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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. School-Based Support (Child)

Approach. Support families that are facing homelessness or housing instability early to ensure children remain in school and do not fall behind

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Overview. School-based support for children and families facing homelessness is important and can assist in providing various services and resources to help mitigate the challenges they face. School-based support can assist children and families facing homelessness by providing stability and continuity in housing, basic needs assistance (such as clothing, toiletries, food), educational advocacy, emotional support, parental involvement, community partnerships, and academic support.[1,2] By providing a holistic support system that addresses the educational, emotional, and basic needs of homeless children and families, school-based support programs can play a vital role in helping them overcome the barriers associated with homelessness and achieve academic success.[2]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

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

  • Policy. This strategy helps to promote decisions, laws, and regulations that promote public health practices and interventions.
  • 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.

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. Case Management (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. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

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

PROCESS MEASURES:

  • Number of school personnel, including teachers, counselors, and support staff, trained to identify and support students and families experiencing homelessness or housing instability. (Measures workforce capacity building for school-based support)
  • Number of partnerships established between schools, housing providers, and community-based organizations to provide coordinated, wraparound support to students and families in need. (Shows cross-sector collaboration for comprehensive support)

OUTCOME MEASURES:

  • Number of students experiencing homelessness or housing instability who maintain consistent school attendance and participation as a result of receiving school-based support. (Measures direct impact on educational engagement and stability)
  • Number of families experiencing homelessness or housing instability who secure stable housing through school-based referrals and support services. (Assesses impact on housing stability outcomes)

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

PROCESS MEASURES:

  • Percent of school-based support services that are provided in a trauma-informed, culturally responsive, and stigma-free manner to students and families experiencing homelessness or housing instability. (Measures quality and sensitivity of service delivery)
  • Percent of school-based support providers and partners who are representative of the cultural and linguistic diversity of the students and families served. (Shows cultural competency and representation in school-based support workforce)

OUTCOME MEASURES:

  • Percent of students experiencing homelessness or housing instability who report feeling safe, supported, and valued in their school environment as a result of school-based support. (Measures student-reported outcomes and experiences of belonging)
  • Percent of families experiencing homelessness or housing instability who report increased access to essential resources, reduced stress, and improved family stability through school-based support. (Assesses family-reported outcomes and wellbeing)

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

PROCESS MEASURES:

  • Number of school districts that adopt formal policies and procedures to identify, support, and monitor the needs of students and families experiencing homelessness or housing instability. (Measures systems change and institutionalization of school-based support)
  • Number of community-wide initiatives implemented to raise awareness about the educational impacts of homelessness and housing instability and mobilize resources to support affected students and families. (Assesses public engagement and resource mobilization for systems change)

OUTCOME MEASURES:

  • Number of schools and districts that demonstrate significant reductions in chronic absenteeism, school mobility, and educational disparities among students experiencing homelessness or housing instability. (Measures population-level impact on educational equity and stability)
  • Number of communities that implement comprehensive, coordinated school-housing partnerships that result in measurable decreases in student and family homelessness and improvements in housing stability over time. (Assesses collective impact on preventing and ending homelessness)

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

PROCESS MEASURES:

  • Percent of school-based support initiatives that are designed and led by individuals with lived experience of homelessness, including students, parents, and educators from affected communities. (Measures authentic community leadership and decision-making power in program design and implementation)
  • Percent of school and community leaders who demonstrate increased understanding and action to dismantle the structural inequities and trauma that disproportionately impact students and families experiencing homelessness, particularly those from historically marginalized groups. (Shows transformative impact on dominant narratives, power structures, and systems change)

OUTCOME MEASURES:

  • Percent reduction in racial, ethnic, and socioeconomic disparities in experiences of homelessness, housing instability, and educational outcomes among students and families participating in school-based support programs. (Measures impact on advancing equity and justice in housing and education)
  • Percent of students and families from historically medically underserved communities who report that school-based support affirmed their agency, dignity, and inherent worth, rather than perpetuating stigma or deficit-based narratives about their experiences. (Assesses effectiveness of support in enacting liberatory and humanizing practices)

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] Stargel, L. E., & Easterbrooks, M. A. (2022). Children's early school attendance and stability as a mechanism through which homelessness is associated with academic achievement. Journal of School Psychology, 90, 19-32.
[2] Pavlakis, A. E. (2018). Reaching all families: Family, school, and community partnerships amid homelessness and high mobility in an urban district. Urban Education, 53(8), 1043-1073.

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.