Evidence map›Paper›PMID 30777888›Full record

SynthesisJournal of epidemiology and community health2019

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.

Andrew J Baxter, Emily J Tweed, Srinivasa Vittal Katikireddi, Hilary Thomson

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of epidemiology and community health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 139 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  4. Effectiveness of Interventions for Meaningful Activity Participation in Homelessness: A Systematic Review.Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2024
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79 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Andrew J BaxterCollege of Medicinal, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.ORCID 0000-0002-7654-9687
Emily J TweedMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.ORCID 0000-0001-6659-812X
Srinivasa Vittal KatikireddiMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.ORCID 0000-0001-6593-9092
Hilary ThomsonMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.ORCID 0000-0002-6810-9948

Funding

Chief Scientist Office CAF/17/11Chief Scientist Office SCAF/15/02Chief Scientist Office SPHSU13Chief Scientist Office SPHSU15Medical Research Council MC_UU_12017/13Medical Research Council MC_UU_12017/15
6 · The paper itself

Abstract

backgroundHomelessness 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.

methodsWe 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.

resultsWe 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).

conclusionHF 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.

Indexed as

HousingMental HealthHumansIll-Housed PersonsPersonal SatisfactionQuality of LifeRandomized Controlled Trials as TopicSubstance-Related Disordershealthhomelessnesshousing firstmental illnesssubstance use

Identifiers

PMID30777888
PMCPMC6581117

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.