Strategy. Wraparound Services (Child)
Approach. Provide families, particularly parents, facing housing loss, insecurity, or emergency shelter placement with wraparound social services to improve mental health outcomes and reduce economic impacts
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Overview. Wraparound services benefit families experiencing homelessness by providing comprehensive and coordinated support to address their complex needs, offering a holistic approach to care. Wraparound services play a crucial role in addressing the multifaceted challenges families experiencing homelessness face by supporting them on their journey towards stability and self-sufficiency.[1,2,3]
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.
- Mental Health. This strategy promotes emotional, psychological, and social well-being of individuals and communities.
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).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of service providers and community partners mobilized to provide a comprehensive array of wraparound supports to families, including mental health, economic stability, and other essential services. (Assesses breadth and depth of multi-disciplinary support network)
- Number of families with children in housing crises who are connected to evidence-based mental health interventions and supportive services through wraparound coordination. (Shows linkage to appropriate mental health support)
- Number of parents and caregivers receiving wraparound services who experience improved mental health outcomes, such as reduced symptoms of depression, anxiety, and trauma. (Assesses impact on promoting mental health and wellbeing)
- Number of families receiving wraparound services who are able to maintain or improve their economic stability, such as through sustained employment, increased income, or reduced debt. (Shows impact on mitigating economic hardship associated with housing instability)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of wraparound service providers and partners who are trained in delivering culturally responsive, trauma-informed, and whole-family approaches to support. (Measures workforce capacity for providing effective, equitable services)
- Percent of mental health and other wraparound support services that are co-located or easily accessible to families in housing crisis, such as through mobile or community-based service delivery models. (Shows accessibility and responsiveness of service design)
- Percent of families receiving wraparound services who report improved quality of life, reduced stress, and increased resilience and coping skills. (Measures family-reported psychosocial and wellbeing outcomes)
- Percent of children in families receiving wraparound services who demonstrate positive mental health and developmental outcomes, such as healthy attachment, self-regulation, and social-emotional functioning. (Assesses impact on promoting child wellbeing in the context of housing instability)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of collaborative partnerships and referral networks established across housing, mental health, early childhood, and other key service systems to enable seamless wraparound support for families in housing crises. (Measures system coordination and integration)
- Number of communities that implement data-sharing and technology solutions to facilitate real-time coordination and monitoring of wraparound service delivery and outcomes for families in housing crises. (Shows data-driven, accountable approach to systems management)
- Number of families receiving wraparound services who experience reductions in utilization of costly crisis services, such as emergency departments, child welfare, or justice systems, as a result of improved housing and mental health stability. (Measures cross-sector impact and cost-effectiveness of upstream prevention approach)
- Number of organizations and communities that demonstrate sustained capacity and commitment to providing wraparound supports to families in housing crises, even in the face of funding or policy challenges. (Assesses systems resilience and adaptability to meet evolving family needs)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of wraparound service models and initiatives that are designed and led by parents and caregivers with lived experience of housing instability and mental health challenges. (Measures authentic family partnership and leadership)
- Percent of wraparound service investments and resources allocated to community-based, culturally-specific organizations and approaches that build on the assets and resilience of families. (Assesses cultural responsiveness and equity in resource allocation)
- Percent reduction in racial, ethnic, and socioeconomic disparities in access to mental health and wraparound support services among families experiencing housing instability. (Measures impact on advancing health equity and social justice)
- Percent of communities that demonstrate sustained shifts in the structural determinants of mental health inequities for families experiencing housing instability, such as through increased access to affordable housing, living wage jobs, and community mental health supports. (Shows long-term, transformative impact on advancing health and housing justice)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- 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] Wu, Q., Slesnick, N., & Murnan, A. (2018). Understanding Parenting Stress And Children's Behavior Problems Among Homeless, Substance‐Abusing Mothers. Infant mental health journal, 39(4), 423-431.
[2] Holtrop, K., & Holcomb, J. E. (2018). Adapting and pilot testing a parenting intervention for homeless families in transitional housing. Family process, 57(4), 884-900.
[3] Croft, L. A., Marossy, A., Wilson, T., & Atabong, A. (2021). A building concern? The health needs of families in temporary accommodation. Journal of Public Health, 43(3), 581-586.
