Order #: 14639

Authors:

Beyond Shelter.

Title:

Pew Partnership for Civic Change Program Evaluation: Beyond Shelter's Housing First Program for Homeless Families.

Source:

Los Angeles, CA: Beyond Shelter, 2005. (Fact Sheet: 4 Pages)

Abstract:

This fact sheet begins with a brief overview of the basic methodology of Beyond Shelter's Housing First Program for Homeless Families.  In 1999, the program was designated one of 19 innovative programs nationwide to be included in a two-year national evaluation initiative. The evaluation is described, and the study's implications for ending and preventing homelessness among families with children are assessed. Information about 97 families enrolled in the program over a two-year period generated detailed, scientifically valid evidence of the program's outcomes. The rigorously designed research protocol of the Pew study described here will enable replications by other organizations and encourage their contributions to the growing knowledge bases about housing first for homeless families. Available From: Institute for Research, Training, and Technical Assistance at Beyond Shelter, 520 South Virgil Avenue, Los Angeles, CA 90020, (213) 252-0772, www.beyondshelter.org/aaa_housing_first/ending_homelessness.shtml

Order #: 15018

Authors:

Calsyn, R. J., Yonker, R. D., Lemming, M. R., Morse, G. A., Klinkenberg, W. D.

Title:

Impact of Assertive Community Treatment and Client Characteristics on Criminal Justice Outcomes in Dual Disorder Homeless Individuals.

Source:

Criminal Behaviour and Mental Health 15(4): 236-248, 2005. (Journal Article: 13 pages)

Abstract:

This study was designed to test the effects of client characteristics on six criminal justice outcomes among homeless (at intake) people with mental illness and substance misuse disorders.  The sample was of participants in a randomized controlled trial comparing standard treatment, assertive community treatment (ACT) and integrated treatment (IT).  Data were analyzed using hierarchical logistical regression.  Half the sample was arrested and a quarter incarcerated during the two-year follow-up period.  The regression models explained between 22% and 35% of the variance of the following criminal justice measures: major offenses, minor offenses, substance-use-related offenses, incarcerations, arrests, and summons.  Prior criminal behavior was the strongest predictor of all of the dependent variables; in general, demographic and diagnostic variables were not.  Similarly, neither the type nor the amount of mental health treatment received predicted subsequent criminal behavior.  Elsewhere the authors have shown that ACT and IT had advantages for health and stability of accommodation both these analyses suggest that more specialized interventions are needed to reduce criminal behavior in dual disorder individuals (authors). 

Order #: 14517

Authors:

Cunningham, C.O., Shapiro, S., Berg, K.M., Sacajiu, G., Paccione, G., Goulet, J.L.

Title:

An Evaluation of a Medical Outreach Program Targeting Unstably Housed HIV-Infected Individuals.

Source:

Journal of Health Care for the Poor and Underserved 16(1): 127-138, 2005. (Journal Article: 12 pages)

Abstract:

This study's objective was to evaluate a medical outreach program that targets unstably housed individuals infected with human immunodeficiency virus (HIV). One hundred sixty-one cross-sectional interviews were conducted prior to and after establishing a medical outreach program in single room occupancy hotels. Participants' mean age was 42 years; 58% were men, 95% minority, and 59% active substance users. The postintervention group was more likely to have a regular health care provider, and take Pneumocystis carinii pneumonia prophylaxis and antiretroviral medication than the pre-intervention group. Quality of care was more positively perceived in the postintervention group. On multivariate analysis the postintervention group remained more likely to have a regular provider, take antiretroviral medication, and have a better perception of quality of care. A medical outreach program targeting unstably housed individuals infected with HIV was associated with increased use of regular medical care and improved perceived quality of care (authors). 

Order #: 14581

Authors:

Gill, J.M., Fagan, H.B., Townsend, B., Mainous, A.G.

Title:

Impact of Providing a Medical Home to the Uninsured: Evaluation of a Statewide Program.

Source:

Journal of Health Care for the Poor and Underserved 16(3): 515-535, 2005. (Journal Article: 21 Pages)

Abstract:

This study examined the impact of a statewide program called the Community Healthcare Access Program (CHAP), which provided a RSOC for uninsured persons in Delaware.  This cohort study used survey data to compare health care utilization from baseline to six months after enrollment in CHAP.  The 795 eligible enrollees had significant increases in Pap tests, mammograms, breast exams, cholesterol tests, sigmoid/colonoscopy and influenza immunizations but not stool blood tests or pneumococcal immunizations.  There was a significant decrease in the proportion with emergency department visits but not hospitalizations, and there was a significant improvement in satisfaction with care.  Delaware's CHAP program is associated with significant improvements across many measures of health care utilization and represents a successful and financially feasible method for states to improve health care for their uninsured populations (authors). 

Order #: 14709

Authors:

Khadduri, J.

Title:

Measuring the Performance of Programs That Serve Homeless People.

Source:

Cambridge, MA: Abt Associates, 2005. (Report: 55 pages)

Abstract:

This report examines the Department of Housing and Urban Development (HUD)’s performance measures for the Supportive Housing Program, Shelter Plus Care, Single Room Occupancy Moderate Rehabilitation for the Homeless and Emergency Shelter Grants programs, which are funded by McKinney-Vento Homeless Assistance Grants. The report discusses the weaknesses and strengths of HUD’s current measures and identifies opportunities for improving these measures (authors). Available From: Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138, (617) 492-7100, Jill_Khadduri@abtassociates.com, www.abtassociates.com/reports/Measuring_Performance_Programs_that_Serve_Homeless_9.6.pdf

Order #: 14683

Authors:

May, P., Serna, P., Hurt, L., DeBruyn, L.

Title:

Outcome Evaluation of a Public Health Approach to Suicide Prevention in an American Indian Tribal Nation.

Source:

American Journal of Public Health 95(7): 1238-1244, 2005. (Journal Article: 6 pages)

Abstract:

For this study, the authors evaluated the efficacy of fifteen years of a public health oriented suicidal-behavior prevention program among youth living on an America Indian reservation.  All suicides, suicide attempts, and suicidal gestures were monitored.  Age-specific analyses over time were used to assess outcomes. Data from this community-based approach document a remarkable downward trend - measured by both magnitude and temporal trends in the specifically targeted age cohorts - in suicidal acts.  The sequential decrease in age-specific rates of suicide attempts and gestures is indicative of the program's success (authors). 

Order #: 14774

Authors:

Morrissey, J.P., Ellis, A.R., Gatz, M., Amaro, H., Reed, B.G., Savage, A., Finkelstein, N., Mazelis, R., Brown, V., Jackson, E.W., Banks, S.

Title:

Outcomes for Women with Co-Occurring Disorders and Trauma: Program and Person-Level Effects.

Source:

Journal of Substance Abuse Treatment 28: 121-133, 2005. (Journal Article: 13 pages)

Abstract:

In this paper from the Women, Co-Occurring Disorders, and Violence Study (WCDVS), six-month outcomes are evaluated from a nine-site quasi-experimental study of women with mental health and substance use disorders who have experienced physical or sexual abuse who enrolled in either comprehensive, integrated, trauma-informed, and consumer/survivor/recovering person-involved services or usual care.  Mental health, post-traumatic stress symptoms, and substance use outcomes are assessed with multilevel regression models, controlling for program and personal characteristics.  Person-level variables predict outcomes independent of intervention condition and, to a small extent, moderate intervention and program effects.  In sites where the intervention condition provided more integrated counseling than the comparison condition, there are increased effects on mental health and substance use outcomes; these effects are partially mediated by person-level variables.  These results encourage further research to identify the longer-term effects of integrated counseling for women with co-occurring disorders and trauma histories (authors). 

Order #: 14758

Authors:

Morrissey, J.P., Jackson, E.W., Ellis, A.R., Amaro, H., Brown, V.B., Najavits, L.M.

Title:

Twelve-Month Outcomes of Trauma-Informed Interventions for Women with Co-Occurring Disorders.

Source:

Psychiatric Services 56(10): 1213-1222, 2005. (Journal Article: 10 pages)

Abstract:

This study examined how for women with co-occurring mental health and substance abuse disorders, who frequently have a history of interpersonal violence, past research has suggested that they are not served effectively by the current service system.  The goal of the Women, Co-Occurring Disorders, and Violence Study (WCDVS) was to develop and test the effectiveness of new service approaches specifically designed for these women.  A quasi-experimental treatment outcome study was conducted from 2001 to 2003 at nine sites.  Although intervention specifics such as treatment length and modality varied across sites, each site used a comprehensive, integrated, trauma-informed, and consumer-involved approach to treatment.  Substance use problem severity, mental health symptoms, and trauma symptoms were measured at baseline, and follow-up data were analyzed with prospective meta-analysis and hierarchical linear modeling.  A total of 2,026 women had data at the 12-month follow-up: 1,018 in the intervention group and 1,008 in the usual-care group.  For substance use outcomes, no effect was found.  The meta-analysis demonstrated small but statistically significant overall improvement in women's trauma and mental health symptoms in the intervention relative to the usual-care comparison condition.  Analysis of key program elements demonstrated that integrating substance abuse, mental health, and trauma-related issues into counseling yielded greater improvement, whereas the delivery of numerous core services yielded less improvement relative to the comparison group.  A few person-level characteristics were associated with increases or decreases in the intervention effect.  These neither moderated nor supplanted the effects integrated counseling.  Outcomes for women with co-occurring disorders and a history of violence and trauma may improve with integrated treatment (authors). 

Order #: 14888

Authors:

Orwin, R.G., Scott, C.K., Arieira, C.

Title:

Transitions Through Homelessness and Factors that Predict Them: Three-Year Treatment Outcomes.

Source:

Journal of Substance Abuse Treatment 28 (Suppl 1): S23-39, 2005. (Journal Article: 17 Pages)

Abstract:

This study's objectives were to examine transitions in and out of homelessness over 3 years post entry into treatment and to determine the treatment and non-treatment factors that predict achieving and sustaining residential stability.  Sixty-one percent of initially homeless participants were stably housed at 36 months.  By contrast, only 14% of initially housed participants were homeless at 36 months.  Sample-wide, homelessness was reduced by 43% over 3 years.  In conditional logistic regression models, the most consistent and persistent predictors were crack as the primary problem substance, which appears to be a risk factor for becoming and remaining homeless, and whether or not others were dependent on the participant for food/shelter, which appears to be a protective factor for achieving housing and preventing homelessness.  In general, specific treatment factors did not predict outcomes. Limitations and implications for treatment are discussed (authors). 

Order #: 14378

Authors:

Post, P.A.

Title:

Developing Outcome Measures to Evaluate Health Care for the Homeless Services.

Source:

Nashville, TN: National Health Care for the Homeless Council, 2005. (Report: 62 Pages)

Abstract:

This report examines difficulties and potential benefits that federally-funded Health Care for the Homeless (HCH) projects can expect as they engage in systematic program evaluation and use that information to improve quality of care and demonstrate the value of their work. This report summarizes recommendations by members of the HCH Outcomes Work Group, convened in 2004-2005 by the National Health Care for the Homeless Council to assess the feasibility of measuring HCH service outcomes in a more comprehensive fashion. The report also points out several factors that pose unique challenges in the field, including that standard clinical outcome measures are sometimes unrealistic for persons who are homeless. The outcomes work group took as its objectives identifying elements of HCH service models that should be assessed, specifying particular outcomes to be measured, determining levels of expertise required to develop effectiveness criteria and indicators, exploring data sources that might be used in tracking outcomes, suggesting data management processes and participants, and projecting the likely cost of meaningful outcomes measurement (author). Available From: National Health Care for the Homeless Council, P.O. Box 60427, Nashville, TN, 37206, (615) 226-2292, www.nhchc.org/Publications/DevelopingHCHOutcomeMeasures.pdf

Order #: 14773

Authors:

Reed, B.G., Mazelis, R.

Title:

Scholarship, Collaboration, Struggle, and Learning in the Women, Co-Occurring Disorders, and Violence Study: Introduction to the Six-Month Outcome Papers.

Source:

Journal of Substance Abuse Treatment 28: 87-89, 2005. (Journal Article: 3 pages)

Abstract:

The four papers in this special section of the Journal of Substance Abuse Treatment describe the design, population, and 6-month outcomes (focused on symptom reduction) from the Women, Co-Occurring Disorders, and Violence Study (WCDVS).  As described more fully in all the papers, previous research has demonstrated that interpersonal violence is pervasive in the lives of women and is related to a wide range of physical, mental health, and substance abuse struggles.  Interventions that address all of these in an integrated way, however, are infrequently available.  This study was designed to assess the feasibility and impact of addressing all of these issues.  The Guidance for Applicants stated that services were to be comprehensive, integrated at the service and system levels, gender-specific, and trauma-informed, and to involve those with lived experience in all aspects of project planning and implementation (authors). 

Order #: 14708

Authors:

Skinner, D.C.

Title:

A Modified Therapeutic Community for Homeless Persons with Co-occurring Disorders of Substance Abuse and Mental Illness in a Shelter: An Outcome Study.

Source:

Substance Use and Misuse 40(4): 483-497, 2005. (Journal Article: 14 Pages)

Abstract:

This article reports on a study conducted to determine the effectiveness of a modified therapeutic community (MTC) shelter on client outcomes. The seven-study hypotheses focused on whether greater effectiveness in the MTC would be demonstrated in longer periods of sobriety, fewer days of psychiatric hospitalization, shorter lengths of stay in a shelter, positive discharge from the shelter, medication compliance, housing placement within the first year, and appropriate housing placement according to level of functioning. The study utilized a quasi-experimental design with two groups: an experimental group (E) homeless persons with co-occurring disorders (COD) of substance abuse/dependence and mental illness who reside in a modified therapeutic community; and a comparison group (C) of veterans with CODs living in a general shelter. The data collection procedures involved a retrospective review of closed case records for subjects in the facilities from September 1, 1998 - June 1, 2000 for the MTC shelter, and from June 1, 1999 - June 1, 2000 for the general shelter. Baseline differences between the E and C groups were found in age, length of homelessness, years of education, years of work experience, veteran status, marital status, and psychiatric diagnosis; all except for veteran status were unrelated to outcomes and were controlled in subsequent analyses. Significant difference was found on medication compliance when controlled for both groups. Overall, this study showed some promise for the MTC approach. The study also raised a question as to the contribution of veteran status to the differences between groups and to treatment of CODs (author).