Partnerships to Demonstrate Effectiveness of Supportive Housing for Families in the Child Welfare System

October 15, 2020 updated by: Anne Farrell, Chapin Hall at the University of Chicago
This was a randomized controlled trial comparing child welfare business as usual (BAU) with two levels of supportive housing (SH). To identify eligible families, a screening tool was developed that helped social workers apply a "housing lens" very early in family child welfare involvement. The study examined the extent to which implementation was faithful to the model and how well state and community partners collaborated. The research included a process evaluation, outcomes study, and economic analysis. Access to either intervention group was associated with higher family preservation and reunification, with service model intensity demonstrating minimal impact. An economic evaluation revealed that the intensive model cost the most, but the existing SH program and routine care incurred equivalent per-child costs.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Supportive Housing for Families is a care management program that serves families who are experiencing child welfare needs (risk of losing custody of children or difficulty regaining custody of children) and severe housing needs. The program has been in operation for over 10 years and has been demonstrating positive outcomes for clients in terms of housing stability and family environment outcomes.

A federally funded, five-year demonstration project and evaluation focused on a new and enhanced version of the program, the Intensive Supportive Housing for Families program (ISHF). Through a three arm randomized controlled trial, this study compared clients in three groups: parents who are randomly assigned to (1) enroll in ISHF, (2) participate in the existing Supportive Housing for Families (SHF) program, and (3) receive Child Welfare Business as Usual Services. This was the first randomized evaluation of this program, and the grant required examination of whether those who participate in an enhanced version of the program, which incorporates prompt access to evidence-based interventions, vocational services, and trauma services, show superior outcomes than clients randomized to the existing program. Further, clients in both of these conditions (SHF and ISHF) were compared to those receiving child welfare services in Connecticut as usual (BAU) without a supportive housing intervention.

This research has three components: a) a process evaluation, b) a cost/economic analysis, and c) an impact analysis.

The process evaluation and cost analysis were previously completed while the project was ongoing. Now that the project has ended, the final report on all project activities has been submitted to the funder, the Administration for Children and Families.

This impact analysis addressed the following primary research questions:

  1. Do clients who receive supportive housing services (SHF and ISHF interventions combined) demonstrate improved child welfare outcomes compared to those in the Child Welfare (DCF) Business as Usual (BAU) intervention?
  2. Do clients who receive any supportive housing services (those in the SHF and ISHF interventions combined) demonstrate improved parental well-being compared to those in the Child Welfare (DCF) Business as Usual (BAU) intervention?
  3. Do clients who receive supportive housing services (SHF and ISHF interventions combined) demonstrate improved parenting skills compared to those in the BAU intervention?
  4. Do clients who receive any supportive housing services (those in the SHF and ISHF interventions combined) demonstrate increased self-sufficiency compared to those in the BAU intervention?
  5. Do clients who receive any supportive housing services (those in the SHF and ISHF interventions combined) demonstrate improved child development compared to those in the Child Welfare Business as Usual intervention?
  6. Do clients who receive any supportive housing services (those in the SHF and ISHF interventions combined) demonstrate improved child well-being compared to those in the Child Welfare Business as Usual intervention?

A set of secondary research questions ask: across each of these outcomes (i.e., child welfare, parental well-being, parenting skills, self-sufficiency, child development, child well-being), are there differential effects across the three intervention options, ISHF, SHF, and BAU [such that those in ISHF show greater improvement than clients in the SHF program who show greater improvement than those in BAU]?

Main outcome measures were assessed at 12, 18, and 24 months post-randomization. Housing outcomes included shelter stay and subsidy deployment. Child welfare outcomes included child removal and reunification, subsequent allegations and substantiations, and case closure.

Results: Access to either intervention group was associated with higher family preservation and reunification, with service model intensity demonstrating minimal impact. An economic evaluation revealed that the intensive model cost the most, but the existing SH program and routine care incurred equivalent per-child costs.

The PI of this research was originally at the University of Connecticut and moved to Chapin Hall. The research has concluded and the investigators are drafting a manuscript.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
217

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • ADULT
  • OLDER_ADULT
  • CHILD

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Families who were newly involved with the child welfare system, demonstrated high housing instability or homelessness, and evidenced high service needs.

Exclusion Criteria:

  • N/A

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: OTHER
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
NO_INTERVENTION: Business As Usual
Families who were involved in the child welfare services
ACTIVE_COMPARATOR: Intensive Supportive Housing for Families
Families who were randomly assigned in this group
Other: Intensive Supportive Housing Services
an intensive treatment SH model with a higher dosage of case management, family teaming, and access to a vocational specialist
ACTIVE_COMPARATOR: Program Supportive Housing for Families
Families who were randomly assigned in this group
Other: Program Supportive Housing Services
The existing statewide SH model that included routine access to housing (voucher) and case management

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Preservation
Time Frame: 2 years
Number of children not being removed from their family
2 years
Reunification
Time Frame: 2 years
Number of children being reunified with their family
2 years
Housing stability
Time Frame: 2 years
Whether family remained stably housed or experienced recidivism on homelessness or near homelessness
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Chapin Hall at the University of Chicago

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
University of Connecticut

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Anne Farrell, Ph.D., Chapin Hall at the University of Chicago

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2013

Primary Completion (ACTUAL)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 31, 2017

Study Completion (ACTUAL)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2017

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 8, 2020

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 15, 2020

First Posted (ACTUAL)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 22, 2020

Study Record Updates

Last Update Posted (ACTUAL)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 22, 2020

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 15, 2020

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IRB18-0174

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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