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Publication Date: 2019
Health utility assessments are important for economic evaluations but few instruments have been validated in homeless people with mental illness. We examined the convergent validity of the EuroQol-5 Dimension 3-level questionnaire (EQ-5D-3L) as a measure of quality of life in homeless adults with mental illness.
Publication Date: 2017
There is evidence that involuntary housing instability may undermine health and well-being. For women who have experienced intimate partner violence (IPV), achieving stability is likely as important for other groups, but can be challenging. Through our analysis of 41 interviews with women who have experienced low income and IPV, we argue that definitions of housing stability are multifaceted and for many centred on a shared understanding of the i...
Publication Date: 2017
Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population.
At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared w...
Publication Date: 2017
Objectives:
This study aimed to identify challenges and facilitators of sustaining a Housing First intervention at the conclusion of a research demonstration project in Toronto.
Methods:
This qualitative study included key informant interviews with organizational leaders (N=13) and focus groups with service team members (N=14) and program participants (N=9) of the At Home/Chez Soi Research Demonstration Project. Thematic analysis was used to iden...
Publication Date: 2017
Research suggests that individuals experiencing homelessness have high rates of overweight and obesity. Unhealthy weights and homelessness are both associated with increased risk of poor health and mortality. Using longitudinal data from 575 participants at the Toronto site of the At Home/Chez Soi randomized controlled trial, we investigate the impact of receiving a Housing First intervention on the Body Mass Index (BMI) and waist circumference o...
Publication Date: 2015
The importance of program implementation in achieving desired outcomes is well-documented, but there remains a need for concrete guidance on how to achieve fidelity to evidence-based models within dynamic local contexts. Housing First (HF), an evidence-based model for people experiencing homelessness and mental illness, provides an important test-case for such guidance; it targets a uniquely underserved subpopulation with complex needs, and is de...
Publication Date: 2015
Objectives
Although Housing First (HF) is a popular evidence-based intervention for persons experiencing homelessness and mental illness, research exploring its sustainability over time is scant. This mixed methods study captures practitioners’ perspectives on key shifts in implementation of Housing First in a large urban center, and factors affecting fidelity to the model over time.
Methods
This study uses fidelity assessments, at baseline an...
Publication Date: 2014
The housing first (HF) model for individuals experiencing homelessness and mental illness differs by design from traditional models that require consumers to achieve “housing readiness” by meeting program or treatment prerequisites in transitional housing settings prior to permanent housing placement. Given a growing body of evidence for its favorable outcomes and cost effectiveness, HF is increasingly seen as an alternative to and argument again...
Publication Date: 2014
Purpose
Participant retention is an important challenge in longitudinal research on homeless people. High attrition can threaten validity, and may represent lost opportunities to deliver interventions. In this article, we report on attrition in the At Home/Chez Soi study, a multi-site randomized controlled trial of a housing intervention for homeless people with mental illness.
Methods
We first calculate life tables, and then use clustered logis...
Publication Date: 2014
Background: Housing First has become a popular treatment model for homeless adults with mental illness, yet little is known about program participants’ early experiences or trajectories. This study used a mixed methods design to examine participant changes in selected domains 6 months after enrolment in a Canadian field trial of Housing First.
Methods: The study sample included 301 participants receiving the Housing First intervention at the Toro...
Publication Date: 2014
This study explores factors contributing to delays and relocations during the implementation of the Housing First model in Toronto, Ontario. While interruptions in housing tenure are expected en route to recovery and housing stability, consumer and service provider views on finding and keeping housing remain largely unknown. In-person interviews and focus groups were conducted with 48 study participants, including 23 case managers or housing work...
Publication Date: 2013
Objective: Although participatory methods have become increasingly popular, people with lived experience of mental illness and homelessness have been historically excluded from service planning and research. To better plan for meaningful inclusion of consumers, this study examines lessons learned from the People with Lived Experience Caucus in the Toronto Site of the At Home/Chez Soi Research Demonstration Project on Homelessness and Mental Healt...
Publication Date: 2012
There is increasing interest in the study of the social determinants of maternal and child health. While there has been growth in the theory and empirical evidence about social determinants, less attention has been paid to the kind of modeling that should be used to understand the impact of social exposures on well-being. We analyzed data from the nationwide 2006 Canadian Maternity Experiences Survey to compare the pervasive disease-specific mode...
Organization: Mental Health Commission of Canada; St. Michael's Hospital
Publication Date: 2013
This report reflects findings from the one year follow-up Implementation Evaluation conducted at the Toronto site. It includes the results of a fidelity assessment completed in April 2012 by a Quality Assurance team for the At Home project, as well as the perspectives of service providers from the Toronto Site. The purpose of this evaluation is to identify changes in program fidelity as well as to understand continued and emerging strengths, chal...
Organization: Mental Health Commission of Canada; St. Michael’s Hospital
Publication Date: 2011
This report describes findings from the Implementation Evaluation phase of the Toronto Site. It describes the context and pathways by which the MHCC intervention works (refer to Appendix A for description of local project context: site description, characteristics of homelessness situation, and description of Care as Usual). The purpose of this report is threefold: (1) to highlight key program components for the Housing First/ACT and Housing Firs...
Organization: Mental Health Commission of Canada; St. Michael’s Hospital
Publication Date: 2012
The ‘At Home/Chez Soi’ Research Demonstration Project (henceforth referred to as “the Project”) is a health intervention that explores a ‘Housing First’ approach to improving the lives of clients who experience both homelessness and serious mental health problems.1 ‘Housing First’ is a promising service model that has been increasingly implemented in North America, in which individuals experiencing homelessness and severe mental health problems a...
Publication Date: 2012
This research focused on the relationships between a national team and five project sites across Canada in planning a complex, community intervention for homeless people with mental illness called At Home/Chez Soi, which is based on the Housing First model. The research addressed two questions: (a) what are the challenges in planning? and (b) what factors that helped or hindered moving project planning forward? Using qualitative methods, 149 nati...