A Pragmatic Trial Integrating Homelessness Diversion Services Into an Emergency Department Discharge System

A Pragmatic Randomized Trial Integrating Homelessness Diversion Services Into an Emergency Department Discharge System

The purpose of this study is to determine whether a homelessness diversion program integrated into a hospital emergency department (ED) will lower ED use, to identify characteristics of individuals most likely to benefit from homelessness diversion and to discover opportunities to tailor Homelessness Diversion (HD) services to better meet the needs of diverse communities.

Study Overview

• Status: Enrolling by invitation
• Conditions: Homelessness
• Intervention / Treatment: Behavioral: Homeless diversion (HD); Behavioral: Treatment-as-usual (TAU)

• Study Type: Interventional
• Enrollment (Estimated): 1000
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • The University of Texas Health Science Center at Houston

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• English or Spanish speaking
• discharged from a Harris Health Hospital ED (Ben Taub or LBJ)
• at imminent risk of homelessness
• patients with Medicaid, Medicare or who are uninsured

Exclusion Criteria:

• having a conservator (legal guardian)
• plans to move away from Texas in 6 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Homeless diversion (HD) group	Behavioral: Homeless diversion (HD); Participants will receive services from specialty-trained community health workers and will be invited to complete monthly assessments via text and phone to assess their health and housing for 6 months and to share feedback on their experience with the intervention after completion by a text message to a link for the survey
Active Comparator: Treatment-as-usual (TAU) group	Behavioral: Treatment-as-usual (TAU); Participants will receive a list of community resources they can contact to receive services and will be invited to complete monthly assessments via text and phone to assess their health and housing for 6 months and to share feedback on their experience with the intervention after completion by a text message to a link for the survey

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Number of ED visits	end of study (6 months after start of study)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants who experience homelessness		end of study (6 months after start of study)
Change in health related quality of life as assessed by the Short Form-12 version 2.0 (SF12v2) health Survey	This is a 12 item questionnaire and scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.	baseline, month 1, month 2, month 3, month 4, month 5 and month 6

Collaborators and Investigators

• Sponsor: The University of Texas Health Science Center, Houston
• Collaborators: National Institute on Minority Health and Health Disparities (NIMHD)
• Investigators: Principal Investigator: Jack Tsai, PhD, The University of Texas Health Science Center, Houston

Study record dates

Study Major Dates

• Study Start (Actual): September 14, 2023
• Primary Completion (Estimated): September 1, 2025
• Study Completion (Estimated): September 1, 2025

Study Registration Dates

• First Submitted: April 8, 2023
• First Submitted That Met QC Criteria: April 8, 2023
• First Posted (Actual): April 21, 2023

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 24, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: HSC-SPH-22-0762; R01MD018213 (U.S. NIH Grant/Contract)

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
• product manufactured in and exported from the U.S.: No