Page 4 of 14 Outcomes All the individuals in the intervention group maintained housed status at 3 and 6 months following hospital discharge. All but one participant in the control group remained homeless after 3 and 6 months (p < .001) Median number of drinks dropped from 15.7 per day prior to housing to 14.0, 12.5, and 10.6 per day at 6, 9, and 12 months in housing respectively. Poisson GEE with a linear time covariate showed a similar trend to the medians, with an approximately 2% decrease per month in daily drinking while participants were housed (RR, 0.98; 95% CI, 0.96-0.99). Fitzpatrick-Lewis et al. BMC Public Health 2011, 11:638 http://www.biomedcentral.com/1471-2458/11/638 Table 2 Summary of Evidence Table: Interventions for Homeless People Study Interventions for Homeless People with Mental Illness Forchuk et al., 2008 [82] Study design: Randomized controlled trial (RCT) Sample size: 14 Study population: Patients being discharged from psychiatric wards to shelters and ‘no fixed address’. Approach: This pilot study examined the effectiveness of an intervention in preventing homelessness upon discharge from a psychiatric admission. Interventions for Homeless People with Substance Abuse Larimer et al., 2009 [83] Study design: Quasi-experimental with four data points (baseline, 3, 6 and 12 months) Sample size: 134 Study population: Study reports drawing from a ‘chronically homeless’ list of individuals with high local crisis services utilization patterns. Chronic homelessness is not further defined. Approach: This study evaluated the association of a Housing First intervention for chronically homeless individuals with severe alcohol problems with health care use and costs. Milby et al., 2004; Milby et al., 2003; Milby et al., 2000 [14-16] Milby et al., 2005; Kertesz et al., 2007 [17,18] Study design: RCT Percentages of days abstinent over proceeding 60 days at 2 months Sample size: 110 (Milby et al., 2000); 141 (Milby et al., 2003; 2004) were for DT 41% versus DT+ 71%, and at 6 months were for DT 15% Study population: Homeless population defined as lacking a fixed versus DT+ 41%. Of the 117 participants who established complete or overnight residence, including shelters or temporary partial abstinence, lapse (i.e., drug use during 1 week or less) was lower accommodations, or were at immediate risk of being homeless. in the DT group than the DT+ group (45% vs 61%). Relapse (i.e., drug Approach: This study the effectiveness of behavioural day use in at least 2 consecutive weeks over the 24-weeek period), however, treatment plus abstinence-contingent housing and work therapy (DT was considerably higher with DT compared to DT+ treatment (81% vs +) versus behavioural day treatment (DT) alone on abstinence and 55%). The only significant difference in percentage days housed between housing outcomes. DT and DT+ was at the 6-month point. The number of mean days housed in the past 60 days increased in both groups. Study design: RCT There was evidence of an overall housing group effect and an effect of Sample size: 196 attendance on abstinence. The mean adjusted consecutive weeks of Study population: Homeless population defined as lacking a fixed abstinence for the ‘No Housing’ (NH), ‘non-abstinence-contingent overnight residence, including shelters or temporary housing’ (NACH) and abstinence-contingent housing (ACH) groups were accommodations, or were at immediate risk of being homeless. 5.28, 4.68, and 7.32, with a significant difference between the ACH group Approach: This RCT examined how substance abuse treatment and the NH group and between the ACH group and the NACH groups, outcomes were affected under 3 different housing provision but no difference between the NACH group and the NH group. There conditions (N = 195). were significant within-group housing changes from baseline to 12 months for all groups and for each group. Gulcur et al., 2003; Tsemberis et al., 2004; Tsemberis et al., 2003; Padgett et al., 2006; Greenwood et al., 2005; Stefancic et al., 2004 [20-22,52-54] Study design: RCT Housing First increased housing tenure and reduced hospitalization. This Sample size: 225 successful program offers housing first and has a focus on client choice. Study population: Met the following criteria for homelessness: Proportion of time homeless: At the end of 6 months after baseline spent 15 out of the last 30 days on the street (not including 79% of the experimental group were living in stable housing compared shelters) and experienced period of ‘housing instability’ (not defined) to 27% in the control group. Proportion of time hospitalized: The within last six months. control group spent significantly more time in hospitals than the Approach: This set of papers reported on an RCT that examined experimental group. Substance use: There were no differences in either two approaches to housing chronically homeless individuals with alcohol or drug use between the 2 groups. Substance use treatment psychiatric disabilities and substance abuse (Pathways First; utilization: The control group reported higher use of substance abuse Continuum of Care) (N = 225). treatment programs than the Housing First group. A decrease in service use occurred in the Housing First group and an increase occurred in the control group over time. Psychiatric symptoms: No significant differences in psychiatric symptoms between groups. Interventions for Homeless People with HIV Kushel et al., 2006 [101]