Identifying variability in permanent supportive housing: a comparative effectiveness approach to measuring health outcomes
Open accessAbstract
Supportive housing has become the dominant model in the United States to provide housing to the chronically homeless and to improve their housing stability and health. Most supportive housing programs follow a "housing first" paradigm modeled after the Pathways to Housing program in New York City. However, components of housing first supportive housing models were poorly defined, and supportive models have varied considerably in their dissemination and implementation to other parts of the country. Recently, research has been conducted to determine the fidelity by which specific housing programs adhere to the Pathways Housing First model. However, evidence regarding which combination of components leads to better health outcomes for particular subpopulations is lacking. This article presents results from qualitative interviews with supportive housing providers in the Chicago, Illinois, metropolitan area. Supportive housing varied according to housing configuration (scattered-site vs. project-based) and service provision model (low-intensity case management, intensive case management and behavioral health), resulting in 6 basic types. Supportive housing programs also differed in services they provided in addition to case management and the extent to which they followed harm-reduction versus abstinence policies. Results showed advantages and disadvantages of each of the 6 basic types. Comparative effectiveness research may help identify which program components lead to better health outcomes among different subpopulations of homeless. Future longitudinal research will use the identified typology and other factors to compare the housing stability and health outcomes of supportive housing residents in programs that differ along these dimensions. (PsycINFO Database Record
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Single-site housing settings could also make it challenging to reduce alcohol use due to other tenants' social use of alcohol.
“Single-site housing settings could also make it challenging to reduce alcohol use due to other tenants' social use of alcohol (Collins et al., 2012b); a finding consistent with the perspectives of Housing First service providers (Dickson-Gomez et al., 2017).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Dickson-Gomez et al., 2017
A harm reduction approach involved use of an 'eviction prevention intervention' in response to drug dealing and harm to others due to substance use, wherein case managers liaise with landlords with the tenant present to advocate for another chance.
“A harm reduction approach involved use of an 'eviction prevention intervention' in response to drug dealing and harm to others due to substance use, wherein case managers liaise with landlords with the tenant present to advocate for another chance”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Dickson-Gomez et al. (2017)
Provision of guidance to use substances in tenants' apartments as opposed to in the halls, lobby, or front of the building is a harm reduction practice.
“Provision of guidance to use substances in tenants' apartments as opposed to in the halls, lobby, or front of the building”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Dickson-Gomez et al. (2017)
Scattered-site housing models could prevent recurrent homelessness when eviction prevention interventions are unsuccessful by supporting tenants to move into units in other buildings.
“Scattered-site housing models could prevent recurrent homelessness when eviction prevention interventions are unsuccessful by supporting tenants to move into units in other buildings”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Dickson-Gomez et al. (2017)
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- Authors
- Dickson-Gomez, J., Quinn, K., Bendixen, A., Johnson, A., Nowicki, K., Ko Ko, T., & Galletly, C.
- Venue
- American Journal of Orthopsychiatry
- Published
- 2017
- Volume
- 87
- Issue
- 4
- Pages
- 414-424
- ISSN
- 0002-9432 (ISSN-L)
- 1939-0025
- PMC
- PMC5503781
- OpenAlex
- W2594958699
- Cited by
- 41
- References
- 29
- Citations by year
- 2025: 6 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 9 · 2020: 6 · 2019: 4 · 2018: 4 · 2017: 1
- FWCI
- 6.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Orthopsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (P30MH052776)
- National Institute on Drug Abuse (R01DA038085)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Urban Studies › Urban and Rural Development Challenges
- Keywords
- supported housing, chronic homelessness, Housing First, implementation fidelity, program typology, case management, harm reduction, behavioral health services, housing stability, health outcomes
- MeSH terms
- Attitude of Health Personnel, Chicago, Health Services, Ill-Housed Persons, Humans, Public Housing, Program Evaluation, Program Development, Comparative Effectiveness Research
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