The effectiveness of a Housing First adaptation for ethnic minority groups: findings of a pragmatic randomized controlled trial.
BMC Public Health
; 16(1): 1110, 2016 10 21.
Article
in En
| MEDLINE
| ID: mdl-27769226
ABSTRACT
BACKGROUND:
Little is known about the effectiveness of Housing First (HF) among ethnic minority groups, despite its growing popularity for homeless adults experiencing mental illness. This randomized controlled trial tests the effectiveness of a HF program using rent supplements and intensive case management, enhanced by anti-racism and anti-oppression practices for homeless adults with mental illness from diverse ethnic minority backgrounds.METHODS:
This unblinded pragmatic field trial was carried out in community settings in Toronto, Canada. Participants were 237 adults from ethnic minority groups experiencing mental illness and homelessness, who met study criteria for moderate needs for mental health services. Participants were randomized to either adapted HF (n = 135) or usual care (n = 102) and followed every 3 months for 24 months. The primary study outcome was housing stability; secondary outcomes included physical and mental health, social functioning, quality of life, arrests and health service use. Intention to treat statistical analyses examined the effectiveness of the intervention compared to usual care.RESULTS:
During the 24-month study period, HF participants were stably housed a significantly greater proportion of time compared to usual care participants, 75 % (95 % CI 70 to 81) vs. 41 % (95 % CI 35 to 48), respectively, for a difference of 34 %, 95 % CI 25 to 43. HF also led to improvements in community integration over the course of the study the change in the mean difference between treatment groups from baseline to 24-months was significantly greater among HF participants compared to those in usual care (change in mean difference = 2.2, 95 % CI 0.06 to 4.3). Baseline diagnosis of psychosis was associated with reduced likelihood of being housed ≥ 50 % of the study period (OR = 0.37, 95 % CI 0.18 to 0.72).CONCLUSION:
Housing First enhanced with anti-racism and anti-oppression practices can improve housing stability and community functioning among ethnically diverse homeless adults with mental illness. TRIAL REGISTRATION International Standard Randomized Control Trial Number Register Identifier ISRCTN42520374 , assigned August 18, 2009.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ill-Housed Persons
/
Ethnicity
/
Mental Health
/
Community Integration
/
Minority Groups
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
Aspects:
Determinantes_sociais_saude
/
Patient_preference
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
BMC Public Health
Journal subject:
SAUDE PUBLICA
Year:
2016
Document type:
Article
Affiliation country:
Canada