Department of Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, NS, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
Ontario Ministry of Children, Community, and Social Services, Toronto, ON, Canada.
Lancet Public Health. 2022 Jan;7(1):e23-e35. doi: 10.1016/S2468-2667(21)00234-6. Epub 2021 Nov 24.
Intimate partner violence (IPV) is the leading cause of women's homelessness. However, what works best to respond to the needs of women experiencing IPV and homelessness remains unclear. We aimed to systematically review the effects of housing interventions on the physical, psychosocial, and economic wellbeing of women experiencing IPV.
In this systematic review, we searched 15 electronic databases and conducted an extensive grey literature and hand reference search between Jan 29, 2020, and May 31, 2021. We included controlled quantitative studies of housing interventions (from emergency shelter to permanent supportive housing) that were reported in English, without time restrictions, and examined any physical, psychosocial, or economic outcomes among women experiencing IPV. We critically appraised included studies using the Cochrane Effective Practice and Organisation of Care criteria and extracted data using a piloted extraction form. We synthesised our results using harvest plots to summarise whether the weight of the evidence suggested benefits, disadvantages, or null effects; patterns by study quality; and evidence gaps. This study is registered with PROSPERO, CRD42020176705.
We screened 23 902 unique records and identified 34 eligible studies with quantitative data on the outcomes of housing interventions among women experiencing IPV. Most studies evaluated the outcomes of either shelter interventions (18 studies [53%]) or shelter plus some other programming (eight [24%]). The remaining eight studies evaluated longer-term housing solutions, including supportive housing (five studies [15%]), critical time interventions (one [3%]), transitional housing (one [3%]), and stay-at-home models (one [3%]). There was no cumulative evidence of disadvantages following any IPV-housing intervention. Evidence of benefits was strongest for mental health outcomes, intent to leave partner, perceived safety, and housing and partner-related stress. Included studies were at high risk of bias across most domains (eg, confounding).
There is promising evidence on the continuum of IPV-housing services for women, especially in terms of proximal outcomes, such as mental health, intent to leave partner, safety, and housing stress. However, more research of higher quality is needed, particularly on long-term housing solutions and from outside of the USA.
The Social Sciences and Humanities Research Council (430-2021-01176) and Canadian Institutes of Health Research (HSI-166388).
亲密伴侣暴力（IPV）是导致女性无家可归的主要原因。然而，对于如何最好地满足遭受 IPV 和无家可归的女性的需求，目前仍不清楚。我们旨在系统地回顾住房干预措施对遭受 IPV 的女性的身体、心理社会和经济福利的影响。
在这项系统评价中，我们于 2020 年 1 月 29 日至 2021 年 5 月 31 日期间检索了 15 个电子数据库，并进行了广泛的灰色文献和手工参考文献搜索。我们纳入了报告为英语、无时间限制的住房干预措施（从紧急避难所到永久性支持性住房）的对照定量研究，并检查了遭受 IPV 的女性的任何身体、心理社会或经济结果。我们使用 Cochrane 有效实践和护理组织标准对纳入的研究进行了批判性评估，并使用经过试验的提取表格提取数据。我们使用收获图来综合总结证据权重是否表明存在益处、劣势或无影响；按研究质量划分的模式；以及证据差距。本研究在 PROSPERO 注册，CRD42020176705。
我们筛选了 23902 条独特的记录，确定了 34 项符合条件的研究，这些研究具有关于遭受 IPV 的女性住房干预措施结果的定量数据。大多数研究评估了庇护干预措施的结果（18 项研究[53%]）或庇护加其他一些方案的结果（8 项研究[24%]）。其余 8 项研究评估了更长期的住房解决方案，包括支持性住房（5 项研究[15%]）、关键时间干预（1 项研究[3%]）、过渡性住房（1 项研究[3%]）和居家模式（1 项研究[3%]）。没有任何 IPV-住房干预措施存在不利影响的累积证据。在心理健康结果、离开伴侣的意愿、感知安全以及住房和伴侣相关压力方面，有证据表明益处最强。纳入的研究在大多数领域（如混杂）都存在高偏倚风险。
在 IPV-住房服务的连续体中，针对女性，尤其是在心理健康、离开伴侣的意愿、安全和住房压力等近期结果方面，有希望的证据。然而，需要更多高质量的研究，特别是来自美国以外的长期住房解决方案的研究。
社会科学和人文研究理事会（430-2021-01176）和加拿大卫生研究院（HSI-166388）。
