MedPath

Silicon Valley Guaranteed Income Project

Not Applicable
Recruiting
Conditions
Families Experiencing Homelessness and/or Housing Instability
Interventions
Other: Public Benefits Information Session
Other: Guaranteed Income
Registration Number
NCT05698498
Lead Sponsor
University of California, San Francisco
Brief Summary

The goal of this clinical trial is to learn about how unconditional cash payments equivalent to $1,000 for 24 months (also called 'guaranteed income') might help families experiencing homelessness and/or unstable housing in Santa Clara County, California.

The main questions it aims to answer are:

1. What is the impact of guaranteed income on homelessness and housing stability among families experiencing homelessness or housing instability?

2. What is the impact of guaranteed income on the health and well-being of families experiencing homelessness or housing instability?

3. In terms of size and frequency of cash payments, do families prefer monthly recurrent payments ($1,000/month) vs a larger up front amount followed by smaller monthly payments ($6,500/month, then $500/month)? Is one payment strategy more helpful than the other in terms of achieving improved housing stability, health, or other measures of well-being?

Detailed Description

Study design and overall objective: This is a mixed-methods randomized controlled trial (RCT) to assess the effectiveness of guaranteed income on improving housing stability, health, economic and overall well-being among 300 families experiencing homelessness in Santa Clara County.

The specific aims are:

Aim 1. Assess the effect of guaranteed income on housing stability and homelessness. The investigators will randomly select 150 households experiencing homelessness to receive guaranteed income equivalent to $1000 per month for 24 months in addition to usual care, with the remaining 150 households receiving usual care only (control group). The investigators will assess and compare measures of housing stability, housing services use and emergency shelter use at baseline, 6, 12, 18, 24, 27, 30, and 36 months after randomization. Hypothesis: Guaranteed income will improve housing stability and reduce the risk of continuing homelessness.

Aim 2. Assess the effect of guaranteed income on the health and well-being of families experiencing homelessness and their social networks. The investigators will assess and compare self-reported physical and mental health and well-being, health and social service use, employment and income volatility, financial assets and spending, food insecurity, agency, and network strain and support at baseline and then at 6, 12, 18, 24, 27, 30, and 36 months after randomization. The investigators will use a mixed methods approach, employing both validated survey instruments and qualitative interviews to assess measures of interest. Hypothesis: Families receiving guaranteed income will have improved health and well-being, and multiplier effects will accrue to their social networks.

Aim 3. Assess the effect of monthly vs a hybrid payment strategy (larger up-front lump sum plus a smaller monthly sum) on housing stability, health, and well-being. Individuals in the guaranteed income group (intervention group) will self-select whether they prefer to receive payments in a a) monthly ($1,000/month x 12 months) vs b) hybrid payment schedule ($6,500 x 1 month, then $500 x 11 month), with the option to change payment schedules after the first 12 months. Hypothesis: Individuals receiving a hybrid model of payments will obtain and sustain positive changes in stable housing and well-being more successfully over time compared to monthly payments.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
300
Inclusion Criteria
  1. ≥18 years of age at baseline visit/assessment

  2. Experiencing homelessness, as defined by:

    1. The HEARTH Act; or
    2. Living in a public or private space intended for temporary (≤6 month) residence, such as residing in a hotel/motel;
    3. Residing in a space without a legal right to the space and therefore being at threat of being asked to leave at any time (i.e., no lease); and/or
    4. Being in a shared living situation intended to be temporary (i.e., being 'doubled up' due to lack of available and/or affordable housing).
  3. Vulnerability-Index Service Prioritization Decision Assistance Tool (VI-SPDAT) score within the eligibility range for referral to rapid rehousing assistance programs in Santa Clara County (score of 4-8 for households), if available at the time of study entry.

    • The VI-SPDAT score is commonly used by housing assistance service providers to prioritize households for housing assistance programs, where households with scores of 0-3 are lower priority for referral to programs, and households with scores of 9+ are recommended for referral to more intensive housing services such as permanent supportive housing (which combine affordable housing assistance with voluntary support services including health and mental health care, case management and other social supportive services). Households with a score of 4-8 are considered most appropriate for referral to housing assistance programs that may not offer additional supportive services.
  4. Living in a household with ≥1 dependent children (i.e., ≤17 years of age at the time of study entry)

  5. Written informed consent (and assent when applicable) obtained from participant or participant's legal representative and ability for participant to comply with the requirements of the study.

Exclusion Criteria
  1. Substantial to severe level of problematic substance use as defined by the validated Drug Abuse Screening Test (DAST-10) (score of 6-8 or 9-10, respectively).
  2. Hazardous or harmful alcohol consumption, or active and severe alcohol use disorder as defined by the validated Alcohol Use Disorders Identification Test (AUDIT) (score of 8-14 and ≥15, respectively).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual CarePublic Benefits Information SessionParticipants in the active comparator control group will receive usual care, which includes usual public benefit, assistance and social service programs that are available at the local, county, state, and federal levels to all residents of Santa Clara County. They will also be offered the option to attend a Public Benefits Information Session.
Guaranteed IncomeGuaranteed IncomeParticipants in the intervention group will receive guaranteed income gift payments equivalent to $1,000/month for a total of 24 months in addition to usual care. They will also have the option to attend the same Public Benefits Information Session being offered to the control group as above.
Guaranteed IncomePublic Benefits Information SessionParticipants in the intervention group will receive guaranteed income gift payments equivalent to $1,000/month for a total of 24 months in addition to usual care. They will also have the option to attend the same Public Benefits Information Session being offered to the control group as above.
Primary Outcome Measures
NameTimeMethod
Number of days experiencing homelessnessAt 24 months after randomization

'Experiencing homelessness' will be defined as: 1) per the Homeless Emergency Assistance and Rapid Transition to Housing Act (HEARTH) Defining Homeless Final Rule published in the Federal Register in 2011; and/or 2) living in a public or private space intended for temporary (≤6 month) residence, such as residing in a hotel/motel; 3) residing in a space without a legal right to the space and therefore being at threat of being asked to leave at any time (i.e., no lease); and/or 4) being in a shared living situation intended to be temporary (i.e., being 'doubled up' due to lack of available and/or affordable housing).

Secondary Outcome Measures
NameTimeMethod
Time to stable housing from randomizationUp to 24 months after randomization

'Stable housing' will be defined as any form of housing that does not meet the definition of 'experiencing homelessness' as above

Proportion of families who obtain stable housingAt 24 months after randomization

'Stable housing' will be defined as any form of housing that does not meet the definition of 'experiencing homelessness' as above

Number of days experiencing homelessnessAt 36 months after randomization

'Stable housing' will be defined as any form of housing that does not meet the definition of 'experiencing homelessness' as above

Proportion of families who retain stable housing after the end of the 24-month intervention periodAt 36 months after randomization

'Stable housing' will be defined as any form of housing that does not meet the definition of 'experiencing homelessness' as above

Days experiencing unsheltered homelessness in previous 6 monthsAt 36 months after randomization

Number of days spent living in a homeless shelter, in a place not typically used for sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train station, or temporarily in an institution

Time series analysis of days experiencing unsheltered homelessness in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Number of days spent living in a homeless shelter, in a place not typically used for sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train station, or temporarily in an institution

Days residing in a hotel or motel in previous 6 months36 months after randomization

Number of days spent residing in a hotel or motel as a form of temporary housing

Time series analysis of days residing in a hotel or motel in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Number of days spent residing in a hotel or motel as a form of temporary housing

Proportion of families who are unleased36 months after randomization

Residing in a space without any legal right to the space (i.e., residing in a space without a lease)

Time series analysis of proportion of families who are unleasedTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months 30 months, 36 months after randomization

Will assess change in proportion of families who are unleased over time (i.e, residing in a space without a lease)

Change in proportion of families who are unleased at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Residing in a space without any legal right to the space (i.e., residing in a space without a lease)

Change in proportion of families who are unleased at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Residing in a space without any legal right to the space (i.e., residing in a space without a lease)

Change in proportion of families who are unleased at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Residing in a space without any legal right to the space (i.e., residing in a space without a lease)

Days doubled up in previous 6 months36 months after randomization

Number of days spent in a shared living situation intended to be temporary ('doubled up' with a friend or relative due to being unable to find or afford own housing)

Time series analysis of days doubled up in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Number of days spent in a shared living situation intended to be temporary ('doubled up' with a friend or relative due to being unable to find or afford own housing)

Total proportion of families experiencing any homelessness24 months after randomization

Proportion of of families experiencing homelessness for ≥1 night during study period

Proportion of families experiencing any homelessness in previous 6 months36 months after randomization

Proportion of of families experiencing homelessness for ≥1 night during study period

Time series analysis of proportion of families experiencing any homelessness in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Proportion of of families experiencing homelessness for ≥1 night during study period

Total proportion of families ever experiencing unsheltered homelessnessAt 24 months after randomization

Proportion of families living in a homeless shelter, in a place not typically used for sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train station, or temporarily, in an institution for ≥1 night during study period

Proportion of families experiencing unsheltered homelessness in previous 6 months36 months after randomization

Proportion of families living in a homeless shelter, in a place not typically used for sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train station, or temporarily, in an institution for ≥1 night during study period

Time series analysis of proportion of families experiencing unsheltered homelessness in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Proportion of families living in a homeless shelter, in a place not typically used for sleeping, such as on the street, in a car, in an abandoned building, or in a bus or train station, or temporarily, in an institution for ≥1 night during study period

Proportion of families doubled up in previous 6 months36 months after randomization

Proportion of families in a shared living situation intended to be temporary ('doubled up' with a friend or relative due to being unable to find or afford own housing) ≥1 night during study period

Time series analysis of proportion of families doubled up in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Proportion of families in a shared living situation intended to be temporary ('doubled up' with a friend or relative due to being unable to find or afford own housing) ≥1 night during study period

Total proportion of families returning to a homeless shelter36 months after randomization

Proportion of families with any return to a homeless shelter at any time between 24 months and 36 months after randomization. Assessed only in the subgroup of families who reported living in a shelter at baseline.Assessed only in the subgroup of families who reported living in a shelter at baseline.

Total proportion of families living in a homeless shelter36 months after randomization

Proportion of families who report any stay in a homeless shelter at the end of the 36-month data collection period

Change in total proportion of families living in a homeless shelter from baseline to 24 monthsWill include measurements at baseline and 24 months

Proportion of families who report any stay in a homeless shelter at baseline vs 24 months

Total proportion of families ever residing in a hotel or motelAt 24 months after randomization; and changes between baseline and 6 months, 12 months, 18 months, 24 months after randomization; and changes between 24 and 36 months after randomization

Proportion of families living in a hotel or motel as a form of temporary housing for ≥1 night during study period

Proportion of families residing in a hotel or motel in previous 6 months36 months after randomization

Proportion of families living in a hotel or motel as a form of temporary housing for ≥1 night during study period

Time series analysis of proportion of families residing in a hotel or motel in previous 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Proportion of families living in a hotel or motel as a form of temporary housing for ≥1 night during study period

Change in total proportion of families living in a homeless shelter from baseline to 36 monthsWill include measurements at baseline and 36 months

Proportion of families who report any stay in a homeless shelter at baseline vs 36 months

Change in total proportion of families living in a homeless shelter from 24 to 36 monthsWill include measurements at 24 and 36 months

Proportion of families who report any stay in a homeless shelter at 24 vs 36 months

Proportion of monthly income spent on housing-related expenses (composite of expenses for rent, mortgage, other shelter, and/or hotel/motel)36 months after randomization

Housing affordability

Time series analysis of proportion of monthly income spent on housing-related expenses (composite of expenses for rent, mortgage, other shelter, and/or hotel/motel)Times series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Housing affordability

Change in proportion of monthly income spent on housing-related expenses at baseline vs 24 months (composite of expenses for rent, mortgage, other shelter, and/or hotel/motel)Will include measurements at baseline and 24 months after randomization

Housing affordability

Change in proportion of monthly income spent on housing-related expenses at baseline vs 36 months (composite of expenses for rent, mortgage, other shelter, and/or hotel/motel)Will include measurements at baseline and 36 months after randomization

Housing affordability

Change in proportion of monthly income spent on housing-related expenses at 24 vs 36 months (composite of expenses for rent, mortgage, other shelter, and/or hotel/motel)Will include measurements at 24 and 36 months after randomization

Housing affordability

Number of moves in prior 6 months36 months after randomization

Housing stability

Time series analysis of number of moves in prior 6 monthsTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Housing stability

Number of moves out of Santa Clara County in prior 6 months36 months after randomization

Housing stability

Time series analysis of number of moves out of Santa Clara County in prior 6 monthsTimes series will include measurements at 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Housing stability

Monthly household expendituresBaseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Proportion/amount of monthly expenses on key household expenditure categories, assessed through selected questions adapted from the US Bureau of Labor Statistics Consumer Expenditures Survey

Physical well-being36 months after randomization

Measured through the Short-Form 12 v2 (SF12v2). The SF12v2 data calculate two summary component scores, Physical Component Summary Score (PCS) and Mental Health Component Summary Score (MCS) with eight sub-domains. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Time series analysis of physical well-beingTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Measured through the Short-Form 12 v2 (SF12v2). The SF12v2 data calculate two summary component scores, Physical Component Summary Score (PCS) and Mental Health Component Summary Score (MCS) with eight sub-domains. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Change in physical well-being at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Measured through the Short-Form 12 v2 (SF12v2). The SF12v2 data calculate two summary component scores, Physical Component Summary Score (PCS) and Mental Health Component Summary Score (MCS) with eight sub-domains. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Change in physical well-being at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Measured through the Short-Form 12 v2 (SF12v2). The SF12v2 data calculate two summary component scores, Physical Component Summary Score (PCS) and Mental Health Component Summary Score (MCS) with eight sub-domains. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Psychological well-being36 months after randomization

Measured through the Kessler 6 (K6) scale. Each of the six items of the K6 is scored using a 5-level response scale, ranging from 0 to 4 (0 = none of the time, 1 = a little of the time, 2 = some of the time, 3 = most of the time, 4 = all of the time). The six items are summed to yield a total score with a range between zero and 24 with higher scores indicating higher psychological distress.

Change in physical well-being at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Measured through the Short-Form 12 v2 (SF12v2). The SF12v2 data calculate two summary component scores, Physical Component Summary Score (PCS) and Mental Health Component Summary Score (MCS) with eight sub-domains. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.

Time series analysis of psychological well-beingTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Measured through the Kessler 6 (K6) scale. Each of the six items of the K6 is scored using a 5-level response scale, ranging from 0 to 4 (0 = none of the time, 1 = a little of the time, 2 = some of the time, 3 = most of the time, 4 = all of the time). The six items are summed to yield a total score with a range between zero and 24 with higher scores indicating higher psychological distress.

Change in psychological well-being at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Measured through the Kessler 6 (K6) scale. Each of the six items of the K6 is scored using a 5-level response scale, ranging from 0 to 4 (0 = none of the time, 1 = a little of the time, 2 = some of the time, 3 = most of the time, 4 = all of the time). The six items are summed to yield a total score with a range between zero and 24 with higher scores indicating higher psychological distress.

Change in psychological well-being at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Measured through the Kessler 6 (K6) scale. Each of the six items of the K6 is scored using a 5-level response scale, ranging from 0 to 4 (0 = none of the time, 1 = a little of the time, 2 = some of the time, 3 = most of the time, 4 = all of the time). The six items are summed to yield a total score with a range between zero and 24 with higher scores indicating higher psychological distress.

Change in psychological well-being at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Measured through the Kessler 6 (K6) scale. Each of the six items of the K6 is scored using a 5-level response scale, ranging from 0 to 4 (0 = none of the time, 1 = a little of the time, 2 = some of the time, 3 = most of the time, 4 = all of the time). The six items are summed to yield a total score with a range between zero and 24 with higher scores indicating higher psychological distress.

Overcrowding36 months after randomization

People per room excluding bathrooms and kitchens. A higher number of people per room is associated with increased overcrowding.

Time series analysis of overcrowdingTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

People per room excluding bathrooms and kitchens. A higher number of people per room is associated with increased overcrowding.

Change in overcrowding at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

People per room excluding bathrooms and kitchens. A higher number of people per room is associated with increased overcrowding.

Change in overcrowding at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

People per room excluding bathrooms and kitchens. A higher number of people per room is associated with increased overcrowding.

Change in overcrowding at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

People per room excluding bathrooms and kitchens. A higher number of people per room is associated with increased overcrowding.

Housing quality36 months after randomization

Measured through proportion of households describing overall housing condition as 'excellent' or 'good'. Measured only in the subset of households who respond that they are currently living in a house, apartment/condo, garage, or basement.

Time series analysis of housing qualityTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Measured through proportion of households describing overall housing condition as 'excellent' or 'good'. Measured only in the subset of households who respond that they are currently living in a house, apartment/condo, garage, or basement.

Change in housing quality from baseline to 24 monthsWill include measurements from baseline and 24 months

Measured through proportion of households describing overall housing condition as 'excellent' or 'good'. Measured only in the subset of households who respond that they are currently living in a house, apartment/condo, garage, or basement.

Change in housing quality from baseline to 36 monthsWill include measurements from baseline and 36 months

Measured through proportion of households describing overall housing condition as 'excellent' or 'good'. Measured only in the subset of households who respond that they are currently living in a house, apartment/condo, garage, or basement.

Change in housing quality from 24 to 36 monthsWill include measurements from 24 and 36 months

Measured through proportion of households describing overall housing condition as 'excellent' or 'good'. Measured only in the subset of households who respond that they are currently living in a house, apartment/condo, garage, or basement.

Housing quality: infrastructure and appliances36 months after randomization

Composite score assessing presence of a working stove/cooktop, refrigerator, kitchen sink, hot and cold water, bathroom sink with running water, toilet, and bathtub/shower. Range of total items present is 0-7, with higher score suggesting higher housing quality in terms of infrastructure and appliances. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Time series analysis of housing quality: infrastructure and appliancesTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Composite score assessing presence of a working stove/cooktop, refrigerator, kitchen sink, hot and cold water, bathroom sink with running water, toilet, and bathtub/shower. Range of total items present is 0-7, with higher score suggesting higher housing quality in terms of infrastructure and appliances. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Change in housing quality: infrastructure and appliances from baseline to 24 monthsWill include measurements from baseline and at 24 months

Composite score assessing presence of a working stove/cooktop, refrigerator, kitchen sink, hot and cold water, bathroom sink with running water, toilet, and bathtub/shower. Range of total items present is 0-7, with higher score suggesting higher housing quality in terms of infrastructure and appliances. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Change in housing quality: infrastructure and appliances from baseline to 36 monthsWill include measurements from baseline and at 36 months

Composite score assessing presence of a working stove/cooktop, refrigerator, kitchen sink, hot and cold water, bathroom sink with running water, toilet, and bathtub/shower. Range of total items present is 0-7, with higher score suggesting higher housing quality in terms of infrastructure and appliances. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Change in housing quality: infrastructure and appliances from 24 to 36 monthsWill include measurements from 24 months and at 36 months

Composite score assessing presence of a working stove/cooktop, refrigerator, kitchen sink, hot and cold water, bathroom sink with running water, toilet, and bathtub/shower. Range of total items present is 0-7, with higher score suggesting higher housing quality in terms of infrastructure and appliances. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Housing quality: safety issues36 months after randomization

Composite score assessing presence of exposed electrical wiring (or lack thereof), mildew/water damage, flooring problems, holes/cracks, bad odors, bathroom plumbing problems, nonfunctioning toilet, electrical outages, lack of heating, rodents, cockroaches. Range of potential safety problems present is 0-11, with higher score suggesting worse housing safety. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Time series analysis of housing quality: safety issuesTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Composite score assessing presence of exposed electrical wiring (or lack thereof), mildew/water damage, flooring problems, holes/cracks, bad odors, bathroom plumbing problems, nonfunctioning toilet, electrical outages, lack of heating, rodents, cockroaches. Range of potential safety problems present is 0-11, with higher score suggesting worse housing safety. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Change in housing quality: safety issues from baseline to 24 monthsWill include measurements at baseline and at 24 months

Composite score assessing presence of exposed electrical wiring (or lack thereof), mildew/water damage, flooring problems, holes/cracks, bad odors, bathroom plumbing problems, nonfunctioning toilet, electrical outages, lack of heating, rodents, cockroaches. Range of potential safety problems present is 0-11, with higher score suggesting worse housing safety. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Change in housing quality: safety issues from baseline to 36 monthsWill include measurements at baseline and at 36 months

Composite score assessing presence of exposed electrical wiring (or lack thereof), mildew/water damage, flooring problems, holes/cracks, bad odors, bathroom plumbing problems, nonfunctioning toilet, electrical outages, lack of heating, rodents, cockroaches. Range of potential safety problems present is 0-11, with higher score suggesting worse housing safety. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Change in housing quality: safety issues from 24 to 36 monthsWill include measurements at 24 and 36 months

Composite score assessing presence of exposed electrical wiring (or lack thereof), mildew/water damage, flooring problems, holes/cracks, bad odors, bathroom plumbing problems, nonfunctioning toilet, electrical outages, lack of heating, rodents, cockroaches. Range of potential safety problems present is 0-11, with higher score suggesting worse housing safety. Adapted from composite measures of material hardship from the Survey of Income and Program Participation.

Financial well-being36 months after randomization

Measured through the Consumer Financial Protection Bureau Financial Well-Being survey. The ten items are scored on a 5-point Likert scale with each answer scored 0-4. A raw score is calculated from the sum of the ten items (range 0-40); the raw score is converted to a financial well-being score with adjustments for age and mode of survey administration. The range of financial well-being scores in adults 18 and older is 16-91 with higher scores corresponding to higher financial well-being.

Time series analysis of financial well-beingTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Measured through the Consumer Financial Protection Bureau Financial Well-Being survey. The ten items are scored on a 5-point Likert scale with each answer scored 0-4. A raw score is calculated from the sum of the ten items (range 0-40); the raw score is converted to a financial well-being score with adjustments for age and mode of survey administration. The range of financial well-being scores in adults 18 and older is 16-91 with higher scores corresponding to higher financial well-being.

Change in financial well-being from baseline to 24 monthsWill include measurements at baseline and 24 months after randomization

Measured through the Consumer Financial Protection Bureau Financial Well-Being survey. The ten items are scored on a 5-point Likert scale with each answer scored 0-4. A raw score is calculated from the sum of the ten items (range 0-40); the raw score is converted to a financial well-being score with adjustments for age and mode of survey administration. The range of financial well-being scores in adults 18 and older is 16-91 with higher scores corresponding to higher financial well-being.

Change in financial well-being from baseline to 36 monthsWill include measurements at baseline and 36 months after randomization

Measured through the Consumer Financial Protection Bureau Financial Well-Being survey. The ten items are scored on a 5-point Likert scale with each answer scored 0-4. A raw score is calculated from the sum of the ten items (range 0-40); the raw score is converted to a financial well-being score with adjustments for age and mode of survey administration. The range of financial well-being scores in adults 18 and older is 16-91 with higher scores corresponding to higher financial well-being.

Change in financial well-being from 24 to 36 monthsWill include measurements at 24 and 36 months after randomization

Measured through the Consumer Financial Protection Bureau Financial Well-Being survey. The ten items are scored on a 5-point Likert scale with each answer scored 0-4. A raw score is calculated from the sum of the ten items (range 0-40); the raw score is converted to a financial well-being score with adjustments for age and mode of survey administration. The range of financial well-being scores in adults 18 and older is 16-91 with higher scores corresponding to higher financial well-being.

Financial well-being (emergency expenses)36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $400 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED).

Time series analysis of financial well-being (emergency expenses)Times series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $400 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED).

Change in financial well-being (emergency expenses) at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $400 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED).

Change in financial well-being (emergency expenses) at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $400 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED).

Change in financial well-being (emergency expenses) at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $400 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED).

Financial well-being (larger emergency expenses)36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $2000 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED) and Urban Institute Survey of Well-Being and Basic Needs. This question is asked only of the subset of households who respond they are 'somewhat' or 'very' confident they could handle a $400 expense in the next month.

Time series analysis of financial well-being (larger emergency expenses)Times series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $2000 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED) and Urban Institute Survey of Well-Being and Basic Needs. This question is asked only of the subset of households who respond they are 'somewhat' or 'very' confident they could handle a $400 expense in the next month.

Change in financial well-being (larger emergency expenses) at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $2000 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED) and Urban Institute Survey of Well-Being and Basic Needs. This question is asked only of the subset of households who respond they are 'somewhat' or 'very' confident they could handle a $400 expense in the next month.

Change in financial well-being (larger emergency expenses) at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $2000 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED) and Urban Institute Survey of Well-Being and Basic Needs. This question is asked only of the subset of households who respond they are 'somewhat' or 'very' confident they could handle a $400 expense in the next month.

Change in financial well-being (larger emergency expenses) at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Measured through proportion of families responding they are 'somewhat' or 'very confident' they could handle a $2000 emergency expense in the next month. Adapted from the Survey of Household Economics and Decisionmaking (or SHED) and Urban Institute Survey of Well-Being and Basic Needs. This question is asked only of the subset of households who respond they are 'somewhat' or 'very' confident they could handle a $400 expense in the next month.

Financial well-being (monthly finances)36 months after randomization

Measured through proportion of families responding they have 'just enough money to make ends meet' or 'some money left over' at the end of each month, as an indicator of stable monthly finances. Adapted from the Family Options Study.

Time series analysis of financial well-being (monthly finances)Times series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Measured through proportion of families responding they have 'just enough money to make ends meet' or 'some money left over' at the end of each month, as an indicator of stable monthly finances. Adapted from the Family Options Study.

Change in financial well-being (monthly finances) at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Measured through proportion of families responding they have 'just enough money to make ends meet' or 'some money left over' at the end of each month, as an indicator of stable monthly finances. Adapted from the Family Options Study.

Change in financial well-being (monthly finances) at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Measured through proportion of families responding they have 'just enough money to make ends meet' or 'some money left over' at the end of each month, as an indicator of stable monthly finances. Adapted from the Family Options Study.

Change in financial well-being (monthly finances) at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Measured through proportion of families responding they have 'just enough money to make ends meet' or 'some money left over' at the end of each month, as an indicator of stable monthly finances. Adapted from the Family Options Study.

Material hardship36 months after randomization

Composite score assessing the presence of: use of payday loan, overdrawn checking account, missed credit card payment, missed loan payment, contacted by a debt collection agency, late gas/electric bill payment, gas/electricity turned off due to non-payment, late phone bill payment, phone service turned off due to non-payment, difficulty paying medical bills, late rent/mortgage payment, and partial rent/mortgage payment. Range of material hardship domains is 0-11 with higher score associated with material hardship. Individual items are adapted from questions from the Survey of Income and Program Participation and the Urban Institute Well-Being and Basic Needs Survey.

Change in total debt to monthly income ratio at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Sum of total debt (composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage) divided by reported average monthly income. A higher ratio indicates a higher burden of debt relative to monthly income.

Time series analysis of material hardshipTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Change over time in composite score assessing the presence of: use of payday loan, overdrawn checking account, missed credit card payment, missed loan payment, contacted by a debt collection agency, late gas/electric bill payment, gas/electricity turned off due to non-payment, late phone bill payment, phone service turned off due to non-payment, difficulty paying medical bills, late rent/mortgage payment, and partial rent/mortgage payment. Range of material hardship domains is 0-11 with higher score associated with material hardship. Individual items are adapted from questions from the Survey of Income and Program Participation and the Urban Institute Well-Being and Basic Needs Survey.

Change in material hardship from baseline to 24 monthsWill include measurements at baseline and 24 months after randomization

Change in composite score assessing the presence of: use of payday loan, overdrawn checking account, missed credit card payment, missed loan payment, contacted by a debt collection agency, late gas/electric bill payment, gas/electricity turned off due to non-payment, late phone bill payment, phone service turned off due to non-payment, difficulty paying medical bills, late rent/mortgage payment, and partial rent/mortgage payment. Range of material hardship domains is 0-11 with higher score associated with material hardship. Individual items are adapted from questions from the Survey of Income and Program Participation and the Urban Institute Well-Being and Basic Needs Survey.

Change in material hardship from baseline to 36 monthsWill include measurements at baseline and 36 months after randomization

Change in composite score assessing the presence of: use of payday loan, overdrawn checking account, missed credit card payment, missed loan payment, contacted by a debt collection agency, late gas/electric bill payment, gas/electricity turned off due to non-payment, late phone bill payment, phone service turned off due to non-payment, difficulty paying medical bills, late rent/mortgage payment, and partial rent/mortgage payment. Range of material hardship domains is 0-11 with higher score associated with material hardship. Individual items are adapted from questions from the Survey of Income and Program Participation and the Urban Institute Well-Being and Basic Needs Survey.

Change in material hardship from 24 to 36 monthsWill include measurements at 24 and 36 months after randomization

Change in composite score assessing the presence of: use of payday loan, overdrawn checking account, missed credit card payment, missed loan payment, contacted by a debt collection agency, late gas/electric bill payment, gas/electricity turned off due to non-payment, late phone bill payment, phone service turned off due to non-payment, difficulty paying medical bills, late rent/mortgage payment, and partial rent/mortgage payment. Range of material hardship domains is 0-11 with higher score associated with material hardship. Individual items are adapted from questions from the Survey of Income and Program Participation and the Urban Institute Well-Being and Basic Needs Survey.

Total debt to monthly income ratio36 months after randomization

Sum of total debt (composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage) divided by reported average monthly income. A higher ratio indicates a higher burden of debt relative to monthly income.

Time series analysis of total debt to monthly income ratioTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Sum of total debt (composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage) divided by reported average monthly income. A higher ratio indicates a higher burden of debt relative to monthly income.

Change in total debt to monthly income ratio at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Sum of total debt (composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage) divided by reported average monthly income. A higher ratio indicates a higher burden of debt relative to monthly income.

Change in total debt to monthly income ratio at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Sum of total debt (composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage) divided by reported average monthly income. A higher ratio indicates a higher burden of debt relative to monthly income.

Total debt36 months

Total self-reported debt (dollar amount, composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage). A higher amount indicates a higher burden of debt.

Time series analysis of total debtTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Total self-reported debt (dollar amount, composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage). A higher amount indicates a higher burden of debt.

Change in total debt at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Total self-reported debt (dollar amount, composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage). A higher amount indicates a higher burden of debt.

Change in total debt at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Total self-reported debt (dollar amount, composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage). A higher amount indicates a higher burden of debt.

Change in total debt at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Total self-reported debt (dollar amount, composite of balance of loans/credit card debt, balance for overdue bills, and balance for overdue rent/mortgage). A higher amount indicates a higher burden of debt.

Household food security36 months after randomization

The United States Department of Agriculture (USDA) U.S. Household Food Security Survey Module: Six-Item Short Form. Responses to each of the six items are coded as 'affirmative' or 'negative', with each affirmative response assigned a score of 1. Scores are summed across the six items to yield a total score ranging from 0 to 6, with higher scores indicating lower household food security.

Time series analysis of household food securityTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

The United States Department of Agriculture (USDA) U.S. Household Food Security Survey Module: Six-Item Short Form. Responses to each of the six items are coded as 'affirmative' or 'negative', with each affirmative response assigned a score of 1. Scores are summed across the six items to yield a total score ranging from 0 to 6, with higher scores indicating lower household food security.

Change in household food security from baseline to 24 monthsWill include measurements at baseline and 24 months after randomization

The United States Department of Agriculture (USDA) U.S. Household Food Security Survey Module: Six-Item Short Form. Responses to each of the six items are coded as 'affirmative' or 'negative', with each affirmative response assigned a score of 1. Scores are summed across the six items to yield a total score ranging from 0 to 6, with higher scores indicating lower household food security.

Change in household food security from baseline to 36 monthsWill include measurements at baseline and 36 months after randomization

The United States Department of Agriculture (USDA) U.S. Household Food Security Survey Module: Six-Item Short Form. Responses to each of the six items are coded as 'affirmative' or 'negative', with each affirmative response assigned a score of 1. Scores are summed across the six items to yield a total score ranging from 0 to 6, with higher scores indicating lower household food security.

Change in household food security from 24 to 36 monthsWill include measurements at 24 and 36 months after randomization

The United States Department of Agriculture (USDA) U.S. Household Food Security Survey Module: Six-Item Short Form. Responses to each of the six items are coded as 'affirmative' or 'negative', with each affirmative response assigned a score of 1. Scores are summed across the six items to yield a total score ranging from 0 to 6, with higher scores indicating lower household food security.

Self-efficacy36 months after randomization

General Self-Efficacy Scale (GSE). Items are scored on a 4-point Likert scale; the total score is calculated by finding the sum of all items (range 6-24) with a higher score indicating greater self-efficacy

Time series analysis of self-efficacyTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

General Self-Efficacy Scale (GSE). Items are scored on a 4-point Likert scale; the total score is calculated by finding the sum of all items (range 6-24) with a higher score indicating greater self-efficacy

Change in self-efficacy at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

General Self-Efficacy Scale (GSE). Items are scored on a 4-point Likert scale; the total score is calculated by finding the sum of all items (range 6-24) with a higher score indicating greater self-efficacy

Change in self-efficacy at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

General Self-Efficacy Scale (GSE). Items are scored on a 4-point Likert scale; the total score is calculated by finding the sum of all items (range 6-24) with a higher score indicating greater self-efficacy

Change in self-efficacy at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

General Self-Efficacy Scale (GSE). Items are scored on a 4-point Likert scale; the total score is calculated by finding the sum of all items (range 6-24) with a higher score indicating greater self-efficacy

Resilience36 months after randomization

Brief Resilience Scale (BRS). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items divided by 6 (range 1-5). Higher scores indicate more resilience.

Time series analysis of resilienceTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Brief Resilience Scale (BRS). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items divided by 6 (range 1-5). Higher scores indicate more resilience.

Change in resilience from baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Brief Resilience Scale (BRS). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items divided by 6 (range 1-5). Higher scores indicate more resilience.

Change in resilience from baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Brief Resilience Scale (BRS). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items divided by 6 (range 1-5). Higher scores indicate more resilience.

Change in resilience from 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Brief Resilience Scale (BRS). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items divided by 6 (range 1-5). Higher scores indicate more resilience.

Perceived stress36 months after randomization

Perceived Stress Scale (PSS-4). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 0-16), with higher scores correlating to more stress

Time series analysis of perceived stressTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Perceived Stress Scale (PSS-4). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 0-16), with higher scores correlating to more stress

Change in perceived stress at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Perceived Stress Scale (PSS-4). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 0-16), with higher scores correlating to more stress

Change in perceived stress at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Perceived Stress Scale (PSS-4). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 0-16), with higher scores correlating to more stress

Change in perceived stress at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Perceived Stress Scale (PSS-4). Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 0-16), with higher scores correlating to more stress

Chaos, Hubbub and Order Scale (CHAOS)36 months after randomization

Validated measure of household environment. Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 6-30) with higher scores corresponding to higher household chaos.

Time series analysis of Chaos, Hubbub and Order Scale (CHAOS)Times series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 30 months, 36 months after randomization

Validated measure of household environment. Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 6-30) with higher scores corresponding to higher household chaos.

Change in Chaos, Hubbub and Order Scale (CHAOS) at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Validated measure of household environment. Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 6-30) with higher scores corresponding to higher household chaos.

Change in Chaos, Hubbub and Order Scale (CHAOS) at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Validated measure of household environment. Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 6-30) with higher scores corresponding to higher household chaos.

Change in Chaos, Hubbub and Order Scale (CHAOS) at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Validated measure of household environment. Items are scored on a 5-point Likert scale. The total score is calculated from the sum of all items (range 6-30) with higher scores corresponding to higher household chaos.

Agency36 months after randomization

Adult State Hope Scale (modified from the Future Scale). Items are scored from 1-8. The total hope score is calculated from the sum of all items (range 6 to 48) with higher scores representing higher hope levels. The agency sub scale score is calculated from the sum of items 2, 4, 6 (range 3 to 24) with higher scores indicating higher levels of agency thinking. The pathways sub scale score is calculated from the sum of items 1, 3, and 5 (range 3 to 24) with higher scores indicating higher levels of pathways thinking.

Time series analysis of agencyTimes series will include measurements at baseline, 6 months, 12 months, 18 months, 24 months, 27 months, 30 months, 36 months after randomization

Adult State Hope Scale (modified from the Future Scale). Items are scored from 1-8. The total hope score is calculated from the sum of all items (range 6 to 48) with higher scores representing higher hope levels. The agency sub scale score is calculated from the sum of items 2, 4, 6 (range 3 to 24) with higher scores indicating higher levels of agency thinking. The pathways sub scale score is calculated from the sum of items 1, 3, and 5 (range 3 to 24) with higher scores indicating higher levels of pathways thinking.

Change in agency at baseline vs 24 monthsWill include measurements at baseline and 24 months after randomization

Adult State Hope Scale (modified from the Future Scale). Items are scored from 1-8. The total hope score is calculated from the sum of all items (range 6 to 48) with higher scores representing higher hope levels. The agency sub scale score is calculated from the sum of items 2, 4, 6 (range 3 to 24) with higher scores indicating higher levels of agency thinking. The pathways sub scale score is calculated from the sum of items 1, 3, and 5 (range 3 to 24) with higher scores indicating higher levels of pathways thinking.

Change in agency at baseline vs 36 monthsWill include measurements at baseline and 36 months after randomization

Adult State Hope Scale (modified from the Future Scale). Items are scored from 1-8. The total hope score is calculated from the sum of all items (range 6 to 48) with higher scores representing higher hope levels. The agency sub scale score is calculated from the sum of items 2, 4, 6 (range 3 to 24) with higher scores indicating higher levels of agency thinking. The pathways sub scale score is calculated from the sum of items 1, 3, and 5 (range 3 to 24) with higher scores indicating higher levels of pathways thinking.

Change in agency at 24 vs 36 monthsWill include measurements at 24 and 36 months after randomization

Adult State Hope Scale (modified from the Future Scale). Items are scored from 1-8. The total hope score is calculated from the sum of all items (range 6 to 48) with higher scores representing higher hope levels. The agency sub scale score is calculated from the sum of items 2, 4, 6 (range 3 to 24) with higher scores indicating higher levels of agency thinking. The pathways sub scale score is calculated from the sum of items 1, 3, and 5 (range 3 to 24) with higher scores indicating higher levels of pathways thinking.

Trial Locations

Locations (2)

¡Sí Se Puede! Collective

🇺🇸

San Jose, California, United States

Santa Clara County Office of Supportive Housing

🇺🇸

San Jose, California, United States

© Copyright 2025. All Rights Reserved by MedPath