Empowering Features and Outcomes of Homeless Interventions: A Systematic Review and Narrative Synthesis

Abstract

The purpose of this systematic review and narrative synthesis was to identify homeless interventions with empowering features and evaluate their effectiveness for developing the psychological empowerment of services users. To identify and evaluate intervention studies, we combined the theoretical frameworks of empowering settings and psychological empowerment (PE). Our conceptualization of PE included outcomes aligned with the intrapersonal, interactional, and behavioral components. Relational outcomes were also included and conceptualized as antecedents for PE development. After systematic searching and screening, 37 studies were included for review. Interventions with empowering features included supported housing, case management, skills and knowledge acquisition, and mutual support. Interventions that were competency‐building effectively improved outcomes aligned with the intrapersonal PE component. Interventions that were collaborative and competency‐building effectively improved outcomes aligned with the behavioral PE component. Weak evidence suggested that interventions with empowering features may effectively improve outcomes aligned with the interactional PE component. Interventions that promoted and developed support effectively improved relational antecedents. Findings align the empirical evidence for homeless interventions with theoretical conceptions of empowering features and processes. Findings may be applied to the design and implementation of homeless interventions to incorporate empowering features and to facilitate the development of homeless services users’ PE. Empowerment theory was applied to review homeless interventions literature. Empowering homeless interventions included supported housing and mutual support, for example. Empowering interventions contributed to indicators of emotional and behavioral empowerment. Fewer empowering interventions contributed to indicators of cognitive empowerment. Service user involvement may facilitate improvements in indicators of psychological empowerment.

Structure and agency in capabilities‐enhancing homeless services: Housing first, housing quality and consumer choice

“…We obtained consistent evidence across eight European countries that people engaged with HF programmes experience services as more capabilities‐enhancing than people engaged with TS. Importantly, we obtained evidence that choice over housing and services (agency) and housing quality (structure) differentiate HF from TAU and that each is associated with experiences of HF programmes as capabilities‐enhancing (O'Shaughnessy et al, 2020; O'Shaughnessy & Greenwood, 2020). We know from previous research that HF can promote ontological security, mastery and recovery (Padgett, 2007; Greenwood et al, 2020b; Greenwood et al, 2005), and findings from this study indicate that choice over housing and support and housing quality are features of HF that can afford adults with histories of homelessness and complex needs important resources that enhance their freedom to be and do as part of a full, meaningful and dignified life.…”

Homelessness on public transit: A review of problems and responses

“…In contrast to punitive measures, studies indicate that outreach is a more effective approach to addressing homelessness. This is also supported by ample empirical evidence on the positive effects of outreach efforts on housing and health outcomes for unhoused people (de Vet et al, 2013;Munthe-Kaas, Berg, & Blaasvaer, 2018;Olivet, Bassuk, Elstad, Kenney, & Jassil, 2010;O'Shaughnessy & Greenwood, 2020). Indeed, studies find that training programmes such as crisis intervention training and collaborations with shelters and mental health agencies are important factors for successful outreach (Hipple, 2017;Turner, 2019).…”

“It Is Our Problem!”: Strategies for Responding to Homelessness on Transit

“…Meanwhile, some transit operators also employ outreach and engagement strategies in an effort to offer critical help to their unhoused riders. Studies on responses to homelessness in environments other than transit generally find outreach more effective at addressing homelessness than punitive strategies ( 21 – 24 ). Though little research has been conducted on outreach on transit in particular, common strategies include training of front-line staff and offering discounted or free fares for unhoused riders ( 2 , 8 ).…”