Trialing the feasibility of a critical time intervention for youth transitioning out of homelessness.

Abstract

Little is known regarding the specific types of service models and collaborations that are necessary to support diverse populations of youth in transition out of homelessness. Transitional supports addressing the complex needs of this population are needed to stabilize the array of housing arrangements that youth access. This study was a pilot randomized controlled trial of one such critical time intervention, called the Housing Outreach Program-Collaboration (HOP-C). HOP-C is a multicomponent, multidisciplinary intervention that provides 6 months of mental health and peer support, along with transitional case management to youth who have transitioned into some form of stable housing out of homelessness. In this trial, 65 youth were randomized to receive HOP-C plus treatment as usual or transitional case management plus treatment as usual. Outcome assessments were completed by 30 treatment and 28 control participants. The findings suggest that this intervention is feasible with mental health, employment or education, and housing metrics favoring HOP-C with odds ratios ranging from 2.28 to 3.18 and better subjective housing stability. Other indicators showed less change. HOP-C appears feasible and should be tested in a fully powered trial, providing the intervention for a duration longer than 6 months. Overall, these data suggest the potential benefit in fostering city-level, multidisciplinary teams sourced from several organizations to support youth transitioning out of homelessness. Pragmatic trial method considerations for this population are also addressed as are the ethical considerations pertinent to engaging highly marginalized youth in clinical trials.

A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness

“…For CTI, our results were relatively consistent with an earlier review (De Vet, 2013 ), except for new evidence indicating that CTI decreased psychiatric symptoms. Another recent RCT reported the feasibility of CTI with mental health, employment or education, and better housing stability favouring a housing outreach programme—collaboration (HOP‐C) (Kidd et al, 2020 ). Nevertheless, there is still limited evidence, particularly in assessing the impact of mental health interventions (ACT and CTI) on income and employment outcomes in selected trials.…”

Outreach programs to improve life circumstances and prevent further adverse developmental trajectories of at‐risk youth in OECD countries: A systematic review

“…Three studies (Herrera et al, 2013; Kidd et al, 2020; and Arbreton & McClanahan, 2002) did not report data in a form that enabled the calculation of effect sizes and standard errors. We contacted the authors and data was kindly provided by author Scott Leon for the Kidd et al, 2020 study.…”

Identification of Housing Stabilization Models for Youth Exiting Homelessness: A grey literature review

“…Several lines of evidence indicate that the predominantly crisis-oriented service systems for young people experiencing homelessness are far less effective than prevention strategies, such as tertiary prevention programs to support young people in sustaining housing (Gaetz, 2014;Kidd et al, 2015). Furthermore, it is clear that housing alone is necessary but not sufficient to ensure that housing is sustained, complex physical and mental health needs are met, and a good quality of life is achieved (Kidd et al, 2020). However, there is little evidence of successful concrete strategies that support young people in transitioning out of homelessness and that support success with retaining housing and flourishing in major life domains.…”