Transcript 'Research to promote evidence-based services'

Research to promote
evidence-based services
Tony Warnes, Maureen Crane and Sarah Coward
University of Sheffield
Presentation to the Research Forum, Homeless Link
8 December 2009
Topics in this presentation
 The FOR-HOME study
 Requirements of an authoritative outcomes
study
 Preliminary findings from FOR-HOME
 Analysis plans
Aims of
To produce longitudinal information about: (a) the
experiences of homeless people who are resettled, and (b)
the factors that influence the outcomes.
To assess the relative contributions to settledness, tenancy
sustainment and achieved independence of:
* the resettled person’s characteristics
* the resettlement preparation and follow-up support
* the condition and amenities of the accommodation
* events and experiences post-resettlement
Funded by the UK Economic and Social Research Council
Study design and data collection
 Study carried out in partnership with six homelessness sector
organisations. The organisations were involved in the study’s
design and implementation. Each appointed a senior staff
member to attend Management Committee – met 6 monthly.
 The sample: 400 single homeless people resettled into
independent accommodation by the collaborating
organisations. Two clusters: London, and Nottingham / Leeds
/ Sheffield (Notts/Yorks).
 Semi-structured interviews conducted immediately before
being resettled, and after 6 and 15/18 months. Key-worker also
completed questionnaire at baseline.
 Interviews from June 2007 to November 2009.
Partner organisations
Funded by Economic and Social Research Council
Requirements of
an authoritative
outcomes study
Designing a study: working rules
 Study population must be precisely defined, and explicit
inclusion / exclusion criteria agreed – in FOR-HOME, the
challenging problems were defining the type of
accommodation that constituted ‘resettlement into
independent living’.
 Sample must represent the study population. FOR-HOME
constructed a sample frame of people resettled by the six
organisations in 2006, and quotas drawn up.
 Recruitment involved many projects and staff. Good
communication within the organisations is essential, and
important that staff understand the objectives of the study, are
‘signed up to it’ and actively co-operate.
 The achieved sample is broadly representative of those
resettled.
Recruitment: the experiences of FOR-HOME
 A link-worker was appointed in each organisation to collect
information about people about to be resettled and to refer to
the study. Training the link-worker and establishing a good
working relationship very important.
 Many staff did not see research as priority – did not always
notify link-worker of imminent resettlements, nor complete
staff questionnaires. The link-workers were not managers and
so had no authority to direct other staff. Senior staff had to
intervene.
 Some organisations have many dispersed hostels / projects.
Research team and link-workers attended staff and team
meetings, and prepared updates for staff newsletters to
promote study. Repeated when staff changed.
 Recruitment slow at first, and was extended three months to
reach target number.
Retention of the respondents
 Essential to minimise attrition. Very challenging and timeconsuming. Requires building trust, sheer persistence,
learning habits and routines, being available to interview at any
time (evenings / weekends), and being able to respond at short
notice.
 Incentive payment critical to encourage the respondents to
participate in an interview and to keep in contact, e.g. by
notifying changes of address. Christmas cards helped.
 Contact details collected for relatives, friends, and services
used – very important element of keeping in touch.
 Respondents given ‘change of contact’ cards and freepost
envelopes.
 Tracking exercise at 12 months to establish whereabouts;
more frequently for those at high risk of leaving / losing
tenancy. Link workers helped with tracking.
Early FOR-HOME
findings
Social Housing, Lenton, Nottingham
The respondents’ characteristics at time resettled
400 respondents:
 74% men; 26% women
 56% in London; 44% in Nottingham/ Leeds/ Sheffield
 24% aged 16-24; 62% aged 25-49; 14% aged 50+
 60% White British/ Irish; 40% other ethnic groups
 18% homeless up to 12 months; 14% homeless 10+ years
 In last five years, 62% had mental health problems, 33%
had alcohol problems, 56% had used illegal drugs.
Housing tenure by region (%)
London
Notts /
Yorks
Total
Local authority
30
71
48
Housing association
54
18
38
Private rented
17
11
14
Sample sizes
(223)
(177)
(400)
Tenure
Settled in the accommodation (6 months)
100%
80%
60%
0
73
79
50-59
60+
26
30
40%
20%
11
41
51
0%
17-24
25-49
Age groups (years)
Definitely
Think so
Don't think so
Definitely not
Housing outcomes at 15/18 months by region
London
Notts/Yorks
Outcome
%
%
Number
%
In original accommodation
86
67
255
77
Moved to another tenancy
4
11
25
8
Returned to homelessness
8
12
33
10
Evicted / abandoned,
unknown if homeless
1
5
10
3
In prison or rehab.
1
5
8
2
(180)
(151)
(331)
(331)
Sample sizes
Total
Notes: Excludes four who had died, 50 still not interviewed, and 15 refused / lost contact.
Among those described as homeless, 12 with relatives / friends, and 21 had returned to streets
or hostels.
Housing outcomes at 15/18 months by tenure
Local
authority
Housing
association
Private
rented
Total
Outcome
%
%
%
%
In original
accommodation
79
87
44
77
Moved to another tenancy
6
6
17
8
Returned to
homelessness
6.5
5.5
33.4
10.0
Evicted / abandoned,
unknown if homeless
4.5
1.0
4.0
3.0
4
1
2
2
(155)
(128)
(48)
(331)
In prison or rehab.
Sample sizes
Excludes four who had died, 50 not yet interviewed, and 15 refused / lost contact.
Type of accommodation in which resettled by
housing outcome at 15/18 months
90
88
84
Percentages
75
60
42
45
32
26
30
15
5
7
8
8
0
Self-contained flat
Original accomm
Studio flat
Changed tenancy
Bedsit
Homeless
Analysis plans
What we hope to learn from FOR-HOME
 Factors that associate with positive and negative outcomes of
resettlement. A large sample and longitudinal data enables
rigorous, multivariate analysis.
 Innumerable hypotheses associated with respondents’
backgrounds, problems, the help they received, preparation for
resettlement, the condition and type of accommodation,
tenancy support, friends and relatives’ support, and events
post-resettlement.
 Analysis will iterate between the ‘big picture’ and close
attention to particular issues or problems. Workshops with
staff and respondents.
 Attention has already been drawn to debts, tenancy support
and continuing support in dealing with substance abuse.
Our warm thanks to …
All the respondents who have participated in this study over a
very long time.
Ruby Fu, Camilla Mercer and Louise Joly who have helped
massively with running the project and coding the data.
The freelance interviewers – Gary Bellamy, Paul Gilsenan, Louise
Joly and John Miles.
Members of the Management Committee: David Fisher
(Broadway), Caroline Day and Jennifer Monfort (Centrepoint),
Peter Radage and Rachel Harding (Framework), Julie Robinson
and Tony Beech (St Anne’s), Simon Hughes and George Miller (St
Mungo’s), and John Crowther and Debra Ives (Thames Reach),
and to all their colleagues who have been Link Workers or have
otherwise assisted with recruitment and tracking.
Contact details
Tony Warnes: [email protected]
Maureen Crane: [email protected]
Sarah Coward: [email protected]
www.shef.ac.uk/sisa/research/fields/homeless