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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Housing Instability: Child.

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Strategy. Case Management and Social Support. (Child)

Approach. Support families in need of stable housing services and community programs to improve child mental and physical health outcomes.

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Overview. Case management plays a crucial role in supporting homeless families, especially those involved with child welfare. Effective case management can provide individualized services tailored to the specific needs of each family, helping them navigate complex systems and access necessary resources. Overall, effective case management for homeless families, particularly those involved with child welfare, is essential for providing holistic support, addressing underlying issues, and promoting stability and well-being for both parents and children.[1]

Evidence. Mixed Evidence. Strategies with this rating have been tested more than once with results that sometimes trend positive...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
  • Policy. This strategy helps to promote decisions, laws, and regulations that promote public health practices and interventions.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Referral and Follow-Up (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of case managers and support staff trained to provide family-centered, trauma-informed services to address housing and health needs. (Assesses workforce capacity and competency) Number of community-based organizations and programs partnering to provide comprehensive housing and social support services to families with children. (Shows service integration and collaboration)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of case management and support services promoted by Title V that utilize evidence-based practices tailored to the unique needs of families with children. (Measures quality and relevance of services) Percent of case managers and support staff who are representative of the families and communities served. (Shows responsiveness of workforce)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of families with children supported by Title V receiving case management who report improved family functioning, parenting skills, and overall household stability. (Measures family-level outcomes and wellbeing) Number of community-wide initiatives implemented to build public awareness and support for addressing family homelessness and its impact on child health and development that lead to increase in knowledge and/or skill. (Shows efforts to shift narrative and build political will) Number of families with children who experience improved overall quality of life and reduced stress as a result of stable housing and support services. (Measures family wellbeing and resilience outcomes) Number of communities that demonstrate significant reductions in the prevalence and duration of family homelessness over time. (Assesses population-level impact on housing stability)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of families with children supported by Title V receiving case management who report improved family functioning, parenting skills, and overall household stability. (Measures family-level outcomes and wellbeing) Percent of community-wide initiatives implemented to build public awareness and support for addressing family homelessness and its impact on child health and development that lead to increase in knowledge and/or skill. (Shows efforts to shift narrative and build political will) Percent of families with children who experience improved overall quality of life and reduced stress as a result of stable housing and support services. (Measures family wellbeing and resilience outcomes) Percent of communities that demonstrate significant reductions in the prevalence and duration of family homelessness over time. (Assesses population-level impact on housing stability)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Collins, C. C., Bai, R., Fischer, R., Crampton, D., Lalich, N., Liu, C., & Chan, T. (2020). Housing instability and child welfare: Examining the delivery of innovative services in the context of a randomized controlled trial. Children and Youth Services Review, 108, 104578.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.