PROTOCOL: Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta‐analysis and thematic synthesis

Weightman, Alison Lesley; Kelson, Mark; Thomas, Ian; Mann, Mala; Searchfield, Lydia; Hannigan, Ben; Smith, Robin; Willis, Simone; Cordiner, Rhiannon

doi:10.1002/cl2.1220

Cited by 4 publications

(4 citation statements)

References 53 publications

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“…Of note, due to our project's sample size and timeline, we were unable to gather data about CTI's effectiveness as part of this pilot initiative; as CTI is a well-established EBP (Susser et al, 1997 ; Herman et al, 2000 , 2011 ; Social Programs that Work, 2018 ; Ponka et al, 2020 ; Weightman et al, 2022 ), we relied heavily on existing data about practice effectiveness. However, the planned national implementation initiative will collect data about CTI's implementation and effectiveness by integrating qualitative and quantitative data.…”

Section: Acknowledgment Of Any Conceptual or Methodological Constraintsmentioning

confidence: 99%

Engaging stakeholders to inform national implementation of critical time intervention in a program serving homeless-experienced Veterans

Gabrielian

Cordasco²,

Finley³

et al. 2022

Front. Psychol.

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The Veterans Affairs (VA) Grant and Per Diem Case Management “Aftercare” program provides 6 months of case management for homeless-experienced Veterans (HEVs) transitioning to permanent housing, with the aim of decreasing returns to homelessness. Implementing Critical Time Intervention (CTI)—an evidence-based case management practice—would standardize care across the 128 community-based agencies that provide Aftercare services. To prepare for national CTI implementation in Aftercare, guided by Replicating Effective Programs (REP), we conducted a four-site pilot in which we adapted a CTI implementation package (training, technical assistance, and external facilitation); characterized stakeholder perspectives regarding the acceptability and appropriateness of this package; and identified contextual factors that affected CTI implementation. We engaged a stakeholder workgroup to tailor existing CTI training and technical assistance materials for Aftercare. To provide tailored support for providers and leaders to adopt and incorporate evidence-based practices (EBPs) into routine care, we also developed external facilitation materials and processes. Over 9 months, we implemented this package at four sites. We conducted semi-structured interviews at pre-implementation, mid-implementation, and 6 months post-implementation, with HEVs (n = 37), case managers (n = 16), supervisors (n = 10), and VA leaders (n = 4); these data were integrated with templated reflection notes from the project facilitator. We used rapid qualitative analysis and targeted coding to assess the acceptability and appropriateness of CTI and our implementation package and identify factors influencing CTI implementation. Stakeholders generally found CTI acceptable and appropriate; there was consensus that components of CTI were useful and compatible for this setting. To adapt our implementation package for scale-up, this pilot highlighted the value of robust and tangible CTI training and technical assistance—grounded in real-world cases—that highlights the congruence of CTI with relevant performance metrics. Variations in agency-level contextual factors may necessitate more intense and tailored supports to implement and sustain complex EBPs like CTI. Processes used in this pilot are relevant for implementing other EBPs in organizations that serve vulnerable populations. EBP scale-up and sustainment can be enhanced by engaging stakeholders to tailor EBPs for specific contexts; pilot testing and refining implementation packages for scale-up; and using qualitative methods to characterize contextual factors that affect EBP implementation.

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Section: Acknowledgment Of Any Conceptual or Methodological Constraintsmentioning

confidence: 99%

Engaging stakeholders to inform national implementation of critical time intervention in a program serving homeless-experienced Veterans

Gabrielian

Cordasco²,

Finley³

et al. 2022

Front. Psychol.

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“…Effectiveness studies were synthesised with a meta-analysis where feasible; while a framework synthesis was used to synthesise the factors that may impact on implementation. Methods followed those in the published protocol (Weightman, 2022) and findings are reported in line with the Campbell MECCIR reporting standards. 2…”

Section: Types Of Studiesmentioning

confidence: 99%

“…As per protocol (Weightman, 2022) it was agreed that, if a very large number of studies were identified, the review team would use a 'Best Fit Approach' based on a sample of studies using formal qualitative methods, and which are deemed most relevant (see Assessment of Findings).…”

Section: Implementation Studiesmentioning

confidence: 99%

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta‐analysis and thematic synthesis

Weightman

Kelson

Thomas

et al. 2023

Campbell Systematic Reviews

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Background Adequate housing is a basic human right. The many millions of people experiencing homelessness (PEH) have a lower life expectancy and more physical and mental health problems. Practical and effective interventions to provide appropriate housing are a public health priority. Objectives To summarise the best available evidence relating to the components of case‐management interventions for PEH via a mixed methods review that explored both the effectiveness of interventions and factors that may influence its impact. Search Methods We searched 10 bibliographic databases from 1990 to March 2021. We also included studies from Campbell Collaboration Evidence and Gap Maps and searched 28 web sites. Reference lists of included papers and systematic reviews were examined and experts contacted for additional studies. Selection Criteria We included all randomised and non‐randomised study designs exploring case management interventions where a comparison group was used. The primary outcome of interest was homelessness. Secondary outcomes included health, wellbeing, employment and costs. We also included all studies where data were collected on views and experiences that may impact on implementation. Data Collection and Analysis We assessed risk of bias using tools developed by the Campbell Collaboration. We conducted meta‐analyses of the intervention studies where possible and carried out a framework synthesis of a set of implementation studies identified by purposive sampling to represent the most ‘rich’ and ‘thick’ data. Main Results We included 64 intervention studies and 41 implementation studies. The evidence base was dominated by studies from the USA and Canada. Participants were largely (though not exclusively) people who were literally homeless, that is, living on the streets or in shelters, and who had additional support needs. Many studies were assessed as having a medium or high risk of bias. However, there was some consistency in outcomes across studies that improved confidence in the main findings. Case Management and Housing Outcomes Case management of any description was superior to usual care for homelessness outcomes (standardised mean difference [SMD] = −0.51 [95% confidence interval [CI]: −0.71, −0.30]; p < 0.01). For studies included in the meta‐analyses, Housing First had the largest observed impact, followed by Assertive Community Treatment, Critical Time Intervention and Intensive Case Management. The only statistically significant difference was between Housing First and Intensive Case Management (SMD = −0.6 [–1.1, −0.1]; p = 0.03) at ≥12 months. There was not enough evidence to compare the above approaches with standard case management within the meta‐analyses. A narrative comparison across all studies was inconclusive, though suggestive of a trend in favour of more intensive approaches. Case Management and Mental Health Outcomes The overall evidence suggested that case management of any description was not more or less effective compared to usual care for an individual's mental he...

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“…Some case management models, such as assertive community treatment, involve multidisciplinary teams rather than single case managers. Other models, such as critical time intervention, explicitly recognise the importance of the right form of support being delivered at the right time, especially during periods of transition for clients (Weightman, Kelson et al 2022). The design of a systematic review of case management models identified the following as elements which can potentially be used to categorise models:…”

Section: Case Management Modelsmentioning

confidence: 99%

Crisis Accommodation: now and in the future

Batterham,

Tually,

Coram

et al. 2023

AHURI Final Report

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AHURI is a national independent research network with an expert not-for-profit research management company, AHURI Limited, at its centre. AHURI's mission is to deliver high quality research that influences policy development and practice change to improve the housing and urban environments of all Australians.Using high quality, independent evidence and through active, managed engagement, AHURI works to inform the policies and practices of governments and the housing and urban development industries, and stimulate debate in the broader Australian community. AHURI undertakes evidence-based policy development on a range of priority policy topics that are of interest to our audience groups, including housing and labour markets, urban growth and renewal, planning and infrastructure development, housing supply and affordability, homelessness, economic productivity, and social cohesion and wellbeing. AHURI Limited also gratefully acknowledges the contributions, both financial and in-kind, of its university research partners who have helped make the completion of this material possible.The authors wish to acknowledge and thank a range of people who supported this research. Their support and assistance was provided in the midst of the coronavirus disease 2019 (COVID-19) pandemic, which was a particularly challenging time for the specialist homelessness services sector. We wish to thank Launch Housing staff at multiple levels and across sites, Victorian Homelessness Networkers, and the senior managers of the homelessness alliances across South Australia (SA), who assisted greatly with promoting the research and supporting recruitment for the lived experience interviews and staff focus groups. A special thanks also to Shannon Paulson from the SA Housing Authority for his assistance with recruitment of frontline staff.

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PROTOCOL: Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta‐analysis and thematic synthesis

Abstract: This is the protocol for a Campbell review. The objectives are as follows: To carry out a mixed methods review to summarise current evidence relating to the components of case‐management interventions for people experiencing homelessness.

Cited by 4 publications

References 53 publications

Engaging stakeholders to inform national implementation of critical time intervention in a program serving homeless-experienced Veterans

Engaging stakeholders to inform national implementation of critical time intervention in a program serving homeless-experienced Veterans

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta‐analysis and thematic synthesis

Crisis Accommodation: now and in the future

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