Family Options Study: 3-Year Impacts of Housing and Services Interventions for Homeless Families

Gubits, Daniel; Shinn, Marybeth; Wood, Michelle; Bell, Stephen H.; Dastrup, Samuel; Solari, Claudia D.; Brown, Scott R.; McInnis, Debi; McCall, Tom; Kattel, Utsav

doi:10.2139/ssrn.3055295

Cited by 60 publications

(128 citation statements)

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“…Furthermore, analyses suggested that risk reductions were explained not by changes in caregiver behavior (substance abuse, domestic violence) or economic circumstances, but rather reductions in days homeless (Shinn et al, in press). No other signifi-cant differences existed between conditions on preservation, or on rates of reunification (33%) with children who had been living away from caregivers at random assignment (Gubits et al, 2016). …”

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 98%

“…A multisite randomized controlled trial compared housing interventions for families entering homeless shelters in 12 communities across the United States (Gubits et al, 2016). More than 2000 homeless families randomly received referrals for emergency shelter (i.e., services as usual) versus one of three other housing interventions, including rapid rehousing that provided 18 months of rental assistance, temporary housing for 24 months plus 24 months of housing, and permanent housing vouchers through local public housing authorities.…”

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 99%

“…No differences emerged on rates of foster care placement (12%) in the 37 months after random assignment; however, families referred for rapid rehousing spent significantly fewer days in foster care compared with homeless services as usual. In addition, children in families who received permanent housing exhibited more positive emotional and behavioral outcomes compared with services as usual (Gubits et al, 2016). Findings suggest lower risk for family separation associated with homelessness compared with work done in the 1990s, as well as key benefits from homeless programming for preservation and child well-being.…”

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 99%

“…Results suggested families assigned to supportive housing housed more quickly and children experienced more positive well-being over a 2-year follow-up; however, no differences emerged on child out-of-home placement (Samuels et al, 2015; Shinn, Samuels, Fisher, Thompkins, & Fowler, 2015). The large-scale randomized controlled trial of homeless services also showed no impact of transitional housing that provided housing up to 24 months plus case management on formal or informal out-of-home placements (Gubits et al, 2016; Shinn et al, in press). Across interventions, limited impacts on parental and child well-being were observed (Bassuk et al, 2014).…”

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 99%

“…Foremost, permanent housing is essential to mitigate the impact of homelessness on child maltreatment. Vouchers represent a key component of housing interventions delivered across service systems; evidence clearly demonstrates their value for families entering homeless shelters (Gubits et al, 2015; Shinn et al, in press). Although effect sizes appear more modest, permanent housing shows promise in keeping families together among those already under investigation (Fowler, Brown, et al, 2017b; Pergamit et al, in press).…”

Section: Evidence In Context Of Scale-upmentioning

confidence: 99%

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Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Fowler

Farrell

Marçal

et al. 2017

American J of Comm Psychol

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Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale-up for the child welfare system. In child welfare, scale-up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale-up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system.

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Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 98%

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 99%

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 99%

Section: Policy Initiatives and Emerging Evidence On Housing Intervenmentioning

confidence: 99%

Section: Evidence In Context Of Scale-upmentioning

confidence: 99%

See 3 more Smart Citations

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Fowler

Farrell

Marçal

et al. 2017

American J of Comm Psychol

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Association of Temporary Financial Assistance With Housing Stability Among US Veterans in the Supportive Services for Veteran Families Program

et al. 2021

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Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

et al. 2022

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ImportanceHousing insecurity—that is, difficulty with housing affordability and stability—is prevalent and results in increased risk for both homelessness and poor health. However, whether interventions that prevent housing insecurity upstream of homelessness improve health remains uncertain.ObjectiveTo review evidence characterizing associations of primary prevention strategies for housing insecurity with adult physical health, mental health, health-related behaviors, health care use, and health care access.Evidence ReviewPairs of independent reviewers systematically searched PubMed, Web of Science, EconLit, and the Social Interventions Research and Evaluation Network for quantitative studies published from 2005 to 2021 that evaluated interventions intended to directly improve housing affordability and/or stability either by supporting at-risk households (targeted primary prevention) or by enhancing community-level housing supply and affordability in partnership with the health sector (structural primary prevention). Risk of bias was appraised using validated tools, and the evidence was synthesized using modified Grading of Recommendations Assessment, Development, and Evaluation criteria.FindingsA total of 26 articles describing 3 randomized trials and 20 observational studies (16 longitudinal designs and 4 cross-sectional quasi–waiting list control designs) were included. Existing interventions have focused primarily on mitigating housing insecurity for the most vulnerable individuals rather than preventing housing insecurity outright. Moderate-certainty evidence was found that eviction moratoriums were associated with reduced COVID-19 cases and deaths. Certainty of evidence was low or very low for health associations of other targeted primary prevention interventions, including emergency rent assistance, legal assistance with waiting list priority for public housing, long-term rent subsidies, and homeownership assistance. No studies evaluated health system–partnered structural primary prevention strategies.Conclusions and RelevanceThis systematic review found mixed and mostly low-certainty evidence that interventions that promote housing affordability and stability were associated with improved adult health outcomes. Existing interventions may need to be paired with other efforts to address the structural determinants of health. As health care systems and insurers respond to increasing opportunities to invest in housing as a determinant of health, further research is needed to clarify where along the housing insecurity pathway interventions should focus for the most effective and equitable health impact.

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Family Options Study: 3-Year Impacts of Housing and Services Interventions for Homeless Families

Cited by 60 publications

References 0 publications

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Association of Temporary Financial Assistance With Housing Stability Among US Veterans in the Supportive Services for Veteran Families Program

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

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