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dc.contributor.authorStergiopoulos, Vickyen
dc.contributor.authorHwang, Stephen W.en
dc.contributor.authorGozdzik, Agnesen
dc.contributor.authorNisenbaum, Rosaneen
dc.contributor.authorLatimer, Ericen
dc.contributor.authorRabouin, Danielen
dc.contributor.authorAdair, Carol E.en
dc.contributor.authorBourque, Jimmyen
dc.contributor.authorConnelly, Joen
dc.contributor.authorFrankish, Jamesen
dc.contributor.authorKatz, Laurence Y.en
dc.contributor.authorMason, Kateen
dc.contributor.authorMisir, Vachanen
dc.contributor.authorO'Brien, Kristenen
dc.contributor.authorSareen, Jitenderen
dc.contributor.authorSchutz, Christian G.en
dc.contributor.authorSinger, Arielleen
dc.contributor.authorStreiner, David L.en
dc.contributor.authorVasiliadis, Helen-Mariaen
dc.contributor.authorGoering, Paula N.en
dc.date.accessioned2019-07-23T15:22:13Z
dc.date.available2019-07-23T15:22:13Z
dc.date.issued2015-03
dc.identifier.urihttp://hdl.handle.net/1974/26407
dc.description.abstractIMPORTANCE: Scattered-site housing with Intensive Case Management (ICM) may be an appropriate and less-costly option for homeless adults with mental illness who do not require the treatment intensity of Assertive Community Treatment. OBJECTIVE: To examine the effect of scattered-site housing with ICM services on housing stability and generic quality of life among homeless adults with mental illness and moderate support needs for mental health services. DESIGN, SETTING, AND PARTICIPANTS: The At Home/Chez Soi project was an unblinded, randomized trial. From October 2009 to July 2011, participants (N = 1198) were recruited in 4 Canadian cities (Vancouver, Winnipeg, Toronto, and Montreal), randomized to the intervention group (n = 689) or usual care group (n = 509), and followed up for 24 months. INTERVENTIONS; The intervention consisted of scattered-site housing (using rent supplements) and off-site ICM services. The usual care group had access to existing housing and support services in their communities. MAIN OUTCOMES AND MEASURES: The primary outcome was the percentage of days stably housed during the 24-month period following randomization. The secondary outcome was generic quality of life, assessed by a EuroQoL 5 Dimensions (EQ-5D) health questionnaire. RESULTS: During the 24 months after randomization, the adjusted percentage of days stably housed was higher among the intervention group than the usual care group, although adjusted mean differences varied across study cities (Site A: 417.3 of 683.0 days [62.7%] for the intervention group vs 189.2 of 621.6 days [29.7%] for the usual care group, mean difference [MD], 33.0% [95% CI, 26.2% to 39.8%]; Site B: 491.5 of 653.4 days [73.2%] for the intervention group vs 157.0 of 606.8 [23.6%] for the usual care group, MD, 49.5% [95% CI, 41.1% to 58.0%]; Site C: 506.7 of 658.1 days [74.4%] for the intervention group vs 255.2 of 626.2 days (38.8%) for the usual care group, MD, 35.6% [95% CI, 29.4% to 41.8%]; Site D: 520.4 of 651.5 days [77.2%] for the intervention group vs 223.1 of 649.1 for the usual care group [31.8%], MD, 45.3% [95% CI, 38.2% to 52.2%]; P<.001 for interaction). The mean change of the EQ-5D score from baseline to 24 months among the intervention group was not statistically different from the usual care group (60.5 [95% CI, 58.6 to 62.5] at baseline and 67.2 [95% CI, 65.2 to 69.1] at 24 months for the intervention group vs 62.1 [95% CI, 59.9 to 64.4] at baseline and 68.6 [95% CI, 66.3 to 71.0] at 24 months for the usual care group, difference in mean changes, 0.10 [95% CI, -2.92 to 3.13], P=.95). CONCLUSIONS AND RELEVANCE: Among homeless adults with mental illness in 4 Canadian cities, scattered site housing with ICM services compared with usual access to existing housing and community services resulted in increased housing stability over 24 months, but did not improve generic quality of life. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN42520374en
dc.language.isoenen
dc.subjectCanadiansen
dc.subjectVeteransen
dc.subjectAdultsen
dc.subjectHomeless Personsen
dc.subjectMentally Illen
dc.subjectHomelessnessen
dc.subjectSurvivorsen
dc.subjectQuality of Lifeen
dc.subjectPsychiatric Disordersen
dc.subjectComorbidityen
dc.subjectDrug Abuseen
dc.subjectRandomized Clinical Trialen
dc.subjectLongitudinal Studyen
dc.subjectTreatment Effectivenessen
dc.subjectMortalityen
dc.subjectHealth Care Costsen
dc.subjectHealth Care Policyen
dc.subjectHealth Care Utilizationen
dc.subjectSocial Caseworken
dc.subjectCase Managementen
dc.subjectUrban Populationsen
dc.titleEffect of Scattered-Site Housing Using Rent Supplements and Intensive Case Management on Housing Stability Among Homeless Adults With Mental Illness A Randomized Trialen
dc.typejournal articleen
dc.identifier.doihttp://dx.doi.org/10.1001/jama.2015.1163


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