Effectiveness of interventions targeting community integration among individuals with lived experiences of homelessness: A systematic review.
Effectiveness of interventions targeting community integration among individuals with lived experiences of homelessness: A systematic review.
复制标题
针对有无家可归经历的个人融入社区的干预措施的有效性：系统评价。
DOI：
--
复制
发表时间：
2020
影响因子：
2.4
通讯作者：
S. Wickett
中科院分区：
文献类型：
--
作者：
C. Marshall;Leonie Boland;Lee Westover;Blair Marcellus;Silka Weil;S. Wickett
社区融合（CI）已被确定为旨在改善无家可归者和最近居住的个人生活的方案的关键成果（Gaetz，加拿大无家可归状况，2016年）。虽然研究人员已经探讨了住房第一（HF）对社会融合的影响程度（Quilgars & Pleace，Soc. Incl.，4，2016），对CI更广泛的其他干预措施的范围和有效性知之甚少。我们使用Joanna Briggs研究所（JBI）指南对实验研究进行了系统回顾。我们的搜索策略部署在六个数据库：EMBASE，CINAHL，PsychINFO，Medline，Sociological Abstracts，和Proquest Dissertations and Theses。我们的检索于2017年启动，并于2019年5月5日更新。使用Wong和所罗门（Ment.健康服务结果：4：13-28，2002），两个独立的评分员在去除重复之后筛选了14，158个标题和摘要。共对157篇文章进行了全文审查。其中包括以英语发表的涉及任何年龄段参与者的研究。我们使用JBI检查表对25项研究进行了严格评估，用于准实验和随机对照试验（Tufanaru，Joanna Briggs Institute Reviewers Manual，2017），随后排除了4项研究，因为它们不符合预先设定的质量阈值得分50/100。共有21项研究被纳入叙述性综合。关键评价评分范围为53.8-100（Mdn = 69.2）。现有文献中评价的干预措施包括住房和住房支持干预措施（n = 9）、HF（n = 5）、心理社会干预措施（n = 5）和就业干预措施（n = 2）。由于纳入研究的结局异质性，无法进行荟萃分析。研究人员测量的CI方面包括社会（n = 17），心理（n = 6）和身体（n = 4）整合。评估HF和住房和住房支持干预措施的研究表明，令人惊讶的混合或缺乏促进CI的有效性。心理社会干预是最有希望的，特别是那些包含同伴支持因素的干预。本综述中包含的文献结果表明，现有干预措施有效针对CI作为结果的程度存在不一致性。此外，我们认为，现有的系统层面的干预措施，包括HF和永久性的支持性住房可能不足以促进CI无家可归者和以前无家可归的人。未来的研究应侧重于开发和评估更有效地针对这一关键结构的干预措施。
Community integration (CI) has been identified as a key outcome of programs designed to improve the lives of homeless and recently housed individuals (Gaetz, The State of Homelessness in Canada 2016, 2016). Although researchers have explored the extent to which Housing First (HF) impacts on social integration (Quilgars & Pleace, Soc. Incl., 4, 2016), little is known about the range and effectiveness of other interventions on CI more broadly. We conducted a systematic review of experimental studies using Joanna Briggs Institute (JBI) guidelines. Our search strategy was deployed in six databases: EMBASE, CINAHL, PsychINFO, Medline, Sociological Abstracts, and Proquest Dissertations and Theses. Our search was initiated in 2017 and updated on May 5, 2019. Using the definition of CI identified by Wong & Solomon (Ment. Health Serv. Res., 4:13-28, 2002), two independent raters screened 14,158 titles and abstracts after the removal of duplicates. A total of 157 articles were subjected to full-text review. Studies published in the English language and involving participants of any age were included. We conducted a critical appraisal of 25 studies using the JBI checklists for quasi-experimental and randomised controlled trials (Tufanaru, Joanna Briggs Institute Reviewers Manual, 2017), and subsequently excluded four studies as they did not meet a pre-established quality threshold score of 50/100. A total of 21 studies were included in a narrative synthesis. Critical appraisal scores ranged from 53.8-100 (Mdn = 69.2). Interventions evaluated in existing literature included housing and housing support interventions (n = 9), HF (n = 5), psychosocial interventions (n = 5), and employment interventions (n = 2). A meta-analysis could not be performed due to the heterogeneity of outcomes in included studies. Aspects of CI measured by researchers included social (n = 17), psychological (n = 6), and physical (n = 4) integration. Studies that evaluated HF and housing and housing support interventions demonstrated surprisingly mixed or a lack of effectiveness for promoting CI. Psychosocial interventions were the most promising, specifically those which incorporated an element of peer support. Findings of literature included in this review suggests that there is inconsistency in the extent to which existing interventions are effectively targeting CI as an outcome. Furthermore, we contend that existing systems-level interventions, including HF and permanent supportive housing alone may not be enough to promote CI among homeless and formerly homeless individuals. Future research should focus on the development and evaluation of interventions that more effectively target this critical construct.