1
|
Marshall CA, Boland L, Westover LA, Goldszmidt R, Bengall J, Aryobi S, Isard R, Easton C, Gewurtz R. Effectiveness of employment-based interventions for persons experiencing homelessness: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2142-2169. [PMID: 35748222 DOI: 10.1111/hsc.13892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/26/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Employment is frequently desired by persons who experience homelessness yet is often elusive. Little is known about the range and effectiveness of employment-based interventions evaluated in existing literature on key psychosocial outcomes including employment participation, mental well-being, housing tenure, community integration and substance use. To identify and synthesise existing studies, we conducted a systematic review of effectiveness using the methodology proposed by the Joanna Briggs Institute (JBI) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Following the removal of duplicates, we screened 13,398 titles and abstracts, and reviewed 79 studies at the full-text review stage using two independent raters. A total of 16 studies met criteria for inclusion in a narrative synthesis and were subjected to critical appraisal. The majority of studies were conducted in the US (n = 14; 87.5%) with other studies published in Canada (n = 1; 6.3%) and Australia (n = 1; 6.3%). Interventions evaluated in existing studies included combined substance use and vocational skills interventions (n = 7; 43.8%), supported employment (n = 6; 37.5%), and integrated supports including an employment component (n = 3; 18.8%). The effectiveness of these interventions on employment, mental well-being, housing tenure, community integration, and substance use is presented. Findings suggest that research evaluating employment interventions for persons who experience homelessness is in an early stage of development. Researchers and practitioners may consider collaborating with persons with lived experiences of homelessness and practitioners in co-designing and modifying existing approaches to target key outcomes more effectively. Policymakers may consider allocating resources to such initiatives to further the development of practice and research aimed at supporting persons who experience homelessness to secure and sustain employment during and following homelessness.
Collapse
Affiliation(s)
- Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Leonie Boland
- Faculty of Health and Human Sciences, Occupational Therapy, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Lee Ann Westover
- Teacher's College, Columbia University, New York City, New York, USA
| | - Rebecca Goldszmidt
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Jordana Bengall
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Suliman Aryobi
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Roxanne Isard
- Disciplinary Coordinator for the Faculty of Information & Media Studies & the Faculty of Education, Allyn & Betty Taylor Library, Western University, London, Ontario, Canada
| | - Corinna Easton
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Rebecca Gewurtz
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
2
|
Bowleg L, Massie JS, Holt SL, Boone CA, Mbaba M, Stroman WA, Urada L, Raj A. The Stroman Effect: Participants in MEN Count, an HIV/STI Reduction Intervention for Unemployed and Unstably Housed Black Heterosexual Men, Define Its Most Successful Elements. Am J Mens Health 2021; 14:1557988320943352. [PMID: 32693659 PMCID: PMC7376297 DOI: 10.1177/1557988320943352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Interventionists often prioritize quantitative evaluation criteria such
as design (e.g., randomized controlled trials), delivery fidelity, and
outcome effects to assess the success of an intervention. Albeit
important, criteria such as these obscure other key metrics of success
such as the role of the interactions between participants and
intervention deliverers, or contextual factors that shape an
intervention’s activities and outcomes. In line with advocacy to
expand evaluation criteria for health interventions, we designed this
qualitative study to examine how a subsample of Black men in MEN
Count, an HIV/STI risk reduction and healthy relationship intervention
with employment and housing stability case management for Black men in
Washington, DC, defined the intervention’s success. We also examined
the contextual factors that shaped participation in the study’s peer
counseling sessions. We conducted structured interviews with 38 Black
men, ages 18 to 60 years (M = 31.1,
SD = 9.33) who completed at least one of three
peer counseling sessions. Analyses highlighted three key themes: (a)
the favorable impact of Mr. Stroman, the lead peer counselor, on
participants’ willingness to participate in MEN Count and disclose
their challenges—we dubbed this the “Stroman Effect”; (b) the
importance of Black men intervention deliverers with relatable life
experiences; and (c) how contextual factors such as the HIV/AIDS
epidemic, needs for housing and employment services and safe spaces to
talk about challenges, and absentee fathers shaped participation. We
discuss the study’s implications for sustainable programs after
funding ends and future multilevel health interventions to promote
health equity for poor urban Black men.
Collapse
Affiliation(s)
- Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Jenné S Massie
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Sidney L Holt
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Cheriko A Boone
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Mary Mbaba
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Wayne A Stroman
- Emery Work Bed Program, Coalition for the Homeless, Inc., Washington, DC, USA
| | - Lianne Urada
- School of Health Sciences, University of San Diego, La Jolla, CA, USA
| | - Anita Raj
- School of Health Sciences, University of San Diego, La Jolla, CA, USA
| |
Collapse
|