Impuls - Netherlands Center for Social Care Research, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Am J Community Psychol. 2017 Sep;60(1-2):175-186. doi: 10.1002/ajcp.12150. Epub 2017 Sep 5.
To help create an evidence base in Europe for effective interventions that improve the well-being of homeless people, we tested whether critical time intervention (CTI), a time-limited intervention developed to support vulnerable people during times of transition, is effective outside the United States. For this multicenter, parallel-group randomized controlled trial, 183 adults who were moving from shelters in the Netherlands to supported or independent housing were allocated to CTI or care-as-usual. The primary outcome was number of days rehoused, which was assessed by interviewing participants four times during a 9-month follow-up. Outcomes were analyzed with three-level mixed-effects models. The primary outcome did not differ between groups. CTI had a significant effect on family support and, for people experiencing less social support, psychological distress. Groups did not differ significantly on social support, fulfillment of care needs, quality of life, self-esteem, excessive alcohol use, or cannabis use. Because few participants were homeless at 9 months, more research is needed to establish whether CTI can prevent long-term recurrent homelessness. Given recent emphasis on informal support in public services and positive effects of CTI on family support and psychological distress, CTI is a fitting intervention for Dutch shelter services.
为了在欧洲建立一个有效的干预措施的证据基础，以改善无家可归者的福祉，我们测试了关键时期干预（CTI）是否在美国以外的地区有效。CTI 是一种限时干预措施，旨在为处于过渡时期的弱势群体提供支持。这项多中心、平行组随机对照试验纳入了 183 名即将从荷兰收容所搬至保障性或独立性住房的成年人，将他们随机分配至 CTI 组或常规护理组。主要结局是重新安置的天数，通过在 9 个月的随访期间对参与者进行 4 次访谈进行评估。采用三级混合效应模型进行分析。两组之间的主要结局没有差异。CTI 对家庭支持有显著影响，对于社会支持较少的人，CTI 对心理困扰也有显著影响。两组在社会支持、护理需求的满足、生活质量、自尊、过度饮酒或大麻使用方面没有显著差异。由于 9 个月时很少有参与者无家可归，因此需要进一步研究以确定 CTI 是否可以预防长期反复无家可归。鉴于最近公共服务部门对非正式支持的重视，以及 CTI 对家庭支持和心理困扰的积极影响，CTI 是荷兰收容所服务的一种合适的干预措施。
