Bassuk Ellen L, DeCandia Carmela J, Tsertsvadze Alexander, Richard Molly K
Center for Social Innovation.
National Center on Family Homelessness American Institutes for Research.
Am J Orthopsychiatry. 2014 Sep;84(5):457-74. doi: 10.1037/ort0000020.
Family homelessness has become a growing public health problem over the last 3 decades. Despite this trend, few studies have explored the effectiveness of housing interventions and housing and service interventions. The purpose of this systematic review is to appraise and synthesize evidence on effective interventions addressing family homelessness. We searched 10 major electronic databases from 2007 to 2013. Empirical studies investigating effectiveness of housing interventions and housing and service interventions for American homeless families regardless of publication status were eligible for inclusion. Outcomes included housing status, employment, parental trauma and mental health and substance use, children's behavioral and academic status, and family reunification. Study quality was appraised using the Effective Public Health Practice Project tool. Six studies were included in this review. Overall, there was some postintervention improvement in housing and employment, but ongoing residential and work stability were not achieved. Methodological limitations, poor reporting quality, and inconsistent definitions across outcomes hindered between-study comparisons. Substantial limitations in research underscore the insufficiency of our current knowledge base for ending homelessness. Although many families were no longer literally homeless, long-term residential stability and employment at a livable wage were not ensured. Developing and implementing evidence-based approaches for addressing homelessness are long overdue.
在过去三十年里,家庭无家可归已成为一个日益严重的公共卫生问题。尽管有这种趋势,但很少有研究探讨住房干预措施以及住房与服务干预措施的有效性。本系统综述的目的是评估和综合关于解决家庭无家可归问题的有效干预措施的证据。我们检索了2007年至2013年期间的10个主要电子数据库。对美国无家可归家庭的住房干预措施以及住房与服务干预措施有效性进行实证研究的文献,无论其发表状态如何,均符合纳入标准。结果包括住房状况、就业情况、父母的创伤及心理健康和物质使用情况、儿童的行为和学业状况以及家庭团聚情况。使用有效公共卫生实践项目工具对研究质量进行评估。本综述纳入了六项研究。总体而言,干预后住房和就业情况有一定改善,但并未实现持续的居住和工作稳定。方法学上的局限性、报告质量差以及各结果定义不一致阻碍了研究间的比较。研究中的重大局限性凸显了我们目前关于终结无家可归现象的知识基础的不足。尽管许多家庭不再处于无家可归的实际状态,但长期的居住稳定性和能维持生计的工资水平的就业并未得到保障。制定和实施基于证据的解决无家可归问题的方法早就该进行了。