Housing Prescriptions as Health Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 78
- 试验地点
- 2
- 主要终点
- Change in housing stability
研究概览
简要总结
Housing Prescriptions as Health Care is a research project studying the effects of an innovative intervention that combines services across the health, housing, social and legal service sectors in order to improve housing stability and child health outcomes among participants. The housing intervention developed for this study specifically addresses issues including families who are: paying more than 50 percent of income on rent or utilities, moving frequently, experiencing homelessness, but are not eligible for shelter through the Department of Housing and Community Development's Emergency Assistance program, or were unable to pay rent on time in the past year. This research explores how coordinated and comprehensive housing services offered through intensive case management improves housing stability and health outcomes for families of young children.
详细描述
Background:
Housing insecurity is a known risk factor for negative child health and developmental outcomes. The goal of this intervention is to reduce housing insecurity among families with young children as a mechanism for improving child health and improving other predictors on the pathway toward child health, including food security and maternal mental health status.
Rationale:
Children's HealthWatch data collected from 2010-2014 at Boston Medical Center, where the sample for this project will be recruited, found 32% of families were behind on rent in the past year and 7% of families moved more than twice in the past year. Previous research by Children's HealthWatch links multiple moves with increased risks of fair or poor child health and developmental delay. Families who are behind on rent are also at risk of fair or poor health, developmental delays, and are below average in length/height, a marker for under-nutrition. Given the significant associations between housing insecurity and child health outcomes, this project is tailored to address challenges faced by families who are severely housing insecure and who are classified as high health care utilizers by industry standards (defined as ≥ 3 emergency department visits in one year).
This research study design for this pilot is a randomized control trial whereby eligible families are randomly assigned to the intervention group or the control group. Those in the intervention group will be referred to a case manager and receive at least one of the six services offered through the program. Families in the control group will receive the current standard of care, which is a packet of outreach resources with information on housing and housing supports.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Caregiver of family experiencing housing instability
- •One or more family members in the household must have had >= 3 emergency room visits in the past year or child with medical complexity enrolled in comprehensive clinical case management program
- •Caregiver of child <11 years, who receives primary care at Boston Medical Center
排除标准
- •None of the members of the household have had >=3 emergency room visits in the past year nor medically complex child enrolled in case management.
- •Family in stable housing
- •Index child not a primary care patient at Boston Medical Center
- •All children in household >11 years
结局指标
主要结局
Change in housing stability
时间窗: baseline, six months, twelve months, 18 months, 24 months
Measured using self-report data on frequency of moves, risk of eviction, and rent affordability. Data collected at baseline, six months, and twelve months to assess change in housing stability from baseline at each time point.
次要结局
- Emergency Department utilization(baseline, six months, twelve months, 18 months, 24 months)
- Adherence to well-child visits schedule(one year, two years)
- Health care hardships(baseline, six months, twelve months, 18 months, 24 months)
- Caregiver mental health(baseline, six months, twelve months, 18 months, 24 months)
- Food security(baseline, six months, twelve months, 18 months, 24 months)
- Energy security(baseline, six months, twelve months, 18 months, 24 months)
- Adherence to immunization schedule(one year, two years)