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Twis MK, Cimino AN, Plunk M. Beyond Victim Identification: A Practitioner's Guide to Designing a Youth Anti-Sex Trafficking Advocacy Program. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:548-560. [PMID: 38916471 DOI: 10.1080/19371918.2024.2370782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Thousands of youth are sexually trafficked each year in the United States. In order to address this concern, anti-trafficking advocates often emphasize the importance of uniform screening protocols to assist with the identification of survivors. Unfortunately, an oft-overlooked component of sex trafficking identification is what to do once a victim has been identified, and how to best meet survivors' complex needs. In this article, the authors provide social work practitioners and other advocates with best practice guidelines for how to design and evaluate anti-sex trafficking advocacy programs for children and youth. These guidelines include considerations related to direct services with clients, community partnerships, and organizational capacity, as well as recommendations for how to begin and then evaluate programming. Regardless of the form selected for the program, all anti-sex trafficking programs should be designed to provide effective, client-centered follow-up and advocacy once a positive identification is made in the community. The recommendations included in this paper are based upon extant literature, the authors' practice experience with survivors, and insights from anti-sex trafficking program evaluations.
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Affiliation(s)
- Mary K Twis
- Department of Social Work, Texas Christian University, Fort Worth, Texas, USA
| | - Andrea N Cimino
- Johns Hopkins School of Nursing, Danger Assessment Training & Technical Assistance Center, Baltimore, MD, USA
| | - Marilyn Plunk
- Department of Social Work, Texas Christian University, Fort Worth, Texas, USA
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Botija M, Vázquez-Cañete AI, Esteban-Romaní L. [Homelessness as a determinant of health and its impact on quality of life]. GACETA SANITARIA 2024; 38:102388. [PMID: 38608386 DOI: 10.1016/j.gaceta.2024.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To determine the health status of the homeless population who spend the night on the streets and in shelters (extreme residential exclusion), with reference to their quality of life, self-perceived health, comorbidity and access to health resources. METHOD A cross-sectional descriptive study was carried out on a sample of 263 homeless people in the city of Valencia by means of a nocturnal count and using the EQ-5D-3L Health Related Quality of Life questionnaire and questions from the European Quality of Life Survey for Spain. RESULTS Of the people who participated in the study, 129 of them slept outdoors, 49% (62.79% men, 19.37% women and 17.84% unidentified), while 134 slept in hostels, i.e. 51% (67.16% men and 32.84% women) with an estimated average age of 41.53 years and 55% had been living on the street for less than 12 months. People staying overnight on the streets presented worse quality of life and more than a quarter of the sample lacked a health card. CONCLUSIONS There is a relationship between homelessness and poor health conditions in terms of quality of life, perceived health, comorbidity and accessibility to health to resources. The inverse care law is evidenced.
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Affiliation(s)
- Mercedes Botija
- Departamento de Trabajo Social y Servicios Sociales, Universitat de Valencia, Valencia, España; Cátedra del Sistema Público Valenciano de Servicios Sociales, Valencia, España
| | | | - Laura Esteban-Romaní
- Departamento de Trabajo Social y Servicios Sociales, Universitat de Valencia, Valencia, España; Federación Española de Fibrosis Quística, Valencia, España.
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Marshall CA, Easton C, Javadizadeh E, Holmes J, Phillips B, Isard R. Effectiveness of Interventions for Meaningful Activity Participation in Homelessness: A Systematic Review. Can J Occup Ther 2024:84174241233519. [PMID: 38436121 DOI: 10.1177/00084174241233519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background. Meaningful activity participation has been identified as a key outcome of services designed to support individuals during and following homelessness. Little is known about the effectiveness of interventions for promoting this outcome. Purpose. To identify the range and effectiveness of interventions on promoting meaningful activity participation among persons with experiences of homelessness. Method. We conducted a systematic review using the Joanna Briggs Institute methodology following PRISMA guidelines including a critical appraisal and narrative synthesis. Findings. Of 12,343 titles and abstracts screened, we included 12 studies. The authors of the included studies primarily used standardized measures of meaningful activity engagement. Critical appraisal scores ranged from 50.0 to 77.8. The most common interventions evaluated in the included studies were psychosocial interventions (n = 6; 50.0%), followed by case management and housing support interventions (n = 4; 33.3%) and Housing First (n = 2; 16.7%). While several interventions demonstrated effectiveness in promoting meaningful activity participation including psychosocial and case management interventions, Housing First, Critical Time Intervention, and a peer support intervention were found to be ineffective for promoting engagement in meaningful activity. Conclusion. Few intervention studies have been conducted that demonstrate effectiveness for promoting participation in meaningful activity for individuals during and following homelessness. Occupational therapy researchers and practitioners can build on existing evidence by developing and evaluating novel approaches by co-designing interventions in collaboration with persons with experiences of homelessness and service providers.
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Mayer M, Mejia Urieta Y, Martinez LS, Komaromy M, Hughes U, Chatterjee A. Encampment Clearings And Transitional Housing: A Qualitative Analysis Of Resident Perspectives. Health Aff (Millwood) 2024; 43:218-225. [PMID: 38315933 DOI: 10.1377/hlthaff.2023.01040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
The number of people experiencing homelessness in tent encampments in the US has increased significantly. Citing concerns over health and safety, many cities have pursued highly visible encampment removals. In January 2022, a major tent encampment in Boston, Massachusetts, was cleared using a unique approach: Most encampment residents were placed in transitional harm reduction housing. We conducted interviews between July 2022 and February 2023 with thirty former encampment residents to explore how the encampment clearing affected their health and sense of safety. We also explored participants' perspectives on harm reduction housing. Of those interviewed, fourteen people had been placed in such housing. Among those not placed, the encampment clearing tended to exacerbate health and safety concerns, especially those related to mental health conditions and risk for violence. Among people successfully placed, harm reduction housing improved health and safety and allowed participants to make meaningful progress toward long-term goals such as addiction recovery, management of chronic health conditions, and permanent housing. Our findings suggest that encampments can have safety-promoting characteristics, but if encampment removal is pursued, offering harm reduction housing after removal can be beneficial.
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Affiliation(s)
- Michael Mayer
- Michael Mayer , Boston Medical Center, Boston, Massachusetts
| | | | | | | | - Ursel Hughes
- Ursel Hughes, Dimmock Community Health Center, Boston, Massachusetts
| | - Avik Chatterjee
- Avik Chatterjee, Boston Medical Center and Boston University
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Stokes G, Sutcliffe K, Thomas J. Is a one-size-fits-all '12-month rule' appropriate when it comes to the last search date in systematic reviews? BMJ Evid Based Med 2023; 28:359-363. [PMID: 36600443 DOI: 10.1136/bmjebm-2022-112060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Gillian Stokes
- Social Research Institute, EPPI Centre, University College London, London, UK
| | - Katy Sutcliffe
- Social Research Institute, EPPI Centre, University College London, London, UK
| | - James Thomas
- Social Research Institute, EPPI Centre, University College London, London, UK
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Slesnick N, Brakenhoff B, Bunger A, Chavez L, Cuthbertson C, Famelia R, Feng X, Fitzpatrick M, Ford J, Hatsu I, Holowacz E, Jaderlund S, Kelleher K, Luthy E, Mallory A, Martin J, Pizzulo A, Stone-Sabali S, Yilmazer T, Wu Q, Zhang J. Lessons learned from housing first, rapid rehousing trials with youth experiencing homelessness. Addict Sci Clin Pract 2023; 18:58. [PMID: 37775777 PMCID: PMC10542262 DOI: 10.1186/s13722-023-00413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Youth, 18 to 24 years, experiencing homelessness (YEH) are recognized as having developmental challenges dissimilar to older adults. Yet, research on efforts to end homelessness and prevent or intervene in drug use and mental health problems among youth have lagged behind that of adults. The Housing First (HF) Model which underlies Permanent Supportive Housing (PSH) and Rapid Re-Housing (RRH) has become preferred over treatment-first models. METHODS AND RESULTS We provide an overview of PSH and RRH studies to date and summarize our current understanding of their utility for use with YEH. Finally, we review our team's current and past randomized trials testing RRH with YEH, providing lessons learned and recommendations. CONCLUSION Current research efforts to guide best practices are hampered by a lack of fidelity to HF principles, lack of randomized design, and lack of focus on youth. Lessons learned and recommendations from our work are offered to facilitate the future work of those who seek to end homelessness and address drug use and mental health problems among youth.
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Affiliation(s)
- Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA.
| | - Brittany Brakenhoff
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Alicia Bunger
- College of Social Work, The Ohio State University, 1947 N. College Road, Columbus, OH, 43210, USA
| | - Laura Chavez
- Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Caleb Cuthbertson
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Ruri Famelia
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Xin Feng
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Maggie Fitzpatrick
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH, 43210, USA
| | - Jodi Ford
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH, 43210, USA
| | - Irene Hatsu
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Eugene Holowacz
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Soren Jaderlund
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Kelly Kelleher
- Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Ellison Luthy
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Allen Mallory
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Jared Martin
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Alexis Pizzulo
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Steven Stone-Sabali
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Tansel Yilmazer
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Qiong Wu
- Department of Family and Child Sciences, Florida State University, Tallahassee, FL, USA
| | - Jing Zhang
- Department of Human Development and Family Studies, Kent State University, Kent, OH, USA
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Corrigendum to "Effectiveness of interventions to reduce homelessness: A systematic review and meta-analysis". CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1333. [PMID: 37520794 PMCID: PMC10381362 DOI: 10.1002/cl2.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
[This corrects the article DOI: 10.4073/csr.2018.3.].
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Weightman AL, Kelson MJ, Thomas I, Mann MK, Searchfield L, Willis S, Hannigan B, Smith RJ, Cordiner R. Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1329. [PMID: 37206622 PMCID: PMC10189499 DOI: 10.1002/cl2.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
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 health (SMD = 0.02 [-0.15, 0.18]; p = 0.817). Case Management and Other Outcomes Based on meta-analyses, case management was superior to usual care for capability and wellbeing outcomes up to 1 year (an improvement of around one-third of an SMD; p < 0.01) but was not statistically significantly different for substance use outcomes, physical health, and employment. Case Management Components For homelessness outcomes, there was a non-significant trend for benefits to be greater in the medium term (≤3 years) compared to long term (>3 years) (SMD = -0.64 [-1.04, -0.24] vs. -0.27 [-0.53, 0]; p = 0.16) and for in-person meetings in comparison to mixed (in-person and remote) approaches (SMD = -0.73 [-1.25,-0.21]) versus -0.26 [-0.5,-0.02]; p = 0.13). There was no evidence from meta-analyses to suggest that an individual case manager led to better outcomes then a team, and interventions with no dedicated case manager may have better outcomes than those with a named case manager (SMD = -0.36 [-0.55, -0.18] vs. -1.00 [-2.00, 0.00]; p = 0.02). There was not enough evidence from meta-analysis to assess whether the case manager should have a professional qualification, or if frequency of contact, case manager availability or conditionality (barriers due to conditions attached to service provision) influenced outcomes. However, the main theme from implementation studies concerned barriers where conditions were attached to services. Characteristics of Persons Experiencing Homelessness No conclusions could be drawn from meta-analysis other than a trend for greater reductions in homelessness for persons with high complexity of need (two or more support needs in addition to homelessness) as compared to those with medium complexity of need (one additional support need); effect sizes were SMD = -0.61 [-0.91, -0.31] versus -0.36 [-0.68, -0.05]; p = 0.3. The Broader Context of Delivery of Case Management Programmes Other major themes from the implementation studies included the importance of interagency partnership; provision for non-housing support and training needs of PEH (such as independent living skills), intensive community support following the move to new housing; emotional support and training needs of case managers; and an emphasis on housing safety, security and choice. Cost Effectiveness The 12 studies with cost data provided contrasting results and no clear conclusions. Some case management costs may be largely off-set by reductions in the use of other services. Cost estimates from three North American studies were $45-52 for each additional day housed. Authors' Conclusions Case management interventions improve housing outcomes for PEH with one or more additional support needs, with more intense interventions leading to greater benefits. Those with greater support needs may gain greater benefit. There is also evidence for improvements to capabilities and wellbeing. Current approaches do not appear to lead to mental health benefits. In terms of case management components, there is evidence in support of a team approach and in-person meetings and, from the implementation evidence, that conditions associated with service provision should be minimised. The approach within Housing First could explain the finding that overall benefits may be greater than for other types of case management. Four of its principles were identified as key themes within the implementation studies: No conditionality, offer choice, provide an individualised approach and support community building. Recommendations for further research include an expansion of the research base outside North America and further exploration of case management components and intervention cost-effectiveness.
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Affiliation(s)
| | - Mark J. Kelson
- Department of Mathematics and Statistics, Faculty of Environment, Science and EconomyUniversity of ExeterExeterUK
| | - Ian Thomas
- Wales Institute of Social and Economic Research and Data (WISERD)Cardiff UniversityCardiffUK
| | - Mala K. Mann
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
| | - Lydia Searchfield
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
| | - Simone Willis
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
| | - Ben Hannigan
- Mental Health Nursing, School of Healthcare SciencesCardiff UniversityCardiffUK
| | | | - Rhiannon Cordiner
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
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Singh S, Fitzpatrick S, Lakshminarayanan M, Saran A, Wood J, Yang T, White H. PROTOCOL: An evidence and gap map of studies of implementation issues for interventions for those affected by and at risk of homelessness in high-income countries. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1305. [PMID: 36911861 PMCID: PMC9942265 DOI: 10.1002/cl2.1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows. The proposed evidence and gap map will present relevant process evaluations and other studies of barriers and facilitators, both qualitative and quantitative, for eligible homelessness interventions to highlight the issues arising in the implementation of these interventions. Specifically, the objectives of the map are to: (i) develop a clear taxonomy of interventions and implementation issues (e.g., barriers and facilitators-factors which works as barriers to hinder successful implementation of policies and programmes and factors which facilitate the intervention and therefore support its implementation) related to homelessness in high-income countries; (ii) map available systematic reviews and primary studies of the implementation issues of interventions for those experiencing homelessness and those at risk of homelessness, with an overview provided in a summary report; (iii) provide a searchable database of included studies accessible to research users via CHI website.
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Affiliation(s)
- Sabina Singh
- Campbell South AsiaGlobal Development NetworkNew DelhiIndia
| | - Suzanne Fitzpatrick
- Institute for Social Policy, Housing and Equalities Research (I‐SPHERE)Heriott‐Watt UniversityEdinburghUK
| | | | - Ashrita Saran
- Campbell South AsiaGlobal Development NetworkNew DelhiIndia
| | - Jenny Wood
- Institute for Social Policy, Housing and Equalities Research (I‐SPHERE)Heriott‐Watt UniversityEdinburghUK
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van Everdingen C, Peerenboom PB, van der Velden K, Delespaul P. Vital Needs of Dutch Homeless Service Users: Responsiveness of Local Services in the Light of Health Equity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2546. [PMID: 36767905 PMCID: PMC9915996 DOI: 10.3390/ijerph20032546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Healthcare and social services aim to ensure health equity for all users. Despite ongoing efforts, marginalized populations remain underserved. The Dutch HOP-TR study intends to expand knowledge on how to enable the recovery of homeless service users. METHODS A naturalistic meta-snowball sampling resulted in a representative sample of homeless services (N = 16) and users (N = 436). Interviews collected health and needs from user and professional perspectives in a comprehensive, rights-based ecosystem strategy. We calculated the responsiveness to needs in four domains (mental health, physical health, paid work, and administration). RESULTS Most service users were males (81%) with a migration background (52%). In addition to physical (78%) and mental health needs (95%), the low education level (89%) and functional illiteracy (57%) resulted in needs related to paid work and administration support. Most had vital needs in three or four domains (77%). The availability of matching care was extremely low. For users with needs in two domains, met needs ranged from 0.6-13.1%. Combined needs (>2 domains) were hardly met. CONCLUSIONS Previous research demonstrated the interdependent character of health needs. This paper uncovers some causes of health inequity. The systematic failure of local services to meet integrating care needs demonstrates the urgency to expand recovery-oriented implementation strategies with health equity in mind.
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Affiliation(s)
- Coline van Everdingen
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands
- Van Everdingen Health Care Consultancy, 6132 TP Sittard, The Netherlands
| | | | - Koos van der Velden
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands
- Mondriaan Mental Health Trust, 6401 CX Heerlen, The Netherlands
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Gabrielian S, Cordasco KM, Finley EP, Hoffmann LC, Harris T, Calderon RA, Barnard JM, Ganz DA, Olmos-Ochoa TT. Engaging stakeholders to inform national implementation of critical time intervention in a program serving homeless-experienced Veterans. Front Psychol 2022; 13:1009467. [PMID: 36591052 PMCID: PMC9795188 DOI: 10.3389/fpsyg.2022.1009467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/28/2022] [Indexed: 12/15/2022] Open
Abstract
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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Affiliation(s)
- Sonya Gabrielian
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kristina M. Cordasco
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Erin P. Finley
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Division of Hospital Medicine, Department of Medicine and Department of Psychiatry, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Lauren C. Hoffmann
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles, Los Angeles, CA, United States
| | - Taylor Harris
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles, Los Angeles, CA, United States
| | - Ronald A. Calderon
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles, Los Angeles, CA, United States
| | - Jenny M. Barnard
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - David A. Ganz
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Greater Los Angeles Geriatric Research, Education, and Clinical Center (GRECC), VA Greater Los Angeles, Los Angeles, CA, United States
| | - Tanya T. Olmos-Ochoa
- Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, CA, United States
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O'Leary C, Roberts A, Teixeira L, Coren E. PROTOCOL: The experiences of adults experiencing homelessness when accessing and using psychosocial interventions: A systematic review and qualitative evidence synthesis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1289. [PMID: 36908840 PMCID: PMC9683077 DOI: 10.1002/cl2.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Chris O'Leary
- Policy Evaluation and Research UnitManchester Metropolitan UniversityManchesterUK
| | - Anton Roberts
- Policy Evaluation and Research UnitManchester Metropolitan UniversityManchesterUK
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Clark EC, Cranston E, Polin T, Ndumbe-Eyoh S, MacDonald D, Betker C, Dobbins M. Structural interventions that affect racial inequities and their impact on population health outcomes: a systematic review. BMC Public Health 2022; 22:2162. [PMCID: PMC9685079 DOI: 10.1186/s12889-022-14603-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
AbstractStructural racism is the historical and ongoing reinforcement of racism within society due to discriminatory systems and inequitable distribution of key resources. Racism, embedded within institutional structures, processes and values, perpetuates historical injustices and restricts access to structural factors that directly impact health, such as housing, education and employment. Due to the complex and pervasive nature of structural racism, interventions that act at the structural level, rather than the individual level, are necessary to improve racial health equity. This systematic review was conducted to evaluate the effects of structural-level interventions on determinants of health and health outcomes for racialized populations. A total of 29 articles are included in this review, analyzing interventions such as supplemental income programs, minimum wage policies, nutrition safeguard programs, immigration-related policies, and reproductive and family-based policies. Most studies were quasi-experimental or natural experiments. Findings of studies were largely mixed, although there were clear benefits to policies that improve socioeconomic status and opportunities, and demonstrable harms from policies that restrict access to abortion or immigration. Overall, research on the effects of structural-level interventions to address health inequities is lacking, and the evidence base would benefit from well-designed studies on upstream policy interventions that affect the structural determinants of health and health inequities and improve daily living conditions.
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Chan V, Estrella MJ, Baddeliyanage R, Shah R, Babineau J, Colantonio A. Rehabilitation among individuals experiencing homelessness and traumatic brain injury: A scoping review. Front Med (Lausanne) 2022; 9:916602. [PMID: 36438043 PMCID: PMC9692012 DOI: 10.3389/fmed.2022.916602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 10/24/2022] [Indexed: 09/19/2023] Open
Abstract
Traumatic brain injury (TBI) is disproportionately prevalent among individuals experiencing homelessness. While rehabilitation is critical to facilitating recovery after TBI, there is currently limited information on the extent to which rehabilitation is provided to individuals experiencing homelessness and TBI. If unaddressed, this knowledge gap can perpetuate TBI-related challenges and contribute to a repetitive cycle of TBI and homelessness. This scoping review explored the extent to which rehabilitation, including the types of rehabilitation interventions, are available to, or used by, individuals experiencing homelessness and TBI. A systematic search of electronic databases (MEDLINE, Embase, Cochrane CENTRAL Register of Clinical Trials, CINAHL, APA PsycINFO, Applied Social Sciences Index and Abstracts, and Proquest Nursing and Allied Health) was conducted to identify peer-reviewed articles that met predetermined eligibility criteria. Gray literature and reference lists of eligible articles were also searched for relevant content. A descriptive numerical summary of extracted data was conducted, and qualitative analytic techniques were applied to analyze the data. Fifteen peer-reviewed articles and three gray literature reports were included, describing interventions for individuals experiencing homelessness and TBI (N = 4), rehabilitation for individuals experiencing homelessness without specific inclusion criteria for TBI (N = 11), and rehabilitation interventions that included individuals experiencing homelessness and TBI, without specific inclusion criteria for experiences of homelessness or TBI (N = 3). This review demonstrates that rehabilitation programs or interventions for this population already exist, and those that are focused on individuals experiencing homelessness are already serving individuals with TBI. Findings highlight opportunities to adapt existing rehabilitation for individuals who experience homelessness and TBI through screening for TBI, conducting cognitive and functional assessments, and tailoring interventions with multidisciplinary teams. Education and training for healthcare professionals working with individuals experiencing homelessness and TBI should be explored, including structured education and training, collaboration with a multidisciplinary team, and co-development of educational materials with service users. Research that considers the rehabilitation needs of diverse individuals experiencing homelessness and TBI is urgently needed.
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Affiliation(s)
- Vincy Chan
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Maria Jennifer Estrella
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | | | - Riya Shah
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jessica Babineau
- Library and Information Services, University Health Network, Toronto, ON, Canada
- The Institute for Education Research, University Health Network, Toronto, ON, Canada
| | - Angela Colantonio
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Del Aguila Mejía J, Armon S, Campbell F, Colling R, Chechlinska M, Kowalewska M, Pollán M, Holdenrieder S, Tan PH, Cree I, Indave Ruiz BI. Understanding the use of evidence in the WHO Classification of Tumours: a protocol for an evidence gap map of the classification of tumours of the lung. BMJ Open 2022; 12:e061240. [PMID: 36220326 PMCID: PMC9558796 DOI: 10.1136/bmjopen-2022-061240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/30/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION There are gaps in the evidence base of tumour classification despite being essential for cancer diagnosis, treatment and patient care. The WHO in charge of the production of an updated international classification, the WHO Classification of Tumours (WCT), aims to adapt evidence gap map (EGM) methodology to inform future editions of the WCT, by providing a visual summary of the existing evidence. METHODS AND ANALYSIS Bibliographical references used in the WCT fifth edition of Tumours of the Lung (Thoracic Tumours volume) will be used as search results of a literature search. A descriptive analysis of the cited evidence for tumour types and descriptors will be drafted and plotted in EPPI-Reviewer to develop a visual evidence map. The resulting EGM will reflect the number of cited studies in the size of the spheres, and the level of evidence by applying a four-colour code (red=low level evidence, orange=moderate level, green=high level and blue=unclassifiable). Overview of the findings will be provided in narrative form and a report will discuss the overall stage of cited research in the WCT and will include analysis of gaps, under-researched categories of tumour descriptors and pockets of low-level evidence. ETHICS AND DISSEMINATION No ethics approval will be required as this is a study of previously published material. Findings of the EGM will be published and used to guide editors, stakeholders and researchers for future research planning and related decision-making, especially for the development of future editions of the WCT. PROSPERO REGISTRATION NUMBER CRD42022302327.
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Affiliation(s)
- Javier Del Aguila Mejía
- WHO/IARC Classification of Tumours Programme, International Agency for Research on Cancer, Lyon, France
| | - Subasri Armon
- WHO/IARC Classification of Tumours Programme, International Agency for Research on Cancer, Lyon, France
| | - Fiona Campbell
- Evidence Synthesis Group, Population Health Sciences Institute Newcastle University, Newcastle upon Tyne, UK
| | - Richard Colling
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Magdalena Chechlinska
- Department of Cancer Biology, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Magdalena Kowalewska
- Department of Cancer Biology, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Marina Pollán
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- CIBERESP, Madrid, Spain
| | - Stefan Holdenrieder
- Institute of Laboratory Medicine, Munich Biomarker Research Center, Deutsches Herzzentrum München, Munchen, Germany
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore
| | - Ian Cree
- WHO/IARC Classification of Tumours Programme, International Agency for Research on Cancer, Lyon, France
| | - Blanca Iciar Indave Ruiz
- WHO/IARC Classification of Tumours Programme, International Agency for Research on Cancer, Lyon, France
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Richards H, Staruch R, King A, Pugh C, Kinsella S, Savović J, Young A. Protocol for a Global Burns Research Priority Setting Partnership to agree the most important unanswered questions in international burns care. BMJ Open 2022; 12:e065120. [PMID: 36104134 PMCID: PMC9476147 DOI: 10.1136/bmjopen-2022-065120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Burns affect 11 million people globally and can result in long-term disability with substantial associated healthcare costs. There is limited research funding to support trials to provide evidence for clinical decision-making. Research prioritisation ensures that research focuses on the topics most important to stakeholders, addressing issues of research waste and evidence gaps. The aim of this project is to agree the global top 10 research priorities important to international patients, carers and clinicians from all income status countries. METHODS AND ANALYSIS The Global Burns Research Priority Setting Partnership will use James Lind Alliance methods to establish the top 10 research priorities in global burns care. An initial international online multilingual survey will collect candidate research priorities from stakeholders. To increase equity in participation, the survey will also be available via the social media app WhatsApp. Additionally, interviews will be conducted. Data will be analysed to identify and collate research questions and to verify that the priorities are true clinical uncertainties. This list will then be ranked by stakeholders in order of importance via a second online survey. Finally, a consensus meeting will identify the top 10 research priorities. ETHICS AND DISSEMINATION The University of Bristol Medical School Faculty Ethical Committee has approved this project. Research into burn care should be prioritised to ensure that funding is focused where most needed. This should be undertaken internationally, to ensure inclusion of the views of professionals and patients from lower income countries, where the incidence of thermal burns is highest. The involvement of the James Lind Alliance will ensure that the methodology is robust and that the patient voice is heard. The final top 10 priorities will be disseminated to funders, governments and researchers internationally to inform future global burns research.
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Affiliation(s)
- Hollie Richards
- Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre Surgical Innovation Theme, University Hospitals Bristol and Weston NHS Foundation and the University of Bristol, Bristol, UK
| | - Robert Staruch
- Botnar Research Centre, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Anni King
- Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre Surgical Innovation Theme, University Hospitals Bristol and Weston NHS Foundation and the University of Bristol, Bristol, UK
| | - Catrin Pugh
- Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Suzannah Kinsella
- James Lind Alliance, National Institute for Health Research, School of Healthcare Enterprise and Innovation, University of Southampton, Alpha House, Enterprise Road, Southampton, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Amber Young
- Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Children's Burns Research Centre Bristol, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Dalgaard NT, Flensborg Jensen MC, Bengtsen E, Krassel KF, Vembye MH. PROTOCOL: Group-based community interventions to support the social reintegration of marginalised adults with mental illness. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1254. [PMID: 36909877 PMCID: PMC9283853 DOI: 10.1002/cl2.1254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This is the protocol for a Campbell systematic review. The main objective is to explore the general efficacy of group-based community interventions aimed at supporting marginalised adults with mental illness and related problems on outcomes such as problem behaviour, subjective well-being, homelessness, poverty and employment. Furthermore, the objective is to explore the potential advantages/disadvantages of using a group-based versus an individual intervention when targeting specific problems or when using specific types of interventions.
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Affiliation(s)
- Nina T. Dalgaard
- VIVE—The Danish Centre for Social Science ResearchCopenhagenDenmark
| | | | | | - Karl F. Krassel
- VIVE—The Danish Centre for Social Science ResearchCopenhagenDenmark
| | - Mikkel H. Vembye
- VIVE—The Danish Centre for Social Science ResearchCopenhagenDenmark
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Nutrition programmes for individuals living with disadvantage in supported residential settings: a scoping review. Public Health Nutr 2022; 25:2625-2636. [PMID: 35470791 PMCID: PMC9991776 DOI: 10.1017/s1368980022000969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Health inequities such as chronic disease are significantly higher among individuals living with disadvantage compared with the general population and many are reported to be attributable to preventable dietary risk factors. This study provides an overview of the current nutrition interventions for individuals living with extreme disadvantage, in supported residential settings, to develop insights into the development and implementation of policies and practices to promote long-term nutritional health and well-being. DESIGN A scoping review searched Scopus, ProQuest, CINAHL Plus, MEDLINE, and Web of Science databases using the terms 'resident', 'nutrition', 'disadvantage', 'intervention' and their synonyms, with particular emphasis on interventions in residential settings. SETTING Residential services providing nutrition provision and support. PARTICIPANTS People experiencing extreme disadvantage. RESULTS From 5262 articles, seven were included in final synthesis. Most interventions focused on building food literacy knowledge and skills. Study designs and outcome measures varied; however, all reported descriptive improvements in behaviour and motivation. In addition to food literacy, it was suggested that interventions need to address behaviour and motivations, programme sustainability, long-term social, physical and economic barriers and provide support for participants during transition into independent living. Socio-economic issues remain key barriers to long-term health and well-being. CONCLUSIONS In addition to food literacy education, future research and interventions should consider utilising an academic-community partnership, addressing nutrition-related mental health challenges, motivation and behaviour change and a phased approach to improve support for individuals transitioning into independent living.
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Ahasan R, Alam MS, Chakraborty T, Ali SMA, Alam TB, Islam T, Hossain MM. Applications of geospatial analyses in health research among homeless people: A systematic scoping review of available evidence. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nurse-led service delivery models in primary care: A scoping review protocol. BJGP Open 2022; 6:BJGPO.2021.0194. [DOI: 10.3399/bjgpo.2021.0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 10/31/2022] Open
Abstract
BackgroundEnsuring equitable access to health care is reliant on the strengthening of primary care services. Increasing the utilisation of task-sharing and telehealth models is one strategy to improve patient access and outcomes in primary care. This protocol details the methodology of a proposed scoping review of nurse and midwife involvement in task-sharing and telehealth models in primary care.AimUndertaking this review will identify what models have been utilised in the primary care setting globally, the characteristics and health and economic outcomes of the models and whether these models are acceptable and feasible.Design and settingThis protocol was developed in line with Joanna Briggs Institute Methodology for Scoping Reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis protocols (PRISMA-P).Methods and analysisFive databases (Ovid MEDLINE, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library) will be searched for relevant studies published in English. Articles will be screened for inclusion in Covidence by three authors, with data extracted and synthesised using a chart designed for this review. Evidence will be mapped in both tabular and narrative forms to show characteristics, outcomes and acceptability of the models of care. Ethical approval is not required as data utilised is publicly available.ConclusionsUnderstanding how nurse and midwife-led models of care may operate is crucial to strengthening service provision in primary care. Evidence on nurse and midwife led primary care models will be collated and synthesised to inform future models
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Weightman AL, Kelson MJ, Thomas I, Mann MK, Searchfield L, Hannigan B, Smith RJ, Willis S, Cordiner R. PROTOCOL: Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1220. [PMID: 36908653 PMCID: PMC8866910 DOI: 10.1002/cl2.1220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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.
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Affiliation(s)
| | - Mark J. Kelson
- Alan Turing Institute, School of MathematicsUniversity of ExeterUK
| | - Ian Thomas
- Wales Institute of Social and Economic Research and Data (WISERD)Cardiff UniversityCardiffUK
| | - Mala K. Mann
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
| | - Lydia Searchfield
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
| | - Ben Hannigan
- Mental Health Nursing, School of Healthcare SciencesCardiff UniversityCardiffUK
| | | | - Simone Willis
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
| | - Rhiannon Cordiner
- Specialist Unit for Review Evidence (SURE)Cardiff UniversityCardiffUK
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Babando J, Quesnel DA, Woodmass K, Lomness A, Graham JR. Responding to pandemics and other disease outbreaks in homeless populations: A review of the literature and content analysis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:11-26. [PMID: 33825271 PMCID: PMC8251050 DOI: 10.1111/hsc.13380] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/15/2021] [Accepted: 03/17/2021] [Indexed: 05/06/2023]
Abstract
Considering the recent COVID-19 pandemic, we recognised a lack of synthesis amongst the available literature pertaining to the intersections of homelessness and pandemic response and planning. Therefore, the purpose of this review was to identify relevant peer-reviewed literature in this area to thematically produce evidence-based recommendations that would inform community planning and response amongst homeless populations. Although this review is inspired by the COVID-19 pandemic, our intention was to produce relevant recommendations to for all current and future outbreaks and pandemics more generally. Our search criteria focused on pandemics and rapid-spread illnesses such as contagious respiratory diseases with contact spread and with an emphasis on individuals experiencing homelessness. Content analysis methods were followed to extract and thematically synthesise key information amongst the 223 articles that matched our search criteria between the years of 1984 and 2020. Two reviewers were assigned to the screening process and used Covidence and undertook two rounds of discussion to identify and finalise themes for extraction. This review illustrates that the current breadth of academic literature on homeless populations has thus far focused on tuberculosis (TB) rather than diseases that are more recent and closely related to COVID-19-such as Severe Acute Respiratory Syndrome (SARS) or H1N1. Our thematic content analysis revealed six themes that offer tangible and scalable recommendations which include (1) education and outreach, (2) adapting structure of services, (3) screening and contract tracing, (4) transmission and prevention strategies, (5) shelter protocols and (6) treatment, adherence and vaccination. The breadth and depth of reviews such as these are dependent on the quantity and quality of the available literature. Therefore, the limited existing literature outside of tuberculosis specific to homelessness in this review illustrates a need for more academic research into the intersections of pandemics and homelessness-particularly for evaluations of response and planning. Nonetheless, this review offers timely considerations for pandemic response and planning amongst homeless populations during the current COVID-19 pandemic and can facilitate future research in this area.
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Affiliation(s)
- Jordan Babando
- School of Social WorkUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Danika A. Quesnel
- School of Social WorkUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Kyler Woodmass
- School of Social WorkUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - Arielle Lomness
- Okanagan LibraryUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
| | - John R. Graham
- School of Social WorkUniversity of British Columbia‐Okanagan CampusKelownaBritish ColumbiaCanada
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Naji L, Dennis B, Morgan RL, Sanger N, Worster A, Paul J, Thabane L, Samaan Z. Investigating and addressing the immediate and long-term consequences of the COVID-19 pandemic on patients with substance use disorders: a scoping review and evidence map protocol. BMJ Open 2021; 11:e045946. [PMID: 34493506 PMCID: PMC8424417 DOI: 10.1136/bmjopen-2020-045946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 08/09/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has driven unprecedented social and economic reform in efforts to curb the impact of disease. Governments worldwide have legislated non-essential service shutdowns and adapted essential service provision in order to minimise face-to-face contact. We anticipate major consequences resulting from such policies, with marginalised populations expected to bear the greatest burden of such measures, especially those with substance use disorders (SUDs). METHODS AND ANALYSIS We aim to conduct (1) a scoping review to summarise the available evidence evaluating the impact of the COVID-19 pandemic on patients with SUDs, and (2) an evidence map to visually plot and categorise the current available evidence evaluating the impact of COVID-19 on patients with SUDs to identify gaps in addressing high-risk populations. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review as we plan to review publicly available data. This is part of a multistep project, whereby we intend to use the findings generated from this review in combination with data from an ongoing prospective cohort study our team is leading, encompassing over 2000 patients with SUDs receiving medication-assisted therapy in Ontario prior to and during the COVID-19 pandemic.
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Affiliation(s)
- Leen Naji
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brittany Dennis
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nitika Sanger
- Medical Science Gradaute Program, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Worster
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - James Paul
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Research Institute at St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Abstract
As states move beyond simply managing their homelessness crises to looking for ways to reduce and ultimately end homelessness, broad-scale efforts to prevent homelessness are lacking. Experiences of homelessness are often harmful, traumatic, and costly, making a compelling case for why homelessness prevention should be prioritized. In recent years, countries such as Australia, Finland, and Wales have shifted their focus to prevention, but there remains a conceptual and systematic gap in our collective knowledge about what precisely homelessness prevention is, what policies, programs, and interventions are captured in a homelessness prevention strategy, and how to build a framework for orienting our response to homelessness towards prevention. This article begins to fill that gap by providing a definition and typology of homelessness prevention (THP). Our definition offers a schema to clarify the nature of homelessness prevention and to develop a collective response between various policies and practices that can and should be framed as homelessness prevention. Building off of the public health model of prevention and pre-existing homelessness prevention classification systems, our THP complements the definition by specifying the pragmatic nature of prevention initiatives and the range of sectors, stakeholders, and levels of government required to respond to the causes of homelessness. Our typology is made up of five interrelated elements: structural, systems, early intervention, evictions prevention, and housing stabilization. Each of these elements contains actionable strategies that cut across primary, secondary, and tertiary prevention to ensure that people at various levels of risk have access to the tools and resources necessary to find and maintain safe, appropriate, and suitable housing. Together the definition and THP are useful tools to envision a new way forward in how we respond to homelessness.
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Affiliation(s)
- Erin Dej
- Department of Criminology, Wilfrid Laurier University, 171 Colborne St., Brantford, ON, N3T 6C9, Canada.
| | - Stephen Gaetz
- Faculty of Education, York University, Toronto, ON, Canada.,Canadian Observatory on Homelessness, York University, Toronto, ON, Canada
| | - Kaitlin Schwan
- Canadian Observatory on Homelessness, York University, Toronto, ON, Canada
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Moledina A, Magwood O, Agbata E, Hung J, Saad A, Thavorn K, Pottie K. A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1154. [PMID: 37131928 PMCID: PMC8356292 DOI: 10.1002/cl2.1154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Homelessness has emerged as a public health priority, with growing numbers of vulnerable populations despite advances in social welfare. In February 2020, the United Nations passed a historic resolution, identifying the need to adopt social-protection systems and ensure access to safe and affordable housing for all. The establishment of housing stability is a critical outcome that intersects with other social inequities. Prior research has shown that in comparison to the general population, people experiencing homelessness have higher rates of infectious diseases, chronic illnesses, and mental-health disorders, along with disproportionately poorer outcomes. Hence, there is an urgent need to identify effective interventions to improve the lives of people living with homelessness. Objectives The objective of this systematic review is to identify, appraise, and synthesise the best available evidence on the benefits and cost-effectiveness of interventions to improve the health and social outcomes of people experiencing homelessness. Search Methods In consultation with an information scientist, we searched nine bibliographic databases, including Medline, EMBASE, and Cochrane CENTRAL, from database inception to February 10, 2020 using keywords and MeSH terms. We conducted a focused grey literature search and consulted experts for additional studies. Selection Criteria Teams of two reviewers independently screened studies against our inclusion criteria. We included randomised control trials (RCTs) and quasi-experimental studies conducted among populations experiencing homelessness in high-income countries. Eligible interventions included permanent supportive housing (PSH), income assistance, standard case management (SCM), peer support, mental health interventions such as assertive community treatment (ACT), intensive case management (ICM), critical time intervention (CTI) and injectable antipsychotics, and substance-use interventions, including supervised consumption facilities (SCFs), managed alcohol programmes and opioid agonist therapy. Outcomes of interest were housing stability, mental health, quality of life, substance use, hospitalisations, employment and income. Data Collection and Analysis Teams of two reviewers extracted data in duplicate and independently. We assessed risk of bias using the Cochrane Risk of Bias tool. We performed our statistical analyses using RevMan 5.3. For dichotomous data, we used odds ratios and risk ratios with 95% confidence intervals. For continuous data, we used the mean difference (MD) with a 95% CI if the outcomes were measured in the same way between trials. We used the standardised mean difference with a 95% CI to combine trials that measured the same outcome but used different methods of measurement. Whenever possible, we pooled effect estimates using a random-effects model. Main Results The search resulted in 15,889 citations. We included 86 studies (128 citations) that examined the effectiveness and/or cost-effectiveness of interventions for people with lived experience of homelessness. Studies were conducted in the United States (73), Canada (8), United Kingdom (2), the Netherlands (2) and Australia (1). The studies were of low to moderate certainty, with several concerns regarding the risk of bias. PSH was found to have significant benefits on housing stability as compared to usual care. These benefits impacted both high- and moderate-needs populations with significant cimorbid mental illness and substance-use disorders. PSH may also reduce emergency department visits and days spent hospitalised. Most studies found no significant benefit of PSH on mental-health or substance-use outcomes. The effect on quality of life was also mixed and unclear. In one study, PSH resulted in lower odds of obtaining employment. The effect on income showed no significant differences. Income assistance appeared to have some benefits in improving housing stability, particularly in the form of rental subsidies. Although short-term improvement in depression and perceived stress levels were reported, no evidence of the long-term effect on mental health measures was found. No consistent impact on the outcomes of quality of life, substance use, hospitalisations, employment status, or earned income could be detected when compared with usual services. SCM interventions may have a small beneficial effect on housing stability, though results were mixed. Results for peer support interventions were also mixed, though no benefit was noted in housing stability specifically. Mental health interventions (ICM, ACT, CTI) appeared to reduce the number of days homeless and had varied effects on psychiatric symptoms, quality of life, and substance use over time. Cost analyses of PSH interventions reported mixed results. Seven studies showed that PSH interventions were associated with increased cost to payers and that the cost of the interventions were only partially offset by savings in medical- and social-services costs. Six studies revealed that PSH interventions saved the payers money. Two studies focused on the cost-effectiveness of income-assistance interventions. For each additional day housed, clients who received income assistance incurred additional costs of US$45 (95% CI, -$19, -$108) from the societal perspective. In addition, the benefits gained from temporary financial assistance were found to outweigh the costs, with a net savings of US$20,548. The economic implications of case management interventions (SCM, ICM, ACT, CTI) was highly uncertain. SCM clients were found to incur higher costs than those receiving the usual care. For ICM, all included studies suggested that the intervention may be cost-offset or cost-effective. Regarding ACT, included studies consistently revealed that ACT saved payers money and improved health outcomes than usual care. Despite having comparable costs (US$52,574 vs. US$51,749), CTI led to greater nonhomeless nights (508 vs. 450 nights) compared to usual services. Authors' Conclusions PSH interventions improved housing stability for people living with homelessness. High-intensity case management and income-assistance interventions may also benefit housing stability. The majority of included interventions inconsistently detected benefits for mental health, quality of life, substance use, employment and income. These results have important implications for public health, social policy, and community programme implementation. The COVID-19 pandemic has highlighted the urgent need to tackle systemic inequality and address social determinants of health. Our review provides timely evidence on PSH, income assistance, and mental health interventions as a means of improving housing stability. PSH has major cost and policy implications and this approach could play a key role in ending homelessness. Evidence-based reviews like this one can guide practice and outcome research and contribute to advancing international networks committed to solving homelessness.
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Affiliation(s)
| | - Olivia Magwood
- C.T. Lamont Primary Health Care Research CentreBruyere Research InstituteOttawaCanada
| | - Eric Agbata
- Bruyere Research Institute, School of EpidemiologyPublic Health and Preventive MedicineOttawaCanada
| | - Jui‐Hsia Hung
- Faculty of Medicine, School of Epidemiology and Public HealthUniversity of OttawaOttawaCanada
| | - Ammar Saad
- Department of Epidemiology, C.T. Lamont Primary Care Research Centre, Bruyere Research InstituteUniversity of OttawaOttawaCanada
| | - Kednapa Thavorn
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaCanada
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Keenan C, Miller S, Hanratty J, Pigott T, Hamilton J, Coughlan C, Mackie P, Fitzpatrick S, Cowman J. Accommodation-based interventions for individuals experiencing, or at risk of experiencing, homelessness. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1165. [PMID: 37131929 PMCID: PMC8356295 DOI: 10.1002/cl2.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
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. Data Collection and Analysis Due to the diverse nature of the literature on accommodation-based approaches, the way in which the approaches are implemented in practice, and the disordered descriptions of the categories, the review team created a novel typology to allow meaningful categorisations for functional and useful comparison between the various intervention types. Once these eligible categories were identified, we undertook dual data extraction, where two authors completed data extraction and risk of bias (ROB) assessments independently for each study. NMA was conducted across outcomes related to housing stability and health.Qualitative data from process evaluations is included using a "Best Fit" Framework synthesis. The purpose of this synthesis is to complement the quantitative evidence and provide a better understanding of what factors influenced programme effectiveness. All included Qualitative data followed the initial framework provided by the five main analytical categories of factors of influence (reflected in the EGM), namely: contextual factors, policy makers/funders, programme administrators/managers/implementing agencies, staff/case workers and recipients of the programme. Main Results There was a total of 13,128 people included in the review, across 51 reports of 28 studies. Most of the included studies were carried out in the United States of America (25/28), with other locations including Canada and the UK. Sixteen studies were RCTs (57%) and 12 were nonrandomised (quasi-experimental) designs (43%). Assessment of methodological quality and potential for bias was conducted using the second version of the Cochrane Risk of Bias tool for Randomised controlled trials. Nonrandomised studies were coded using the ROBINS- I tool. Out of the 28 studies, three had sufficiently low ROB (11%), 11 (39%) had moderate ROB, and five (18%) presented serious problems with ROB, and nine (32%) demonstrated high, critical problems with their methodology. A NMA on housing stability outcomes demonstrates that interventions offering the highest levels of support alongside unconditional accommodation (High/Unconditional) were more effective in improving housing stability compared to basic support alongside unconditional housing (Basic/Unconditional) (ES=1.10, 95% confidence interval [CI] [0.39, 1.82]), and in comparison to a no-intervention control group (ES=0.62, 95% CI [0.19, 1.06]). A second NMA on health outcomes demonstrates that interventions categorised as offering Moderate/Conditional (ES= 0.36, 95% CI [0.03, 0.69]) and High/Unconditional (ES = 0.22, 95% CI [0.01, 0.43]) support were effective in improving health outcomes compared to no intervention. These effects were smaller than those observed for housing stability. The quality of the evidence was relatively low but varied across the 28 included studies. Depending on the context, finding accommodation for those who need it can be hindered by supply and affordability in the market. The social welfare approach in each jurisdiction can impact heavily on support available and can influence some of the prejudice and stigma surrounding homelessness. The evaluations emphasised the need for collaboration and a shared commitment between policymakers, funders and practitioners which creates community and buy in across sectors and agencies. However, co-ordinating this is difficult and requires sustainability to work. For those implementing programmes, it was important to invest time in developing a culture together to build trust and solid relationships. Additionally, identifying sufficient resources and appropriate referral routes allows for better implementation planning. Involving staff and case workers in creating processes helps drive enthusiasm and energy for the service. Time should be allocated for staff to develop key skills and communicate engage effectively with service users. Finally, staff need time to develop trust and relationships with service users; this goes hand in hand with providing information that is up to date and useful as well making themselves accessible in terms of location and time. Authors' Conclusions The network meta-analysis suggests that all types of accommodation which provided support are more effective than no intervention or Basic/Unconditional accommodation in terms of housing stability and health. The qualitative evidence synthesis raised a primary issue in relation to context: which was the lack of stable, affordable accommodation and the variability in the rental market, such that actually sourcing accommodation to provide for individuals who are homeless is extremely challenging. Collaboration between stakeholders and practitioners can be fruitful but difficult to coordinate across different agencies and organisations.
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Affiliation(s)
- Ciara Keenan
- Campbell UK & Ireland, Centre for Evidence and Social InnovationQueen's UniversityBelfastUK
| | - Sarah Miller
- Campbell UK & Ireland, Centre for Evidence and Social InnovationQueen's UniversityBelfastUK
| | - Jennifer Hanratty
- Campbell UK & Ireland, Centre for Evidence and Social InnovationQueen's UniversityBelfastUK
| | - Terri Pigott
- School of Public HealthGeorgia State UniversityAtlantaGeorgiaUSA
| | - Jayne Hamilton
- Campbell UK & Ireland, Centre for Evidence and Social InnovationQueen's UniversityBelfastUK
| | - Christopher Coughlan
- Campbell UK & Ireland, Centre for Evidence and Social InnovationQueen's UniversityBelfastUK
| | | | | | - John Cowman
- Department of Social WorkHealth Service ExecutiveDublinIreland
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372:n160. [PMID: 33781993 PMCID: PMC8005925 DOI: 10.1136/bmj.n160+10.1136/bmj.n160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
The methods and results of systematic reviews should be reported in sufficient detail to allow users to assess the trustworthiness and applicability of the review findings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was developed to facilitate transparent and complete reporting of systematic reviews and has been updated (to PRISMA 2020) to reflect recent advances in systematic review methodology and terminology. Here, we present the explanation and elaboration paper for PRISMA 2020, where we explain why reporting of each item is recommended, present bullet points that detail the reporting recommendations, and present examples from published reviews. We hope that changes to the content and structure of PRISMA 2020 will facilitate uptake of the guideline and lead to more transparent, complete, and accurate reporting of systematic reviews.
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Affiliation(s)
- Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Isabelle Boutron
- Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004 Paris, France
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Cynthia D Mulrow
- University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States; Annals of Internal Medicine
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Julie Glanville
- York Health Economics Consortium (YHEC Ltd), University of York, York, UK
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Manoj M Lalu
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Denver, Denver, Colorado, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Elizabeth W Loder
- Division of Headache, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States; Head of Research, The BMJ, London, UK
| | - Evan Mayo-Wilson
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States
| | - Steve McDonald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Luke A McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, London, UK
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Epidemiology Division of the Dalla Lana School of Public Health and the Institute of Health Management, Policy, and Evaluation, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Vivian A Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Penny Whiting
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ : BRITISH MEDICAL JOURNAL 2021. [DOI: 10.1136/bmj.n160 10.1136/bmj.n160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372:n160. [PMID: 33781993 PMCID: PMC8005925 DOI: 10.1136/bmj.n160] [Citation(s) in RCA: 3101] [Impact Index Per Article: 1033.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Isabelle Boutron
- Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004 Paris, France
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Cynthia D Mulrow
- University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States; Annals of Internal Medicine
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Toronto, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
| | - Julie Glanville
- York Health Economics Consortium (YHEC Ltd), University of York, York, UK
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Manoj M Lalu
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada; Clinical Epidemiology Program, Blueprint Translational Research Group, Ottawa Hospital Research Institute, Ottawa, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine, University of Colorado Denver, Denver, Colorado, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Elizabeth W Loder
- Division of Headache, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States; Head of Research, The BMJ, London, UK
| | - Evan Mayo-Wilson
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States
| | - Steve McDonald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Luke A McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesley A Stewart
- Centre for Reviews and Dissemination, University of York, York, UK
| | - James Thomas
- EPPI-Centre, UCL Social Research Institute, University College London, London, UK
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Epidemiology Division of the Dalla Lana School of Public Health and the Institute of Health Management, Policy, and Evaluation, University of Toronto, Toronto, Canada; Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, Queen's University, Kingston, Canada
| | - Vivian A Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Penny Whiting
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Baral S, Bond A, Boozary A, Bruketa E, Elmi N, Freiheit D, Ghosh SM, Goyer ME, Orkin AM, Patel J, Richter T, Robertson A, Sutherland C, Svoboda T, Turnbull J, Wong A, Zhu A. Seeking shelter: homelessness and COVID-19. Facets (Ott) 2021. [DOI: 10.1139/facets-2021-0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Those experiencing homelessness in Canada are impacted inequitably by COVID-19 due to their increased exposure, vulnerability of environment and medical comorbidities, and their lack of access to preventive care and treatment in the context of the pandemic. In shelter environments one is unable to effectively physically distance, maintain hygiene, obtain a test, or isolate. As a result, unique strategies are required for this population to protect them and those who serve them. Recommendations are provided to reduce or prevent further negative consequences from the COVID-19 pandemic for people experiencing homelessness. These recommendations were informed by a systematic review of the literature, as well as a jurisdictional scan. Where evidence did not exist, expert consensus from key providers and those experiencing homelessness throughout Canada was included. These recommendations recognize the need for short-term interventions to mitigate the immediate risk to this community, including coordination of response, appropriate precautions and protective equipment, reducing congestion, cohorting, testing, case and contact management strategies, dealing with outbreaks, isolation centres, and immunization. Longer-term recommendations are also provided with a view to ending homelessness by addressing the root causes of homelessness and by the provision of adequate subsidized and supportive housing through a Housing First strategy. It is imperative that meaningful changes take place now in how we serve those experiencing homelessness and how we mitigate specific vulnerabilities. These recommendations call for intersectoral, collaborative engagement to work for solutions targeted towards protecting the most vulnerable within our community through both immediate actions and long-term planning to eliminate homelessness.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Inner City Health Associates, Toronto, ON M5C 1K6, Canada
| | - Andrew Bond
- Inner City Health Associates, Toronto, ON M5C 1K6, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Andrew Boozary
- Population Health and Social Medicine, University Health Network, Toronto, ON M5G 2C4, Canada
- University of Toronto, Toronto, ON M5S 1A8, Canada
- Columbia University, New York, NY 10032, USA
| | - Eva Bruketa
- Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Nika Elmi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | | | - S. Monty Ghosh
- Department of General Internal Medicine & Neurology, University of Alberta, Edmonton, AB T6G 2G3, Canada
- Department of Medicine & Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Marie Eve Goyer
- Family Medicine and Emergency Department, University of Montréal, Montréal, QC H3T 1J4, Canada
| | - Aaron M. Orkin
- Inner City Health Associates, Toronto, ON M5C 1K6, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Department of Emergency Medicine, St. Joseph’s Health Centre, Toronto, ON M6R 1B5, Canada
- Department of Emergency Medicine, Humber River Hospital, Toronto, ON M3M 0B2, Canada
| | - Jamie Patel
- Faculty of Community Services, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Tim Richter
- Canadian Alliance to End Homelessness, Calgary, AB T3H 0N8, Canada
| | - Angela Robertson
- Parkdale Queen West Community Health Centre, Toronto, ON M6K 1L2, Canada
| | - Christy Sutherland
- PHS Community Services Society, Vancouver, BC V6A 1M9, Canada
- Department of Family Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Tomislav Svoboda
- Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Jeffrey Turnbull
- University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Ottawa Inner City Health, Ottawa, ON K1N 5N7, Canada
| | - Alexander Wong
- Department of Medicine, University of Saskatchewan, Regina, SK S4T 0H8, Canada
| | - Alice Zhu
- University of Toronto, Toronto, ON M5S 1A8, Canada
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Fajardo-Bullón F, Pérez-Mayo J, Esnaola I, Anderson I, Knutagård M. Influence of Psychosocial Variables on the Health of People Living in Housing Exclusion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8983. [PMID: 33276637 PMCID: PMC7730692 DOI: 10.3390/ijerph17238983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion.
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Affiliation(s)
- Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, Avenida de Elvas s/n, 06006 Badajoz, Spain
| | - Jesús Pérez-Mayo
- Department of Economics, University of Extremadura, 06006 Badajoz, Spain;
| | - Igor Esnaola
- Department of Development and Educational Psychology, Faculty of Education, University of the Basque Country, UPV/EHU, Avenida de Tolosa, 70, San Sebastián, 20018 Leioa, Spain
| | - Isobel Anderson
- Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK;
| | - Marcus Knutagård
- School of Social Work, Lund University, Box 23, 221 00 Lund, Sweden;
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White H, Albers B, Gaarder M, Kornør H, Littell J, Marshall Z, Mathew C, Pigott T, Snilstveit B, Waddington H, Welch V. Guidance for producing a Campbell evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1125. [PMID: 37016607 PMCID: PMC8356343 DOI: 10.1002/cl2.1125] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Evidence and Gap Maps (EGMs) are a systematic evidence synthesis product which display the available evidence relevant to a specific research question. EGMs are produced following the same principles as a systematic reviews, that is: specify a PICOS, a comprehensive search, screening against explicit inclusion and exclusion criteria, and systematic coding, analysis and reporting. This paper provides guidance on producing EGMs for publication in Campbell Systematic Reviews.
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Affiliation(s)
| | | | - Marie Gaarder
- International Initiative for Impact EvaluationNew DelhiIndia
| | - Hege Kornør
- Norwegian Institute of Public HealthOsloNorway
| | | | | | | | | | - Birte Snilstveit
- International Initiative for Impact EvaluationLondonUnited Kingdom
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Miller S, Keenan C, Hanratty J, Hamilton J, Coughlan C, Mackie P, Fitzpatrick S, Maddock A. PROTOCOL: Improving access to health and social services for individuals experiencing, or at risk of experiencing, homelessness. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1118. [PMID: 37016614 PMCID: PMC8356276 DOI: 10.1002/cl2.1118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
- Sarah Miller
- Centre for Evidence and Social Innovation, Campbell UK & IrelandQueen's University BelfastBelfastUK
| | - Ciara Keenan
- School of Geography and PlanningCardiff UniversityCardiffUK
| | - Jennifer Hanratty
- Institute for Social Policy, Housing, Environment and Real Estate (I‐SPHERE)Heriot‐Watt UniversityEdinburghUK
| | - Jayne Hamilton
- Centre for Evidence and Social Innovation, Campbell UK & IrelandQueen's University BelfastBelfastUK
| | - Christopher Coughlan
- Centre for Evidence and Social Innovation, Campbell UK & IrelandQueen's University BelfastBelfastUK
| | - Peter Mackie
- School of Geography and PlanningCardiff UniversityCardiffUK
| | - Suzanne Fitzpatrick
- Institute for Social Policy, Housing, Environment and Real Estate (I‐SPHERE)Heriot‐Watt UniversityEdinburghUK
| | - Alan Maddock
- School of Social Sciences, Education and Social WorkQueen's University BelfastBelfastUK
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Ben Charif A, Zomahoun HTV, Massougbodji J, Khadhraoui L, Pilon MD, Boulanger E, Gogovor A, Campbell MJ, Poitras MÈ, Légaré F. Assessing the scalability of innovations in primary care: a cross-sectional study. CMAJ Open 2020; 8:E613-E618. [PMID: 33011682 PMCID: PMC7567510 DOI: 10.9778/cmajo.20200030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Canadian health funding currently prioritizes scaling up for evidence-based primary care innovations, but not all teams prepare for scaling up. We explored scalability assessment among primary care innovators in the province of Quebec to evaluate their preparedness for scaling up. METHODS We performed a cross-sectional survey from Feb. 18 to Mar. 18, 2019. Eligible participants were 33 innovation teams selected for the 2019 Quebec College of Family Physicians' Symposium on Innovations. We conducted a Web-based survey in 2 sections: innovation characteristics and the Innovation Scalability Self-administered Questionnaire. The latter includes 16 criteria (scalability components) grouped into 5 dimensions: theory (1 criterion), impact (6 criteria), coverage (4 criteria), setting (3 criteria) and cost (2 criteria). We classified innovation types using the International Classification of Health Interventions. We performed a descriptive analysis using frequency counts and percentages. RESULTS Out of 33 teams, 24 participated (72.7%), with 1 innovation each. The types of innovation were management (15/24), prevention (8/24) and therapeutic (1/24). Most management innovations focused on patient navigation (9/15). In order of frequency, teams had assessed theory (79.2%) and impact (79.2%) criteria, followed by cost (77.1%), setting (59.7%) and coverage (54.2%). Most innovations (16/24) had assessed 10 criteria or more, including 10 management innovations, 5 prevention innovations and 1 therapeutic innovation. Implementation fidelity was the least assessed criterion (6/24). INTERPRETATION The scalability assessments of a primary care innovation varied according to its type. Management innovations, which were the most prevalent and assessed the most scalability components, appear to be most prepared for primary care scale-up in Canada.
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Affiliation(s)
- Ali Ben Charif
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Hervé Tchala Vignon Zomahoun
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - José Massougbodji
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Lobna Khadhraoui
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Maxine Dumas Pilon
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Elise Boulanger
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Amédé Gogovor
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Marie-Josée Campbell
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - Marie-Ève Poitras
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que
| | - France Légaré
- VITAM - Centre de recherche en santé durable (Ben Charif, Zomahoun, Massougbodji, Khadhraoui, Gogovor, Légaré), Québec, Que.; Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation (Ben Charif, Gogovor, Légaré), Université Laval; Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit (Zomahoun, Massougbodji, Khadhraoui, Gogovor), Université Laval; Collège québécois des médecins de famille (Dumas Pilon, Boulanger, Campbell), Laval, Que.; Department of Family Medicine and Emergency Medicine (Poitras), Université de Sherbrooke, Sherbrooke, Que.; Department of Family Medicine and Emergency Medicine (Ben Charif, Légaré), Université Laval, Québec, Que.; Department of Family Medicine (Dumas Pilon) and School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences (Zomahoun), McGill University, Montréal, Que.
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Keenan C, Miller S, Hanratty J, Pigott TD, Mackie P, Cowman J, Coughlan C, Hamilton J, Fitzpatrick S. PROTOCOL: Accommodation-based interventions for individuals experiencing, or at risk of experiencing, homelessness. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1103. [PMID: 37133280 PMCID: PMC8356315 DOI: 10.1002/cl2.1103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Ciara Keenan
- Campbell UK and Ireland, Centre for Evidence and Social InnovationQueen's University BelfastBelfastUK
| | - Sarah Miller
- Campbell UK and Ireland, Centre for Evidence and Social InnovationQueen's University BelfastBelfastUK
| | - Jennifer Hanratty
- Campbell UK and Ireland, Centre for Evidence and Social InnovationQueen's University BelfastBelfastUK
| | - Therese D. Pigott
- College of Education and Human DevelopmentGeorgia State UniversityUSA
| | - Peter Mackie
- School of Geography and PlanningCardiff UniversityUK
| | - John Cowman
- Department of Social WorkHealth Service ExecutiveDublinIreland
| | - Christopher Coughlan
- Campbell UK and Ireland, Centre for Evidence and Social InnovationQueen's University BelfastBelfastUK
| | - Jayne Hamilton
- Campbell UK and Ireland, Centre for Evidence and Social InnovationQueen's University BelfastBelfastUK
| | - Suzanne Fitzpatrick
- Institute for Social Policy, Housing, Environment and Real Estate (I‐SPHERE)Heriott Watt UniversityUK
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Hanratty J, Miller S, Keenan C, Cowman J, Hamilton J, Mackie P. PROTOCOL: Discharge programmes for individuals experiencing, or at risk of experiencing, homelessness: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1109. [PMID: 37131911 PMCID: PMC8356318 DOI: 10.1002/cl2.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Jennifer Hanratty
- Campbell UK and Ireland, Centre for Evidence and Social Innovation, Queen's University BelfastBelfastUK
| | - Sarah Miller
- Campbell UK and Ireland, Centre for Evidence and Social Innovation, Queen's University BelfastBelfastUK
| | - Ciara Keenan
- Campbell UK and Ireland, Centre for Evidence and Social Innovation, Queen's University BelfastBelfastUK
| | - John Cowman
- Department of Social WorkTallaght Adult Mental Health ServicesDublinIreland
| | - Jayne Hamilton
- Campbell UK and Ireland, Centre for Evidence and Social Innovation, Queen's University BelfastBelfastUK
| | - Peter Mackie
- School of Geography and PlanningCardiff UniversityCardiffUK
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Bromberg DJ, Mayer KH, Altice FL. Identifying and managing infectious disease syndemics in patients with HIV. Curr Opin HIV AIDS 2020; 15:232-242. [PMID: 32487816 PMCID: PMC7376494 DOI: 10.1097/coh.0000000000000631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW We will present recent articles focusing on HIV synergistic interactions with other sexually transmitted infections, tuberculosis, and hepatitis, as well as recent advances in the study of social and behavioral determinants that facilitate this clustering of infectious disease. For each synergistic interaction, we highlight evidence-based interventions that clinicians and policymakers should consider to tackle HIV and infectious disease syndemics. RECENT FINDINGS Significant advances in understanding the behavioral and structural determinants of HIV and other infectious disease synergisms have been made in the past years. Intervention strategies based on these new models have also been developed. It is now well understood that treating infectious disease syndemics will require a multidisciplinary and multipronged approach. SUMMARY HIV is synergistic with multiple other infectious diseases because the risk behaviors that lead to HIV acquisition may be similar to the other infections. The influence of HIV on the other infection may be due to immunosuppression associated with disease progression resulting in increased susceptibility (e.g., HIV and tuberculosis), especially when patients are not virologically suppressed using antiretroviral therapy. In reverse, another infectious disease may, when not treated, influence HIV disease progression. Social/structural determinants like homelessness, mass incarceration, and structural discrimination precipitate psychiatric comorbidity, substance use, and risky sex behavior which lead to the spread and co-occurrence of infectious disease.
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Affiliation(s)
- Daniel J Bromberg
- Department of Social and Behavioral Sciences, Yale University School of Public Health
- Yale Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Frederick L Altice
- Yale Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
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Baxter AJ, Tweed EJ, Katikireddi SV, Thomson H. Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials. J Epidemiol Community Health 2019; 73:379-387. [PMID: 30777888 PMCID: PMC6581117 DOI: 10.1136/jech-2018-210981] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/11/2018] [Accepted: 01/10/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Homelessness is associated with poor health. A policy approach aiming to end homelessness across Europe and North America, the 'Housing First' (HF) model, provides rapid housing, not conditional on abstinence from substance use. We aimed to systematically review the evidence from randomised controlled trials for the effects of HF on health and well-being. METHODS We searched seven databases for randomised controlled trials of interventions providing rapid access to non-abstinence-contingent, permanent housing. We extracted data on the following outcomes: mental health; self-reported health and quality of life; substance use; non-routine use of healthcare services; housing stability. We assessed risk of bias and calculated standardised effect sizes. RESULTS We included four studies, all with 'high' risk of bias. The impact of HF on most short-term health outcomes was imprecisely estimated, with varying effect directions. No clear difference in substance use was seen. Intervention groups experienced fewer emergency department visits (incidence rate ratio (IRR)=0.63; 95% CI 0.48 to 0.82), fewer hospitalisations (IRR=0.76; 95% CI 0.70 to 0.83) and less time spent hospitalised (standardised mean difference (SMD)=-0.14; 95% CI -0.41 to 0.14) than control groups. In all studies intervention participants spent more days housed (SMD=1.24; 95% CI 0.86 to 1.62) and were more likely to be housed at 18-24 months (risk ratio=2.46; 95% CI 1.58 to 3.84). CONCLUSION HF approaches successfully improve housing stability and may improve some aspects of health. Implementation of HF would likely reduce homelessness and non-routine health service use without an increase in problematic substance use. Impacts on long-term health outcomes require further investigation. TRIAL REGISTRATION NUMBER CRD42017064457.
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Affiliation(s)
- Andrew J Baxter
- College of Medicinal, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Emily J Tweed
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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