Somers Julian M, Moniruzzaman Akm, Patterson Michelle, Currie Lauren, Rezansoff Stefanie N, Palepu Anita, Fryer Karen
Somers Research Group Faculty of Health Sciences Simon Fraser University Burnaby, Canada.
School of Population and Public Health University of British Columbia Vancouver, Canada.
PLoS One. 2017 Jan 11;12(1):e0168745. doi: 10.1371/journal.pone.0168745. eCollection 2017.
No previous experimental trials have investigated Housing First (HF) in both scattered site (SHF) and congregate (CHF) formats. We hypothesized that CHF and SHF would be associated with a greater percentage of time stably housed as well as superior health and psychosocial outcomes over 24 months compared to treatment as usual (TAU).
Inclusion criteria were homelessness, mental illness, and high need for support. Participants were randomised to SHF, CHF, or TAU. SHF consisted of market rental apartments with support provided by Assertive Community Treatment (ACT). CHF consisted of a single building with supports equivalent to ACT. TAU included existing services and supports.
Of 800 people screened, 297 were randomly assigned to CHF (107), SHF (90), or TAU (100). The percentage of time in stable housing over 24 months was 26.3% in TAU (reference; 95% confidence interval (CI) = 20.5, 32.0), compared to 74.3% in CHF (95% CI = 69.3, 79.3, p<0.001) and 74.5% in SHF (95% CI = 69.2, 79.7, p<0.001). Secondary outcomes favoured CHF but not SHF compared to TAU.
HF in scattered and congregate formats is capable of achieving housing stability among people experiencing major mental illness and chronic homelessness. Only CHF was associated with improvement on select secondary outcomes.
Current Controlled Trials: ISRCTN57595077.
以往尚无实验性试验对分散式住房优先（SHF）和集中式住房优先（CHF）模式进行研究。我们假设，与常规治疗（TAU）相比，CHF和SHF在24个月内与更高比例的稳定住房时间以及更好的健康和社会心理结果相关。
纳入标准为无家可归、患有精神疾病且急需支持。参与者被随机分配至SHF、CHF或TAU组。SHF包括由积极社区治疗（ACT）提供支持的市场租赁公寓。CHF包括一栋提供与ACT相当支持的单一建筑。TAU包括现有服务和支持。
在800名接受筛查的人中，297人被随机分配至CHF组（107人）、SHF组（90人）或TAU组（100人）。TAU组在24个月内稳定住房的时间百分比为26.3%（参照组；95%置信区间（CI）=20.5, 32.0），而CHF组为74.3%（95%CI = 69.3, 79.3，p<0.001），SHF组为74.5%（95%CI = 69.2, 79.7，p<0.001）。与TAU组相比，次要结果有利于CHF组，但不利于SHF组。
分散式和集中式住房优先模式能够使患有严重精神疾病和长期无家可归的人实现住房稳定。只有CHF组在选定的次要结果方面有所改善。
当前对照试验：ISRCTN57595077
