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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. Homelessness Prevention Programs. (Child)

Approach. Collaborate with Medical providers and social service case managers to screen and assist families with children who may face homelessness.

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Overview. Homelessness prevention programs have a significant impact on families and children by providing support and resources to help prevent them from experiencing homelessness. These programs aim to address the root causes of homelessness and provide stability to families who have additional health needs. Homelessness prevention programs play a crucial role in supporting families and children by providing stability, improving health outcomes, enhancing family dynamics, supporting education, promoting economic stability, and building resilience.[1,2,3,4,5] Evidence has found that by addressing the root causes of homelessness and providing the necessary support, these programs have a positive impact on the lives of families and children[].

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

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.
  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.
  • 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. Screening (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 medical providers and social service case managers trained to screen families with children for housing instability and risk of homelessness. (Measures workforce capacity building for prevention) Number of partnerships led by Title V formed between healthcare, social service, and housing organizations to provide coordinated prevention services to families with children. (Shows cross-sector collaboration for prevention)

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

  • Percent of families with children engaged in prevention programs who receive strengths-based services. (Assesses family-centeredness and responsiveness of service delivery) Percent of prevention service providers and partners who reflect the communities served. (Shows representation in prevention workforce)

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

  • Number of families with children receiving prevention services who report increased housing stability, financial security, and overall family wellbeing. (Measures family-reported outcomes and resilience) Number of community-wide initiatives implemented to build public awareness and support for investing in upstream homelessness prevention strategies for families with children that results in an increase in knowledge and/or skill. (Assesses efforts to shift narrative and build interest for prevention) Number of families with children supported by Title V who experience improved health, social, and economic outcomes as a result of participating in homelessness prevention programs. (Measures holistic, long-term impact on family wellbeing) Number of communities partnered with Title V that demonstrate significant reductions in rates of family and child homelessness through implementation of comprehensive prevention strategies. (Assesses population-level impact on homelessness reduction)

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

  • Percent of families with children receiving prevention services who report increased housing stability, financial security, and overall family wellbeing. (Measures family-reported outcomes and resilience) Percent of community-wide initiatives implemented to build public awareness and support for investing in upstream homelessness prevention strategies for families with children that results in an increase in knowledge and/or skill. (Assesses efforts to shift narrative and build interest for prevention) Percent of families with children supported by Title V who experience improved health, social, and economic outcomes as a result of participating in homelessness prevention programs. (Measures holistic, long-term impact on family wellbeing) Percent of communities partnered with Title V that demonstrate significant reductions in rates of family and child homelessness through implementation of comprehensive prevention strategies. (Assesses population-level impact on homelessness reduction)

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] Kube, A. R., Das, S., & Fowler, P. J. (2023). Community-and data-driven homelessness prevention and service delivery: optimizing for equity. Journal of the American Medical Informatics Association, 30(6), 1032-1041.
[2] Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2018). Health care utilization and expenditures of homeless family members before and after emergency housing. American journal of public health, 108(6), 808-814.
[3] Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2019). Infants exposed to homelessness: health, health care use, and health spending from birth to age six. Health Affairs, 38(5), 721-728.
[4] Sandel, M., Sheward, R., Ettinger de Cuba, S., Coleman, S. M., Frank, D. A., Chilton, M., ... & Cutts, D. (2018). Unstable housing and caregiver and child health in renter families. Pediatrics, 141(2).
[5] Sylvestre, J., Kerman, N., Polillo, A., Lee, C. M., Aubry, T., & Czechowski, K. (2018). A qualitative study of the pathways into and impacts of family homelessness. Journal of Family Issues, 39(8), 2265-2285.

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.