Nicole Kozloff1,2, Carol E Adair3,4, Luis I Palma Lazgare5, Daniel Poremski5, Amy H Cheung2,6, Rebeca Sandu7, Vicky Stergiopoulos5,2,8. 1. Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; n.kozloff@mail.utoronto.ca. 2. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 3. Departments of Psychiatry and. 4. Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 5. Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. 6. Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 7. Dartington Social Research Unit, Dartington, Totnes, United Kingdom; and. 8. Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Abstract
BACKGROUND AND OBJECTIVES: "Housing First" has been shown to improve housing stability in homeless individuals with mental illness, but had not been empirically tested in homeless youth. We aimed to evaluate the effect of "Housing First" on housing stability in homeless youth aged 18 to 24 years participating in At Home/Chez Soi, a 24-month randomized trial of "Housing First" in 5 Canadian cities. METHODS:Homeless individuals with mental illness were randomized to receive "Housing First" (combined with assertive community treatment or intensive case management depending on their level of need) or treatment as usual. We defined our primary outcome, housing stability, as the percent of days stably housed as a proportion of days for which residence data were available. RESULTS: Of 2148 participants who completed baseline interviews and were randomized, 7% (n = 156) were youth aged 18 to 24 years; 87 received "Housing First" and 69 received treatment as usual. In an adjusted analysis, youth in "Housing First" were stably housed a mean of 437 of 645 (65%) days for which data were available compared with youth in treatment as usual, who were stably housed a mean of 189 of 582 (31%) days for which data were available, resulting in an adjusted mean difference of 34% (95% confidence interval, 24%-45%; P < .001). CONCLUSIONS: "Housing First" was associated with improved housing stability in homeless youth with mental illness. Future research should explore whether adaptations of the model for youth yield additional improvements in housing stability and other outcomes.
RCT Entities:
BACKGROUND AND OBJECTIVES: "Housing First" has been shown to improve housing stability in homeless individuals with mental illness, but had not been empirically tested in homeless youth. We aimed to evaluate the effect of "Housing First" on housing stability in homeless youth aged 18 to 24 years participating in At Home/Chez Soi, a 24-month randomized trial of "Housing First" in 5 Canadian cities. METHODS: Homeless individuals with mental illness were randomized to receive "Housing First" (combined with assertive community treatment or intensive case management depending on their level of need) or treatment as usual. We defined our primary outcome, housing stability, as the percent of days stably housed as a proportion of days for which residence data were available. RESULTS: Of 2148 participants who completed baseline interviews and were randomized, 7% (n = 156) were youth aged 18 to 24 years; 87 received "Housing First" and 69 received treatment as usual. In an adjusted analysis, youth in "Housing First" were stably housed a mean of 437 of 645 (65%) days for which data were available compared with youth in treatment as usual, who were stably housed a mean of 189 of 582 (31%) days for which data were available, resulting in an adjusted mean difference of 34% (95% confidence interval, 24%-45%; P < .001). CONCLUSIONS: "Housing First" was associated with improved housing stability in homeless youth with mental illness. Future research should explore whether adaptations of the model for youth yield additional improvements in housing stability and other outcomes.
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-03-09 Impact factor: 8.262
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-10-13 Impact factor: 8.262
Authors: Jean Zhuo Wang; Sebastian Mott; Olivia Magwood; Christine Mathew; Andrew Mclellan; Victoire Kpade; Priya Gaba; Nicole Kozloff; Kevin Pottie; Anne Andermann Journal: BMC Public Health Date: 2019-11-14 Impact factor: 3.295