Accommodation‐based interventions for individuals experiencing, or at risk of experiencing, homelessness

Background Globally, almost 1.6 billion individuals lack adequate housing. Many accommodation‐based approaches have evolved across the globe to incorporate additional support and services beyond delivery of housing. Objectives This review examines the effectiveness of accommodation‐based approaches on outcomes including housing stability, health, employment, crime, wellbeing, and cost for individuals experiencing or at risk of experiencing homelessness. Search Methods The systematic review is based on evidence already identified in two existing EGMs commissioned by the Centre for Homelessness Impact (CHI) and built by White et al. The maps were constructed using a comprehensive three stage search and mapping process. Stage one mapped included studies in an existing systematic review on homelessness, stage two was an extensive search of 17 academic databases, three EGM databases, and eight systematic review databases. Finally stage three included web searches for grey literature, scanning reference lists of included studies and consultation with experts to identify additional literature. We identified 223 unique studies across 551 articles from the effectiveness map on 12th April 2019. Selection Criteria We include research on all individuals currently experiencing, or at risk of experiencing homelessness irrespective of age or gender, in high‐income countries. The Network Meta‐Analysis (NMA) contains all study designs where a comparison group was used. This includes randomised controlled trials (RCTs), quasi‐experimental designs, matched comparisons and other study designs that attempt to isolate the impact of the intervention on homelessness. The NMA primarily addresses how interventions can reduce homelessness and increase housing stability for those individuals experiencing, or at risk of experiencing, homelessness. Additional outcomes are examined and narratively described. These include: access to mainstream healthcare; crime and justice; employment and income; capabilities and wellbeing; and cost of intervention. These outcomes reflect the domains used in the EGM, with the addition of cost. Data Collection and Analysis Due to the diverse nature of the literature on accommodation‐based approaches, the way in which the approaches are implemented in practice, and the disordered descriptions of the categories, the review team created a novel typology to allow meaningful categorisations for functional and useful comparison between the various intervention