Housing Quality in a Randomized Controlled Trial of Housing First for Homeless Individuals with Mental Illness: Correlates and Associations with Outcomes.

Housing quality (HQ) is associated with mental health, and may mediate outcomes in housing interventions. However, studies of housing interventions rarely report HQ. The purpose of this study was to describe HQ in a multi-site randomized controlled trial of Housing First (HF) in five Canadian cities...

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Published in:Journal of Urban Health Vol. 93; no. 4; pp. 682 - 698
Main Authors: Adair, Carol, Kopp, Brianna, Distasio, Jino, Hwang, Stephen, Lavoie, Jennifer, Veldhuizen, Scott, Voronka, Jijian, Kaufman, Andrew, Somers, Julian, LeBlanc, Stefanie, Cote, Sonia, Addorisio, Sindi, Matte, Dominique, Goering, Paula, Adair, Carol E, Hwang, Stephen W, Kaufman, Andrew F, Somers, Julian M, LeBlanc, Stefanie R
Format: journal article
Published: Springer Nature Aug2016
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        atl: Housing Quality in a Randomized Controlled Trial of Housing First for Homeless Individuals with Mental Illness: Correlates and Associations with Outcomes.
      aug:
        au:
          Adair, Carol
          Kopp, Brianna
          Distasio, Jino
          Hwang, Stephen
          Lavoie, Jennifer
          Veldhuizen, Scott
          Voronka, Jijian
          Kaufman, Andrew
          Somers, Julian
          LeBlanc, Stefanie
          Cote, Sonia
          Addorisio, Sindi
          Matte, Dominique
          Goering, Paula
          Adair, Carol E
          Hwang, Stephen W
          Kaufman, Andrew F
          Somers, Julian M
          LeBlanc, Stefanie R
        affil:
          Mental Health Commission of Canada , Ottawa Canada
          Institute of Urban Studies , University of Winnipeg , Winnipeg Canada
          Centre for Research on Inner City Health , St. Michael's Hospital , Toronto Canada
          Department of Criminology , Wilfrid Laurier University , Brantford Canada
          Centre for Addiction and Mental Health , Toronto Canada
          Department of Humanities, Social Science and Social Justice , University of Toronto , Toronto Canada
          Faculty of Health Sciences , Simon Fraser University , Burnaby Canada
          Centre de recherche et de développement en éducation , Université de Moncton , Moncton Canada
          At Home/Chez Soi Montreal Site , Montreal Canada
          At Home/Chez Soi Vancouver Site , Vancouver Canada
          At Home/Chez Soi Montreal Site , Douglas University Institute for Mental Health , Montreal Canada
          Mental Health Commission of Canada, Ottawa, Ontario, Canada
          Department of Psychiatry, the University of Calgary, Calgary, Alberta, Canada
          Department of Community Health Sciences, the University of Calgary, Calgary, Alberta, Canada
          Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada
          Institute of Urban Studies, University of Winnipeg, Winnipeg, Manitoba, Canada
          Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
          Centre de recherche et de développement en éducation, Université de Moncton, Moncton, New Brunswick, Canada
      su:
        Canada
        Housing satisfaction
        Quality of life
        Housing & health
        Public housing
        Homelessness
        Mental illness
        Housing
        Homeless persons
        Psychometrics
        Randomized controlled trials
        Psychology
        Comparative studies
        Research methodology
        Medical cooperation
        Regression analysis
        Research
        Evaluation research
        Standards
      sug:
        subj:
          Housing satisfaction
          Quality of life
          Housing & health
          Public housing
          Homelessness
          Mental illness
          Housing
          Homeless persons
          Psychometrics
          Randomized controlled trials
          Psychology
          Canada
          Other Community Housing Services
          Lessors of social housing projects
          Comparative studies
          Research methodology
          Medical cooperation
          Regression analysis
          Research
          Evaluation research
          Standards
      keyword:
        Housing quality
        Housing-related health research
        Public/private housing
        Standardized measures
        Housing quality
        Housing-related health research
        Public/private housing
        Standardized measures
      ab: Housing quality (HQ) is associated with mental health, and may mediate outcomes in housing interventions. However, studies of housing interventions rarely report HQ. The purpose of this study was to describe HQ in a multi-site randomized controlled trial of Housing First (HF) in five Canadian cities and to examine possible differences by treatment group (HF recipients and treatment-as-usual (TAU) participants who were able to find housing through other programs or on their own). We also examined the association between HQ and the primary trial outcome: housing stability. The performance of a new multi-dimensional standardized observer-rated housing quality scale (the OHQS) in a relatively large cross-site sample was also of interest. HQ was rated by trained research assistants for 204 HF participants and 228 TAU participants using the OHQS. General linear regression models were used to examine unit/building quality scores by group and site adjusting for other group differences, and as a predictor of housing stability outcomes after 24 months of follow-up. The OHQS was found to have good reliability and validity, but because most of the neighborhood subscale items were negatively correlated with the overall scale, only unit and building items were included in the total HQ score (possible scores ranging from 13.5 to 135). Unit/building HQ was significantly better for the HF group overall (91.2 (95 % CI = 89.6-92.9) vs. 88.3 (95 % CI = 86.1-90.5); p = .036), and in one site. HQ in the TAU group was much more variable than the HF group overall (W (mean) = 24.7; p < .001) and in four of five sites. Unit/building HQ scores were positively associated with housing stability: (73.4 (95 % CI 68.3-78.5) for those housed none of the time; 91.1 (95 % CI 89.2-93.0) for those housed some of the time; and 93.1 (95 % CI 91.4-94.9)) for those housed all of the time (F = 43.9 p < .001). This association held after adjusting for site, housing characteristics, participant ethnocultural status, community functioning, and social support. This study demonstrates that HQ can be as good or better, and less variable, in HF programs in Canada that systematically and predominantly source housing stock from the private sector compared to housing procured outside of an HF program. HQ is also an important predictor of housing stability outcomes.
      pubtype: Academic Journal
      doctype: journal article
      src: R
    language: English
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