A Pragmatic Trial Integrating Homelessness Diversion Services Into an Emergency Department Discharge System

Study Overview
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Brief Summary
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The purpose of this study is to determine whether a homelessness diversion program integrated into a hospital emergency department (ED) will lower ED use, to identify characteristics of individuals most likely to benefit from homelessness diversion and to discover opportunities to tailor Homelessness Diversion (HD) services to better meet the needs of diverse communities.

Official Title
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A Pragmatic Randomized Trial Integrating Homelessness Diversion Services Into an Emergency Department Discharge System

Conditions
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Homelessness

Intervention / Treatment
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* Behavioral: Homeless diversion (HD)
* Behavioral: Treatment-as-usual (TAU)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: English or Spanish speaking discharged from a Harris Health Hospital ED (Ben Taub or LBJ) at imminent risk of homelessness patients with Medicaid, Medicare or who are uninsured Exclusion Criteria: having a conservator (legal guardian) plans to move away from Texas in 6 months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Homeless diversion (HD) group<br> | Behavioral: Homeless diversion (HD)<br>* Participants will receive services from specialty-trained community health workers and will be invited to complete monthly assessments via text and phone to assess their health and housing for 6 months and to share feedback on their experience with the intervention after completion by a text message to a link for the survey<br>|
| Active Comparator: Treatment-as-usual (TAU) group<br> | Behavioral: Treatment-as-usual (TAU)<br>* Participants will receive a list of community resources they can contact to receive services and will be invited to complete monthly assessments via text and phone to assess their health and housing for 6 months and to share feedback on their experience with the intervention after completion by a text message to a link for the survey<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of ED visits |  | end of study (6 months after start of study) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants who experience homelessness |  | end of study (6 months after start of study) | 
| Change in health related quality of life as assessed by the Short Form-12 version 2.0 (SF12v2) health Survey | This is a 12 item questionnaire and scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health. | baseline, month 1, month 2, month 3, month 4, month 5 and month 6 |