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

Pottie, Kevin; Mathew, Christine; Mendonca, Oreen; Magwood, Olivia; Saad, Ammar; Abdalla, Tasnim; Stergiopoulos, Vicky; Bloch, Gary; Brcic, Vanessa; Andermann, Anne; Aubry, Tim; Ponka, David; Kendall, Claire; Salvalaggio, Ginetta; Mott, Sebastian; Kpadé, Victoire; Lalonde, Christine; Hannigan, Terry; Shoemaker, Esther S.; Thavorn, Kednapa; Tugwell, Peter

doi:10.1002/cl2.1048

Cited by 8 publications

(10 citation statements)

References 107 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…What is the effectiveness of income assistance on the health and social outcomes of people experiencing homelessness and those who are vulnerably housed? The protocol was registered with the Campbell Collaboration (Pottie et al, 2019) and reported according to the preferred reporting items for systematic reviews and meta-analyses for protocols (PRISMA-P; Moher et al, 2015). The results of the review are reported using the PRISMA reporting guidelines (Moher et al, 2009).…”

Section: Objectivesmentioning

confidence: 99%

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

Moledina

Magwood

Agbata

et al. 2021

Campbell Systematic Reviews

Self Cite

View full text Add to dashboard Cite

Background: Homelessness has emerged as a public health priority, with growing numbers of vulnerable populations despite advances in social welfare. In February 2020, the United Nations passed a historic resolution, identifying the need to adopt social-protection systems and ensure access to safe and affordable housing for all.The establishment of housing stability is a critical outcome that intersects with other social inequities. Prior research has shown that in comparison to the general population, people experiencing homelessness have higher rates of infectious diseases, chronic illnesses, and mental-health disorders, along with disproportionately poorer outcomes. Hence, there is an urgent need to identify effective interventions to improve the lives of people living with homelessness.Objectives: The objective of this systematic review is to identify, appraise, and synthesise the best available evidence on the benefits and cost-effectiveness of interventions to improve the health and social outcomes of people experiencing homelessness.Search Methods: In consultation with an information scientist, we searched nine bibliographic databases, including Medline, EMBASE, and Cochrane CENTRAL, from database inception to February 10, 2020 using keywords and MeSH terms. We conducted a focused grey literature search and consulted experts for additional studies.Selection Criteria: Teams of two reviewers independently screened studies against our inclusion criteria. We included randomised control trials (RCTs) and quasi-experimental studies conducted among populations experiencing homelessness in high-income countries. Eligible interventions included permanent supportive housing (PSH), income assistance, standard case management (SCM), peer support, mental health interventions such as assertive community treatment (ACT), intensive case management (ICM), critical time intervention (CTI) and injectable antipsychotics, and substance-use interventions, including supervised consumption facilities (SCFs), managed alcohol programmes and opioid

show abstract

Section: Objectivesmentioning

confidence: 99%

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

Moledina

Magwood

Agbata

et al. 2021

Campbell Systematic Reviews

Self Cite

View full text Add to dashboard Cite

show abstract

“…This systematic review was done in accordance with a peer-reviewed Campbell Collaboration protocol, 29 and the PRISMA 30 and SWiM 31 reporting guidelines (appendix p 5).…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review

Aubry

Bloch

Brcic

et al. 2020

The Lancet Public Health

Self Cite

145

104

View full text Add to dashboard Cite

Background Permanent supportive housing and income assistance are valuable interventions for homeless individuals. Homelessness can reduce physical and social wellbeing, presenting public health risks for infectious diseases, disability, and death. We did a systematic review, meta-analysis, and narrative synthesis to investigate the effectiveness and cost-effectiveness of permanent supportive housing and income interventions on the health and social wellbeing of individuals who are homeless in high-income countries.Methods We searched MEDLINE, Embase, CINAHL, PsycINFO, Epistemonikos, NIHR-HTA, NHS EED, DARE, and the Cochrane Central Register of Controlled Trials from database inception to Feb 10, 2020, for studies on permanent supportive housing and income interventions for homeless populations. We included only randomised controlled trials, quasi-experimental studies, and cost-effectiveness studies from high-income countries that reported at least one outcome of interest (housing stability, mental health, quality of life, substance use, hospital admission, earned income, or employment). We screened studies using a standardised data collection form and pooled data from published studies. We synthesised results using random effects meta-analysis and narrative synthesis. We assessed certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. FindingsOur search identified 15 908 citations, of which 72 articles were included for analysis (15 studies on permanent supportive housing across 41 publications, ten studies on income interventions across 15 publications, and 21 publications on cost or cost-effectiveness). Permanent supportive housing interventions increased long-term (6 year) housing stability for participants with moderate support needs (one study; rate ratio [RR] 1•13 [95% CI 1•01-1•26]) and high support needs (RR 1•42 [1•19-1•69]) when compared with usual care. Permanent supportive housing had no measurable effect on the severity of psychiatric symptoms (ten studies), substance use (nine studies), income (two studies), or employment outcomes (one study) when compared with usual social services. Income interventions, particularly housing subsidies with case management, showed long-term improvements in the number of days stably housed (one study; mean difference at 3 years between intervention and usual services 8•58 days; p<0•004), whereas the effects on mental health and employment outcomes were unclear. Interpretation Permanent supportive housing and income assistance interventions were effective in reducing homelessness and achieving housing stability. Future research should focus on the long-term effects of housing and income interventions on physical and mental health, substance use, and quality-of-life outcomes. Funding Inner City Health Associates.

show abstract

“…We conducted a systematic review according to a published peer-reviewed protocol [29]. The protocol was not registered in an open-access registry (e.g.…”

Section: Protocol Registration and Reportingmentioning

confidence: 99%

The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Individuals who are homeless or vulnerably housed are at an increased risk for mental illness, other morbidities and premature death. Standard case management interventions as well as more intensive models with practitioner support, such as assertive community treatment, critical time interventions, and intensive case management, may improve healthcare navigation and outcomes. However, the definitions of these models as well as the fidelity and adaptations in real world interventions are highly variable. We conducted a systematic review to examine the effectiveness and cost-effectiveness of case management interventions on health and social outcomes for homeless populations. Methods and findings We searched Medline, Embase and 7 other electronic databases for trials on case management or care coordination, from the inception of these databases to July 2019. We sought outcomes on housing stability, mental health, quality of life, substance use, hospitalization, income and employment, and cost-effectiveness. We calculated pooled random effects estimates and assessed the certainty of the evidence using the GRADE approach. Our search identified 13,811 citations; and 56 primary studies met our full inclusion criteria. Standard case management had both limited and short-term effects on substance use and housing outcomes and showed potential to increase hostility and depression. Intensive case

show abstract

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

Cited by 8 publications

References 107 publications

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

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

Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review

The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review

Contact Info

Product

Resources

About