Effectiveness of interventions to reduce homelessness: a systematic review and meta‐analysis

This Campbell systematic review examines the effectiveness of interventions to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless. Forty‐three studies were included in the review, 37 of which are from the USA. Included interventions perform better than the usual services at reducing homelessness or improving housing stability in all comparisons. These interventions are: High intensity case management Housing First Critical time intervention Abstinence‐contingent housing Non‐abstinence‐contingent housing with high intensity case management Housing vouchers Residential treatment These interventions seem to have similar beneficial effects, so it is unclear which of these is best with respect to reducing homelessness and increasing housing stability. Executive summary Background The United Nations Universal Declaration of Human Rights (Article 25) states that everyone has a right to housing. However, this right is far from being realized for many people worldwide. According to the United Nations High Commissioner for Refugees (UNHCR), there are approximately 100 million homeless people worldwide. The aim of this report is to contribute evidence to inform future decision making and practice for preventing and reducing homelessness. Objectives To identify, appraise and summarize the evidence on the effectiveness of housing programs and case management to improve housing stability and reduce homelessness among people who are homeless or at‐risk of becoming homeless. Search methods We conducted a systematic review in accordance with the Norwegian Knowledge Centre's handbook. We systematically searched for literature in relevant databases and conducted a grey literature search which was last updated in January 2016. Selection criteria Randomized controlled trials that included individuals who were already, or at‐risk of becoming, homeless were included if they examined the effectiveness of relevant interventions on homelessness or housing stability. There were no limitations regarding language, country or length of homelessness. Two reviewers screened 2,918 s and titles for inclusion. They read potentially relevant references in full, and included relevant studies in the review. Data collection and analysis We pooled the results and conducted meta‐analyses when possible. Our certainty in the primary outcomes was assessed using the Grading of Recommendations Assessment, Development, and Evaluation