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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Housing Instability: Pregnancy.

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Strategy. Rapid Rehousing Programs (Pregnancy)

Approach. Collaborate with local level organizations to ensure women and children are able to find safe and secure housing

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Overview. Rapid rehousing is a short-term subsidy program that assists individuals experiencing homelessness find affordable permanent housing. It provides up to 12 months of subsidy based on need. Rapid rehousing benefits unhoused families by providing them with immediate access to stable housing, which can have several positive impacts: housing stability, support services, improved well-being, children's stability, prevention of homelessness, and community integration. Overall, rapid rehousing offers a swift and effective solution to help unhoused families secure stable housing and work towards long-term housing stability and self-sufficiency.[1]

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). This strategy is also supported as "Rapid Re-Housing Programs" in the What Works for Health database.

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.

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. Collaboration (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 local organizations engaged as partners in providing rapid rehousing services for pregnant women and their children. (Measures community collaboration and capacity for rehousing)
  • Number of pregnant women and their children identified and referred to rapid rehousing programs. (Assesses reach and tailoring of rehousing efforts)

OUTCOME MEASURES:

  • Number of pregnant women and their children who are successfully placed into safe and stable housing through rapid rehousing programs. (Measures direct impact of rehousing on housing stability)
  • Number of pregnant women in stable housing who access and utilize prenatal care and other health-promoting services. (Assesses effect of housing on maternal health care utilization)

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

PROCESS MEASURES:

  • Percent of rapid rehousing programs that adhere to Housing First principles and practices, emphasizing client choice, harm reduction, and permanency. (Measures fidelity to evidence-based, client-centered housing model)
  • Percent of rapid rehousing staff who are trained in trauma-informed, culturally responsive practices to support pregnant women and their children. (Shows workforce competency and sensitivity)

OUTCOME MEASURES:

  • Percent of pregnant women in rapid rehousing programs who report improvements in their physical and mental health, stress levels, and overall quality of life. (Measures self-reported impact of housing on maternal wellbeing)
  • Percent of families that remain stably housed and avoid returns to homelessness after rapid rehousing intervention. (Shows sustainability and durability of housing outcomes)

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

PROCESS MEASURES:

  • Number of community-based organizations providing health, social, and legal services that are integrated into rapid rehousing programs for pregnant women and their children. (Measures service coordination and systems integration)
  • Number of landlords and property owners engaged as partners in providing housing units for rapid rehousing of pregnant women and their children. (Assesses cross-sector collaboration and shared responsibility for rehousing)

OUTCOME MEASURES:

  • Number of pregnant women and their children in rapid rehousing programs who experience improved maternal and child health outcomes, increased family stability, and reduced intergenerational poverty. (Measures long-term, two-generation impact of rehousing on wellbeing)
  • Number of communities that demonstrate sustained reductions in family homelessness and improvements in birth outcomes and child welfare indicators as a result of institutionalized rapid rehousing efforts. (Assesses population-level, transformative impact of rehousing on community wellbeing)

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

PROCESS MEASURES:

  • Percent of rapid rehousing programs for pregnant individuals and their children that are designed and implemented with leadership from individuals with lived experience of homelessness and other relevant partners. (Measures authentic community engagement and participatory decision-making)
  • Percent of rapid rehousing staff, partners, and policymakers who demonstrate commitment to anti-bias, culturally humble practices and continuous learning and improvement. (Shows intentional culture and capacity building for equity and justice)

OUTCOME MEASURES:

  • Percent reduction in racial, ethnic, and socioeconomic disparities in family homelessness, maternal health, and birth outcomes among pregnant individuals and children engaged in rapid rehousing programs. (Measures impact of rehousing on dismantling systemic inequities)
  • Percent of communities that demonstrate sustained shifts in the structural determinants of family homelessness and maternal-child health inequities, such as systemic bias, gender discrimination, and economic exploitation. (Shows transformative, systems-level impact of rehousing on advancing social justice)

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] Goodsmith, N., Ijadi-Maghsoodi, R., Melendez, R. M., & Dossett, E. C. (2021). Addressing the urgent housing needs of vulnerable women in the era of COVID-19: The Los Angeles county experience. Psychiatric services, 72(3), 349-352.

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.