Abstract:Homelessness affects individuals who are experiencing life without safe, adequate or stable housing. Conceived in this way, homeless not only describes those individuals who are visibly homeless and living on the street, but also those precariously housed individuals who; stay in emergency accommodation, sleep in crowded or inadequate housing, and those who are not safe in their living environment. Kuhn and Culhane (1998) further classify individuals experiencing homelessness as those who are chronically homel… Show more
“…We propose to draw on the definition of homelessness used by Keenan et al (2020) in a recently published Campbell Collaboration protocol. During the scoping work to develop this protocol, a workshop of five individuals with lived experienced of homelessness was convened to consider definitions, criteria for inclusion and exclusion, and the process of conducting this review.…”
Section: Methodsmentioning
confidence: 99%
“…During the scoping work to develop this protocol, a workshop of five individuals with lived experienced of homelessness was convened to consider definitions, criteria for inclusion and exclusion, and the process of conducting this review. Following recommendations from those involved in this workshop, we have slightly adapted and widened the definition of homelessness developed by Keenan et al (2020). The revised definition for this review is:Homelessness is defined as those individuals who are in inadequate accommodation (environments which are unhygienic and/or overcrowded), who are sleeping rough (sometimes defined as street homeless or unsheltered), those in temporary accommodation (such as shelters and hostels), those in insecure accommodation (such as those facing eviction or in abusive or unsafe environments), and people whose accommodation is inappropriate (such as those living in tents or vehicles, or ‘sofa surfing’).…”
The systematic review set out in this protocol is part of a broader evidence synthesis which intends to produce two systematic reviews to address a significant gap in the evidence base identified by Luchenski et al. (2018) and by White and Narayanan (2021). This review (the focus of this protocol) will be of the experiences of adults experiencing homelessness when accessing and using psychosocial interventions. This review of qualitative data will use thematic synthesis to analyse these experiences as faced by this population when accessing and using psychosocial interventions.
“…We propose to draw on the definition of homelessness used by Keenan et al (2020) in a recently published Campbell Collaboration protocol. During the scoping work to develop this protocol, a workshop of five individuals with lived experienced of homelessness was convened to consider definitions, criteria for inclusion and exclusion, and the process of conducting this review.…”
Section: Methodsmentioning
confidence: 99%
“…During the scoping work to develop this protocol, a workshop of five individuals with lived experienced of homelessness was convened to consider definitions, criteria for inclusion and exclusion, and the process of conducting this review. Following recommendations from those involved in this workshop, we have slightly adapted and widened the definition of homelessness developed by Keenan et al (2020). The revised definition for this review is:Homelessness is defined as those individuals who are in inadequate accommodation (environments which are unhygienic and/or overcrowded), who are sleeping rough (sometimes defined as street homeless or unsheltered), those in temporary accommodation (such as shelters and hostels), those in insecure accommodation (such as those facing eviction or in abusive or unsafe environments), and people whose accommodation is inappropriate (such as those living in tents or vehicles, or ‘sofa surfing’).…”
The systematic review set out in this protocol is part of a broader evidence synthesis which intends to produce two systematic reviews to address a significant gap in the evidence base identified by Luchenski et al. (2018) and by White and Narayanan (2021). This review (the focus of this protocol) will be of the experiences of adults experiencing homelessness when accessing and using psychosocial interventions. This review of qualitative data will use thematic synthesis to analyse these experiences as faced by this population when accessing and using psychosocial interventions.
“…The systematic review and network meta‐analysis was prospectively registered with the Campbell Collaboration to improve quality of the review, promote transparency and replicability, and avoid duplication of effort. The protocol was published in September 2020 (Keenan et al, 2020 ), and can be accessed through the Campbell Collaboration library.…”
Background: Globally, almost 1.6 billion individuals lack adequate housing. Many accommodation-based approaches have evolved across the globe to incorporate additional support and services beyond delivery of housing.Objectives: This review examines the effectiveness of accommodation-based approaches on outcomes including housing stability, health, employment, crime, wellbeing, and cost for individuals experiencing or at risk of experiencing homelessness.Search Methods: The systematic review is based on evidence already identified in two existing EGMs commissioned by the Centre for Homelessness Impact (CHI) and built by White et al. The maps were constructed using a comprehensive three stage search and mapping process. Stage one mapped included studies in an existing systematic review on homelessness, stage two was an extensive search of 17 academic databases, three EGM databases, and eight systematic review databases. Finally stage three included web searches for grey literature, scanning reference lists of included studies and consultation with experts to identify additional literature. We identified 223 unique studies across 551 articles from the effectiveness map on 12th April 2019.Selection Criteria: We include research on all individuals currently experiencing, or at risk of experiencing homelessness irrespective of age or gender, in high-income countries. The Network Meta-Analysis (NMA) contains all study designs where a comparison group was used. This includes randomised controlled trials (RCTs), quasi-experimental designs, matched comparisons and other study designs that attempt to isolate the impact of the intervention on homelessness. The NMA primarily addresses how interventions can reduce homelessness and increase housing stability for those individuals experiencing, or at risk of experiencing, homelessness. Additional outcomes are examined and narratively described. These include: access to mainstream healthcare; crime and justice; employment and income; capabilities and wellbeing; and cost of intervention. These outcomes reflect the domains used in the EGM, with the addition of cost.
“…There are a number of definitions of homelessness available, ( Keenan et al, 2020) Our focus is on adults experiencing (men and women aged 18 years and over), undertaken in any high-income country and published in English. Studies of families or children will be excluded from the review.…”
Background
Homelessness is a major social and public health concern. It is a traumatic experience, and can have a devastating effect on those experiencing it. People who are homeless often face significant barriers when accessing public services, and those experiencing more visible and extreme forms of homelessness have often faced adverse childhood events, extreme social disadvantage, physical, emotional and sexual abuse, neglect, low self‐esteem, poor physical and mental health, and much lower life expectancy compared to the general population. Problematic substance use is disproportionately high amongst people experiencing homelessness, with many using drugs and alcohol to deal with the stress of living on the street, to keep warm, or to block out memories of previous abuse or trauma. Drug overdose is a major cause of death for people experiencing street homelessness. Substance dependency can also create barriers to successful transition to stable housing. There is ongoing policy interest in the effectiveness of different interventions that aim to stop, reduce or prevent problematic substance use, and there is specific interest in the relative effectiveness of interventions that adopt harm reduction or abstinence‐based approaches.
Objectives
The objective of this review is to understand the effectiveness of different substance use interventions. The review will consider the effectiveness of harm reduction‐based interventions, and abstinence‐based interventions, for adults experiencing homelessness. The focus of the review is on high‐income countries.
Search Methods
The primary source of studies for potential inclusion in this review is the Homelessness Effectiveness Studies Evidence and Gaps Maps (EGM). The first of these was published in 2018, with updates published in 2019 and 2020. A further update is due to be published in the summer of 2022. It is this update that provides the final list of studies from which this review will draw. The search for this update (EGM 4th edition) was completed in September 2021. Other potential studies will be identified through a call for grey evidence and hand‐searching key journals.
Selection Criteria
Eligible studies will be impact evaluations with designs at levels, 3, 4 and 5 of the Maryland Scientific Methods scale. This therefore includes all studies categorised as either ‘Randomised Controlled Trials’ or ‘nonexperimental designs with a comparison group’ from the studies which form the basis of the Homelessness Effectiveness Studies Evidence and Gap Maps (EGM) created by CHI and the Campbell Collaboration. We are interested in studies that examine the effect of interventions on substance use outcomes. Studies to be excluded are those with designs at levels 1 and 2 of the Maryland Scientific Methods scale, for example, studies without a control or comparison group, ‘before vs. after’ designs (without an untreated comparison group), and cross‐sectional regressions.
Data Collection and Analysis
Descriptive characteristics and statistical information in included ...
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