Relevant bibliographies by topics / Homelessness in literature

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Homelessness in literature'

Author: Grafiati
Published: 4 June 2021
Last updated: 29 July 2024

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Journal articles on the topic "Homelessness in literature"

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Fraser, Brodie, Nevil Pierse, Elinor Chisholm, and Hera Cook. "LGBTIQ+ Homelessness: A Review of the Literature." International Journal of Environmental Research and Public Health 16, no. 15 (July 26, 2019): 2677. http://dx.doi.org/10.3390/ijerph16152677.

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Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ+) people’s experiences of homelessness is an under-explored area of housing and homelessness studies, despite this group making up 20–40% of homeless populations. Despite this, much of the existing literature focuses on specific elements of LGBTIQ+ homelessness, and often does not consider the intersections of these elements, instead placing them into individual siloes. Our approach is an intersectional one; this paper identifies the key themes in the existing research, and analyses how these themes interact to reinforce the discrimination and stigma faced by LGBTIQ+ people who experience homelessness. This intersectional-systems thinking approach to LGBTIQ+ homelessness can be used to develop well-informed, culturally sensitive support programmes.
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Woodbridge (book author), Linda, and Pamela Allen Brown (review author). "Vagrancy, Homelessness, and English Renaissance Literature." Renaissance and Reformation 37, no. 3 (January 1, 2001): 54–56. http://dx.doi.org/10.33137/rr.v37i3.8713.

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Buckman, Ty, and Linda Woodbridge. "Vagrancy, Homelessness, and English Renaissance Literature." Sixteenth Century Journal 33, no. 4 (2002): 1219. http://dx.doi.org/10.2307/4144217.

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Schmitz, Christoph. "Homelessness Revisited." Novel 53, no. 3 (November 1, 2020): 490–94. http://dx.doi.org/10.1215/00295132-8624733.

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Sygulska, Katarzyna. "Selected areas of the homelessness problem in Poland. Literature review." Praca Socjalna 38, no. 3 (September 30, 2023): 127–48. http://dx.doi.org/10.5604/01.3001.0053.9260.

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The article is the literature review on selected aspects of homelessness and describes areas such as: definitions and causes of homelessness, helping homeless people, experiences of people helping them and postulated recommendations regarding help. The article also presents the issue of family, mental and material situation as well as places where homeless people stay.
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Bramley, Stephanie, Caroline Norrie, and Jill Manthorpe. "Gambling-related harms and homelessness: findings from a scoping review." Housing, Care and Support 21, no. 1 (March 19, 2018): 26–39. http://dx.doi.org/10.1108/hcs-02-2018-0003.

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Purpose People experiencing homelessness are being identified as a potentially vulnerable group in relation to gambling-related harm. The purpose of this paper is to explore the links between gambling-related harm and homelessness. Design/methodology/approach A scoping review of the English-language literature was conducted in 2016-2017 using a wide range of international sources. Qualitative content analysis was employed to code and identify key themes within the literature. Findings Five themes were identified: emerging knowledge about why people experiencing homelessness may participate in gambling; emerging knowledge about the prevalence of gambling within the homeless population; the likelihood that gambling-related harm is under-reported within the homeless population; emerging knowledge about the extent that people experiencing homelessness access gambling support services; and limited awareness about the potential impact of gambling participation among people experiencing homelessness. Originality/value The paper reviews research concerning the links between gambling, gambling-related harm and homelessness, which may be relevant to those working with people experiencing homelessness.
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Meanwell, Emily. "Experiencing Homelessness: A Review of Recent Literature." Sociology Compass 6, no. 1 (January 2012): 72–85. http://dx.doi.org/10.1111/j.1751-9020.2011.00432.x.

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Burnett, Mark Thornton. "Vagrancy, Homelessness, and English Renaissance Literature (review)." Shakespeare Quarterly 54, no. 3 (2003): 321–23. http://dx.doi.org/10.1353/shq.2004.0006.

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Andermann, Anne, Sebastian Mott, Christine M. Mathew, Claire Kendall, Oreen Mendonca, Dawnmarie Harriott, Andrew McLellan, et al. "Evidence-informed interventions and best practices for supporting women experiencing or at risk of homelessness: a scoping review with gender and equity analysis." Health Promotion and Chronic Disease Prevention in Canada 1, no. 1 (January 2021): 1–13. http://dx.doi.org/10.24095/hpcdp.41.1.01.

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Introduction While much of the literature on homelessness is centred on the experience of men, women make up over one-quarter of Canada’s homeless population. Research has shown that women experiencing homelessness are often hidden (i.e. provisionally housed) and have different pathways into homelessness and different needs as compared to men. The objective of this research is to identify evidence-based interventions and best practices to better support women experiencing or at risk of homelessness. Methods We conducted a scoping review with a gender and equity analysis. This involved searching MEDLINE, CINAHL, PsycINFO and other databases for systematic reviews and randomized trials, supplementing our search through reference scanning and grey literature, followed by a qualitative synthesis of the evidence that examined gender and equity considerations. Results Of the 4102 articles identified on homelessness interventions, only 4 systematic reviews and 9 randomized trials were exclusively conducted on women or published disaggregated data enabling a gender analysis. Interventions with the strongest evidence included post-shelter advocacy counselling for women experiencing homelessness due to intimate partner violence, as well as case management and permanent housing subsidies (e.g. tenant-based rental assistance vouchers), which were shown to reduce homelessness, food insecurity, exposure to violence and psychosocial distress, as well as promote school stability and child well-being. Conclusion Much of the evidence on interventions to better support women experiencing homelessness focusses on those accessing domestic violence or family shelters. Since many more women are experiencing or at risk of hidden homelessness, population-based strategies are also needed to reduce gender inequity and exposure to violence, which are among the main structural drivers of homelessness among women.
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Andermann, Anne, Sebastian Mott, Christine M. Mathew, Claire Kendall, Oreen Mendonca, Dawnmarie Harriott, Andrew McLellan, et al. "Evidence-informed interventions and best practices for supporting women experiencing or at risk of homelessness: a scoping review with gender and equity analysis." Health Promotion and Chronic Disease Prevention in Canada 1, no. 1 (January 2021): 1–13. http://dx.doi.org/10.24095/hpcdp.41.1.01.

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Introduction While much of the literature on homelessness is centred on the experience of men, women make up over one-quarter of Canada’s homeless population. Research has shown that women experiencing homelessness are often hidden (i.e. provisionally housed) and have different pathways into homelessness and different needs as compared to men. The objective of this research is to identify evidence-based interventions and best practices to better support women experiencing or at risk of homelessness. Methods We conducted a scoping review with a gender and equity analysis. This involved searching MEDLINE, CINAHL, PsycINFO and other databases for systematic reviews and randomized trials, supplementing our search through reference scanning and grey literature, followed by a qualitative synthesis of the evidence that examined gender and equity considerations. Results Of the 4102 articles identified on homelessness interventions, only 4 systematic reviews and 9 randomized trials were exclusively conducted on women or published disaggregated data enabling a gender analysis. Interventions with the strongest evidence included post-shelter advocacy counselling for women experiencing homelessness due to intimate partner violence, as well as case management and permanent housing subsidies (e.g. tenant-based rental assistance vouchers), which were shown to reduce homelessness, food insecurity, exposure to violence and psychosocial distress, as well as promote school stability and child well-being. Conclusion Much of the evidence on interventions to better support women experiencing homelessness focusses on those accessing domestic violence or family shelters. Since many more women are experiencing or at risk of hidden homelessness, population-based strategies are also needed to reduce gender inequity and exposure to violence, which are among the main structural drivers of homelessness among women.
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Dissertations / Theses on the topic "Homelessness in literature"

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Hurwitz, Melissa. "Dispossessed Women| Female Homelessness in Romantic Literature." Thesis, Fordham University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10281988.

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“Dispossessed Women” examines the status of homeless women in late eighteenth and early nineteenth century literature, with special attention to both the cultural assumptions and aesthetic power that accrued to these figures. Across the Romantic era, vagrant women were ubiquitous not only in poetry, children’s fiction, novels, and non-fiction, but also on the streets of towns and cities as their population outnumbered that of vagrant males. Homeless women became the focus of debates over how to overhaul the nation’s Poor Laws, how to police the unhoused, and what the rising middle class owed the destitute in a rapidly industrializing Britain. Writers in the Romantic period began to treat these characters with increasing realism, rather than sentimentalism or satire. This dissertation tracks this understudied story through the writing of Mary Robinson, Maria Edgeworth, Hannah More, Robert Southey, and William and Dorothy Wordsworth.

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Collins, Martha Anne. "Homelessness in Abraham Cahan's Fiction." W&M ScholarWorks, 1993. https://scholarworks.wm.edu/etd/1539625820.

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Cader, Roshan. "V.S. Naipaul : homelessness and exiled identity." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/1446.

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Hammond, Julia Leanne. "Homelessness and the postmodern home: narratives of cultural change /." view abstract or download file of text, 2006. http://proquest.umi.com/pqdweb?did=1192191901&sid=1&Fmt=2&clientId=11238&RQT=309&VName=PQD.

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Thesis (Ph. D.)--University of Oregon, 2006.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 224-233). Also available for download via the World Wide Web; free to University of Oregon users.
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Shaw, Sarah Kerr. "Living in the Liminal: A Study of Homelessness in Cleveland, Ohio." Kent State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=kent1310494859.

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Embleton, Lonnie, Hana Lee, Jayleen Gunn, David Ayuku, and Paula Braitstein. "Causes of Child and Youth Homelessness in Developed and Developing Countries." AMER MEDICAL ASSOC, 2016. http://hdl.handle.net/10150/614740.

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Hill, Francis H. ""The Whole Foundations of the Solid Globe were Suddenly Rent Asunder": Space Place and Homelessness in Poe's "The Narrative of Arthur Gordon Pym" and Melville's "Benito Cereno"." FIU Digital Commons, 2015. http://digitalcommons.fiu.edu/etd/2280.

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My project examines the phenomenon of the hazy spaces on the periphery of the antebellum imagination that, while existing geographically at the very fringes of daily American life, are nonetheless active in the conceptualization, production, and representation of an idiosyncratic American sense of space: an anxiety of spatial fragmentation, formlessness, and modulation. In particular I am interested in Poe's “The Narrative of Arthur Gordon Pym” and Melville's “Benito Cereno,” both of which deal with American transoceanic travel to the proximity of Antarctica and its surrounding seas. These gothicized nautical fictions demonstrate an important dialectic playing out in these extreme spaces: the oscillating experience of external and closed space. What becomes detectable in antebellum literature in which spaces of enclosure interrupt expansiveness are far-reaching, deeply-rooted anxieties of an ever-transforming American space at risk of fragmenting and necessitating reorientation via the sort of imaginary travel texts being examined.
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Jansen, Zero. "What We Know: Queer Displacement and Reimagining Notions of Home." Ohio University Honors Tutorial College / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ouhonors1556115428029259.

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Hooker, Ashleigh. "Shelter." Thesis, View thesis, 2002. http://handle.uws.edu.au:8081/1959.7/610.

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On a rainy summer afternoon a woman turns up on Bernadette's doorstep. Her long, floral dress and brown leather boots tell a story of illfittedness, of shifting in and out of places. Her baby-fine ginger hair spills around her shoulders, too slippery for knots. Her eyes are restless. Flighty like a sparrow. My name is Georgia, she says. I saw you in town and I knew it was you. Bernadette's solititude is punctured for good. Bernadette's sister Andrea sometimes wonders whether they've come from the same stable. Bernadette never had disconnection notices stuffed in her drawer, never spent a night passed out in someone's backyard, got sunburnt, lost track of time, ate so much that she felt like throwing up. There were cracks, no corners where damp was creeping up. But it also made her easy to be with. There were no surprises. And visiting her felt like coming home. Andrea has been singing at the top of her lungs for years and now her voice is hoarse. So she drops in on Bernadette and it's there that she meets Georgia. Shelter is a story about people taking cover from pain and the lengths that they go to, to protect themselves
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Sigvardson, Malin E. "The Constitution of Movement in Rudy Wiebe's Fiction : A Phenomenological Study of Three Mennonite Novels." Doctoral thesis, Stockholm : Department of English, Stockholm University, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-1299.

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Books on the topic "Homelessness in literature"

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Criswell, Sara Dixon. Homelessness. San Diego, CA: Lucent Books, 1998.

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Stearman, Kaye. Homelessness. Austin, Tex: Raintree Steck-Vaughn, 1999.

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McCauslin, Mark. Homelessness. New York: Crestwood House, 1994.

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G, Kutais B., and Shohov Tatiana 1970-, eds. Homelessness: A guide to the literature. 2nd ed. Commack, N.Y: Nova Science Publishers, 1999.

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Ann, Beavis Mary, Canada Mortgage and Housing Corporation., and University of Winnipeg. Institute of Urban Studies., eds. Literature review: Aboriginal peoples and homelessness. [Canada]: CMHC/SCHL, 1997.

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G, Kutais B., ed. Homelessness: A guide to the literature. Commack, N.Y: Nova Science Publishers, 1994.

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Ann, Beavis Mary, and Canada Mortgage and Housing Corporation., eds. Literature review, aboriginal peoples and homelessness. [Ottawa]: CMHC, 1997.

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Spilsbury, Richard. Talk about homelessness. London: Wayland, 2013.

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Firth, Lisa. Homelessness in society. Cambridge: Independence, 2010.

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Fagan, Margaret. The fight against homelessness. London: Gloucester Press, 1990.

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Book chapters on the topic "Homelessness in literature"

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Weller, Shane. "Homelessness: Martin Heidegger." In Literature, Philosophy, Nihilism, 35–62. London: Palgrave Macmillan UK, 2008. http://dx.doi.org/10.1057/9780230583528_3.

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Compton, Nancy C. "Literature Review." In African American Children who have Experienced Homelessness, 7–66. New York: Routledge, 2021. http://dx.doi.org/10.4324/9781003248910-2.

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Sullivan, Linda. "Review of Literature." In The Impact of Homelessness on Children, 13–25. New York: Routledge, 2023. http://dx.doi.org/10.4324/9781003250197-2.

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Korkmaz-Yaylagul, Nilufer, and Ahmet Melik Bas. "Homelessness Trends in Ageing Literature in the Context of Domains of Social Exclusion." In International Perspectives on Aging, 339–50. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-51406-8_26.

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AbstractHomelessness in later life is closely related to social exclusion and can cause further disadvantages in later life. This chapter explores the relationship between studies on older adult homelessness and the domains of social exclusion. A structure review process, in the form of a summative content analysis and a social network analysis, of all geriatrics and gerontology journals published in English was conducted. This review led to the identification of 59 articles on homelessness in older age as the research sample for this chapter. The patterns that emerged from summative content analysis and the social network analysis are visualised using GEPHI software. Our findings reveal the multidimensional aspects of old-age exclusion in the homelessness literature, and how homelessness can be a significant determinant of interrelated sets of disadvantages. Exclusion from services, amenities, and mobility and community and neighbourhood, and material and financial resources are the domains represented most in homelessness studies in the ageing literature. However, civic participation and socio-cultural aspects of social exclusion were partly ignored within this body of work.
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Neill, Anna. "Conclusion: Global Commerce and Homelessness." In British Discovery Literature and the Rise of Global Commerce, 180–84. London: Palgrave Macmillan UK, 2002. http://dx.doi.org/10.1057/9780230629226_7.

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Ortiz, Ricardo L. "Un-Homey States: Econo-Mimetics of Homelessness in US Latinx Poetry." In Latinx Literature Now, 59–72. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-04708-5_6.

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Lerpold, Lin, Örjan Sjöberg, and Wing-Shing Tang. "Urban Advantage? Sustainability Trade-Offs Across and Within the Intra-Urban Space." In Sustainable Consumption and Production, Volume I, 283–313. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-56371-4_15.

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Abstract“Sustainable cities” as a singular concept may very well be a utopian vision impossible to realise in a broader sense. In this chapter, we review the literature on urban sustainability highlighting the complexities and trade-offs between and within the 3 Es—ecology, economy and equality. In particular, we focus here on the intra-urban dimensions of density, mobility, the built environment and housing, lifestyle trends and gentrification along with social sustainability issues of crime, homelessness and community. While gains from increased size and density can be had, there are also many outcomes that depend on urban morphology and the consequences of spatial sorting. Positive outcomes generated by density and efficiency may be offset by, for instance, less sustainable construction materials or increased income inequality. In particular, rebound effects are often overlooked. Hence, it often becomes an empirical issue whether the potential for sustainability gains materialise. Furthermore, as assessed from a more holistic 3 Es’ view, where social sustainability is as important as environmental sustainability, the potential of a “sustainable city” may be a victim of trade-offs that are difficult to resolve.
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Snel, Guido. "The Return of Pannonia as Imaginary Topos and Space of Homelessness." In Comparative History of Literatures in European Languages, 333–43. Amsterdam: John Benjamins Publishing Company, 2006. http://dx.doi.org/10.1075/chlel.xx.33sne.

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"Lermontov’s Cosmic Homelessness." In The House in Russian Literature, 139–46. Brill | Rodopi, 2009. http://dx.doi.org/10.1163/9789042029156_015.

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Allen, John. "Introduction." In Homelessness in American Literature, 3–21. Routledge, 2018. http://dx.doi.org/10.4324/9781315788364-1.

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Conference papers on the topic "Homelessness in literature"

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Brestovicova, Alexandra, and Zuzana Stanislavova. "HOMELESSNESS AS A TOPIC IN SLOVAK CHILDREN�S LITERATURE." In 7th SWS International Scientific Conference on ART and HUMANITIES - ISCAH 2020 Proceedings. STEF92 Technology, 2020. http://dx.doi.org/10.5593/sws.iscah.2020.7.1/s25.16.

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Bower, Corey. "Homelessness, Mobility, and Academic Performance: A Systematic Review of the Empirical Literature." In 2019 AERA Annual Meeting. Washington DC: AERA, 2019. http://dx.doi.org/10.3102/1446880.

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Kive, Solmaz. "Designing Out: A Framework for Studying Hostile Design." In 112th ACSA Annual Meeting. ACSA Press, 2024. http://dx.doi.org/10.35483/acsa.am.112.88.

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The rising issue of homelessness has led to the deployment of hostile design aimed at discouraging unhoused individuals from using urban and public spaces. A wholistic approach to the problem must address architecture as a cause (not as merely an innocent reflection of an entirely independent problem). This paper provides a literature review of definitions and methods of analyzing hostile design. The growing literature on hostile design mainly focuses on the design strategies and their impact on the unhoused individuals, ignoring the majority, housed population under whose name hostile design is justified. I argue for expanding the study of hostile design to account for the subtle mechanisms of disgusting the true purpose of hostile design.
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Bollo, Christina, and Amanda Donofrio. "A Typology of Very Small Dwellings: Lessons from 15 Years of Permanent Supportive Housing." In 108th Annual Meeting Proceedings. ACSA Press, 2020. http://dx.doi.org/10.35483/acsa.am.108.128.

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Recent building and zoning code changes in the United States and Canada have significantly reduced the minimum size of a dwelling: from 290 to 220 square feet in San Francisco and from 400 to 300 square feet in New York City. Market-rate developers can plan for these new opportunities by turning to examples of well-designed small dwellings from non-profit developers, who have been building such apartments in permanent supportive housing projects for people transitioning from chronic homelessness. This paper presents a typological study of very small studio apartments from North American permanent supportive housing (PSH), formulating a set of spatial descriptors within a typological framework. This paper is grounded in the scholarship on permanent supportive housing and the particular needs of the residents, as well as the emerging literature on very small dwellings. The classifications understood by this study include: width and depth and width/depth ratio; entry sequence; kitchen type and kitchen location; storage size and allocation; bathroom fixture types and layout. Space syntax diagrams reveal that the overall layout is determined primarily by the entry sequence, has two primary diagrams, dependent on whether the resident walks directly into the kitchen or into a distinct entry hall. The placement of each additional component hinges on this first decision. PSH units are a resource for all human-centered designers, whether developing market rate or subsidized housing units. The patterns noted in this study establish design guidelines which will allow teams to learn from existing unit designs. This research has increased benefits for the designers and developers of housing for formerly homeless individuals, as many new communities throughout the country are recognizing the benefit of PSH when addressing the pervasive spread of homelessness.
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Reports on the topic "Homelessness in literature"

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Middaugh, Katie. Homelessness and Health Care: A Literature Review. Ames (Iowa): Iowa State University, December 2023. http://dx.doi.org/10.31274/cc-20240624-837.

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Toumbourou, John, and Jess Heerde. Evidence on programs to address youth homelessness. The Sax Institute, October 2021. http://dx.doi.org/10.57022/uvlm4065.

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This Evidence Check review looked at the grey and peer reviewed literature related to the effectiveness of programs to support children and young people (10-17 years) at risk of homelessness. It aimed to identify key features of effective programs, core/common elements of the included programs and in establishment and rollout, and challenges and facilitators. Twenty programs were included, with 4 rated as “evidence based” and 7 as “promising”, 9 were considered to have insufficient evidence. Programs were also categorised into the following themes – in descending order of evidence: family therapy, intensive case management, service capacity building and early intervention.
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Birchall, Jenny. Intersectionality and Responses to Covid-19. Institute of Development Studies (IDS), March 2021. http://dx.doi.org/10.19088/cc.2021.003.

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There is a small but growing body of literature that discusses the benefits, challenges and opportunities of intersectional responses to the socioeconomic impacts of the Covid-19 pandemic. There is a strong body of evidence pointing to the disproportionate impact of Covid-19 borne by women, who have suffered record job losses, been expected to take on even greater unpaid care burdens and home schooling responsibilities, and faced a “shadow pandemic” of violence against women and girls. However, gender inequalities cannot be discussed in isolation from other inequalities. Emerging literature stresses the importance of a Covid-19 recovery plan that addresses how gender intersects with class, race, disability, age, sexual orientation, geography, immigration status and religion or belief, and other factors such as employment, housing (and homelessness) and environmental and political stressors.
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Levesque, Justine, Nathaniel Loranger, Carter Sehn, Shantel Johnson, and Jordan Babando. COVID-19 prevalence and infection control measures at homeless shelters and hostels in high-income countries: protocol for a scoping review. York University Libraries, 2021. http://dx.doi.org/10.25071/10315/38513.

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The COVID-19 pandemic has disproportionately impacted people experiencing homelessness. Homeless shelters and hostels, as congregate living spaces for residents with many health vulnerabilities, are highly susceptible to outbreaks of COVID-19. A synthesis of the research-to-date can inform evidence-based practices for infection, prevention, and control strategies at these sites to reduce the prevalence of COVID-19 among both shelter/hostel residents and staff. Methods: A scoping review in accordance with Arksey and O’Malley’s framework will be conducted to identify literature reporting COVID-19 positivity rates among homeless shelter and hostel residents and staff, as well as infection control strategies to prevent outbreaks in these facilities. The focus will be on literature produced in high-income countries. Nine academic literature databases and 11 grey literature databases will be searched for literature from March 2020 to July 2021. Literature screening will be completed by two reviewers and facilitated by Covidence, a systematic review management platform. A third reviewer will be engaged to resolve disagreements and facilitate consensus. A narrative summary of the major themes identified in the literature, numerical counts of relevant data including the COVID-19 positivity rates, and recommendations for different infection control approaches will be produced. Discussion: The synthesis of the research generated on COVID-19 prevalence and prevention in homeless shelters and hostels will assist in establishing best practices to prevent the spread of COVID-19 and other airborne diseases at these facilities in high-income countries while identifying next steps to expand the existing evidence base.
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Levesque, Justine, Jordan Babando, Nathaniel Loranger, and Shantel Johnson. COVID-19 prevalence and infection control measures at homeless shelters and hostels in high-income countries: a scoping review. The Homeless Hub, York University, December 2021. http://dx.doi.org/10.25071/10315/38850.

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Background: The COVID-19 pandemic has disproportionately impacted homeless populations and service workers, especially within homeless shelter/hostel settings. To date, there have been few evidence syntheses examining outbreaks of COVID-19 among both homeless shelters residents and service workers, nor has there been a critically engaged summary of relevant infection control and prevention (IPAC) measures. This scoping review offers a timely and much-needed synthesis of COVID-19 prevalence within homeless shelters and a review of current and pertinent IPAC measures. Methods: We conducted a scoping review in June 2021 that synthesized academic and grey literature published from March 2020 to July 2021 pertaining to 1) the prevalence of COVID-19 among both residents and staff in homeless shelters and hostels in high-income countries, and 2) COVID-19 IPAC strategies applied in these settings. Two reviewers independently screened the results of the literature search of several databases that included MEDLINE, PsycInfo, and the WHO’s COVID-19 Global Health Portal. All the extracted data was mapped, categorized, and thematically discussed. Results: Thematic analysis of included literature revealed five key themes: 1) the demographics of COVID-19 in homeless shelters, 2) asymptomatic spread, 3) pre-existing vulnerability of the homeless and shelters, 4) the limited application of IPAC, and 5) IPAC effectiveness. Conclusion: This review offers a useful glimpse into the landscape of COVID-19 outbreaks in homeless shelters/hostels and the major contributing factors to these events. The scoping review revealed that there is no clear indication of generally accepted IPAC standards for homeless populations and shelter care workers. This review also illustrated a great need for future research to establish IPAC best practices as well as additional resources for shelter systems to protect residents and staff at homeless shelters/hostels in high-income countries. Finally, the findings from this review reaffirm that homelessness prevention is a key to limiting disease outbreaks, and the associated negative health outcomes in shelter populations.
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6

Berkman, Nancy D., Eva Chang, Julie Seibert, Rania Ali, Deborah Porterfield, Linda Jiang, Roberta Wines, Caroline Rains, and Meera Viswanathan. Management of High-Need, High-Cost Patients: A “Best Fit” Framework Synthesis, Realist Review, and Systematic Review. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer246.

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Background. In the United States, patients referred to as high-need, high-cost (HNHC) constitute a very small percentage of the patient population but account for a disproportionally high level of healthcare use and cost. Payers, health systems, and providers would like to improve the quality of care and health outcomes for HNHC patients and reduce their costly use of potentially preventable or modifiable healthcare services, including emergency department (ED) and hospital visits. Methods. We assessed evidence of criteria that identify HNHC patients (best fit framework synthesis); developed program theories on the relationship among contexts, mechanisms, and outcomes of interventions intended to change HNHC patient behaviors (realist review); and assessed the effectiveness of interventions (systematic review). We searched databases, gray literature, and other sources for evidence available from January 1, 2000, to March 4, 2021. We included quantitative and qualitative studies of HNHC patients (high healthcare use or cost) age 18 and over who received intervention services in a variety of settings. Results. We included 110 studies (117 articles). Consistent with our best fit framework, characteristics associated with HNHC include patient chronic clinical conditions, behavioral health factors including depression and substance use disorder, and social risk factors including homelessness and poverty. We also identified prior healthcare use and race as important predictors. We found limited evidence of approaches for distinguishing potentially preventable or modifiable high use from all high use. To understand how and why interventions work, we developed three program theories in our realist review that explain (1) targeting HNHC patients, (2) engaging HNHC patients, and (3) engaging care providers in these interventions. Theories identify the need for individualizing and tailoring services for HNHC patients and the importance of building trusting relationships. For our systematic review, we categorized evidence based on primary setting. We found that ED-, primary care–, and home-based care models result in reduced use of healthcare services (moderate to low strength of evidence [SOE]); ED, ambulatory intensive caring unit, and primary care-based models result in reduced costs (low SOE); and system-level transformation and telephonic/mail models do not result in changes in use or costs (low SOE). Conclusions. Patient characteristics can be used to identify patients who are potentially HNHC. Evidence focusing specifically on potentially preventable or modifiable high use was limited. Based on our program theories, we conclude that individualized and tailored patient engagement and resources to support care providers are critical to the success of interventions. Although we found evidence of intervention effectiveness in relation to cost and use, the studies identified in this review reported little information for determining why individual programs work, for whom, and when.
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7

McKenna, Patrick, and Mark Evans. Emergency Relief and complex service delivery: Towards better outcomes. Queensland University of Technology, June 2021. http://dx.doi.org/10.5204/rep.eprints.211133.

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Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.
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