particular portable housing subsidies.…”

“…Although the provision of scattered‐site apartments can enable people with histories of homelessness to access housing in their preferred communities, there is no strong evidence that Housing First yields improvements in community integration compared with other housing models or treatment as usual (Marshall et al, 2020; Padgett et al, 2016). For example, in a multisite randomized controlled trial of Housing First in Canada, no changes in physical integration were found and participants in both the Housing First and standard care conditions showed improvements in psychological integration over 24 months (Aubry et al, 2016).…”