Strategy. Homelessness Prevention Programs (Pregnancy)
Approach. Provide pregnant and postpartum women with social and financial supports while recognizing their resilience
Return to main MCHbest page >>
Overview. Homelessness prevention programs can benefit pregnant women in several ways: early intervention, housing assistance, supportive services, education and support, and collaboration and coordination.[1] By implementing prevention strategies, pregnant women at risk of homelessness can be supported in maintaining stable housing, accessing essential services, and improving their health outcomes during pregnancy. Prevention efforts are designed to address the social determinants of health that contribute to homelessness and promote the well-being of pregnant women and their unborn children.
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):
- 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. 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?")
- Number of social workers, case managers, and outreach staff trained to provide homelessness prevention support to pregnant and postpartum women. (Assesses workforce capacity for prevention programs)
- Number of cross-sector partnerships established to provide comprehensive homelessness prevention services, including housing assistance, income support, and health and social services. (Shows multi-disciplinary collaboration for prevention)
- Number of pregnant and postpartum women who maintain stable housing and avoid homelessness as a result of participating in prevention programs. (Measures direct impact of prevention on housing stability)
- Number of pregnant and postpartum women in stable housing who access and utilize prenatal and postpartum care, as well as other health-promoting services. (Assesses effect of housing stability on maternal health care utilization)
|
Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of homelessness prevention programs for pregnant and postpartum women that utilize evidence-based, trauma-informed, and strengths-based approaches. (Measures adherence to best practices and woman-centered principles)
- Percent of program staff who demonstrate cultural humility, empathy, and respect in their interactions with pregnant and postpartum women experiencing housing instability. (Assesses workforce competencies and relationship-building skills)
- Percent of pregnant and postpartum women in prevention programs who report increased social connectedness, resilience, and self-efficacy in navigating challenges related to housing instability. (Measures psychosocial and support outcomes of prevention support)
- Percent of pregnant and postpartum women who successfully transition from prevention programs to long-term housing and economic stability. (Shows sustainability and durability of prevention outcomes)
|
|
Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of community-wide initiatives implemented to build public awareness and support for preventing homelessness among pregnant and postpartum women. (Measures efforts to shift community norms and build political will for prevention)
- Number of healthcare, housing, and social service organizations that adopt and institutionalize screening and referral protocols to identify and support pregnant and postpartum women at risk of homelessness. (Assesses system-level integration and coordination of prevention efforts)
- Number of pregnant and postpartum women who experience improved maternal and child health outcomes, such as reduced maternal morbidity, optimal birth spacing, and positive parenting practices, as a result of participating in homelessness prevention programs. (Measures impact of prevention on holistic maternal and child wellbeing)
- Number of communities that demonstrate significant and sustained reductions in pregnant and postpartum women experiencing homelessness and housing instability over time. (Shows population-level, transformative impact of institutionalizing prevention efforts)
|
Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of homelessness prevention programs for pregnant and postpartum individuals that are governed by and accountable to individuals with lived expertise of housing instability. (Measures depth of impacted community leadership and ownership of prevention efforts)
- Percent of policymakers, system leaders, and other public figures who demonstrate increased understanding and commitment to addressing housing instability as a critical reproductive justice and birth equity issue. (Assesses narrative and norms change impact of prevention advocacy)
- Percent reduction in racial, ethnic, and socioeconomic disparities in rates of homelessness and adverse maternal and child health outcomes among pregnant and postpartum individuals engaged in prevention programs. (Measures impact of prevention on dismantling intersecting systems of oppression)
- Percent of pregnant and postpartum individuals from medically underserved communities who report experiencing homelessness prevention services as affirming of their identities, strengths, and aspirations for their families. (Assesses prevention effectiveness in embodying reproductive and birth justice principles)
|
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] Ervin, E., Poppe, B., Onwuka, A., Keedy, H., Metraux, S., Jones, L., ... & Kelleher, K. (2021). Characteristics associated with homeless pregnant women in Columbus, Ohio. Maternal and Child Health Journal, 1-7.
