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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. Service-Enriched Housing

Approach. Develop service-enriched housing communities to increase housing stability for families with limited financial resources or experiencing homelessness.

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Overview. Service-enriched housing is permanent, basic rental housing in which social services are available onsite or by referral through a supportive services program or service coordinator.[1] Housing and services can be provided by nonprofit, private, or government organizations; housing options can be unsubsidized, government assisted, mixed income, or a combination. Programs often support families with limited financial resources, older adults, people with disabilities, or veterans.[1, 2, 3] Some service-enriched housing programs also assist families or individuals experiencing homelessness; programs that support households experiencing homelessness are often referred to as permanent supportive housing.[4]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Resident demographics and housing data
  • Service utilization and engagement data
  • Program costs and resource utilization data

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.
  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.

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. Community Organizing (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-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 families with limited financial resources or experiencing homelessness who apply for service-enriched housing services through service coordinators or case managers. (Shows demand and reach of the program)
  • Number of service coordinators or case managers hired to provide on-site support in service-enriched housing. (Indicates capacity for resident services)

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

  • Percent Of families with limited financial resources or experiencing homelessness who apply for service-enriched housing services through service coordinators or case managers. (Shows demand and reach of the program)
  • Percent Of service coordinators or case managers hired to provide on-site support in service-enriched housing. (Indicates capacity for resident services)

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

  • Number of community partnerships developed to provide comprehensive services in service-enriched housing. (Shows collaboration for holistic support)
  • Number of property management staff trained in trauma-informed practices. (Indicates capacity building for supportive housing)
  • Number of families in Title V-sponsored service-enriched housing who access physical and mental health services. (Shows connection to essential health support)
  • Number of children in Title V-sponsored service-enriched housing who maintain consistent school attendance or demonstrate improved academic performance. (Indicates impact on child stability and success)

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

  • Percent of Title V- sponsored service-enriched housing units that are usable and accommodating for residents with disabilities. (Shows commitment to community-wide reach)
  • Percent of Title V- sponsored service-enriched housing staff who reflect the resident population serves. (Indicates responsiveness)
  • Percent reduction in the number of families experiencing homelessness in the community after the introduction of Title V-sponsored service-enriched housing. (Shows community-level impact)
  • Percent of families with limited financial resources or experiencing homelessness who are diverted from higher-intensity interventions through Title V-sponsored service-enriched housing. (Indicates prevention of crisis and system involvement)

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] Sturtevant 2015 - Sturtevant L, Brennan M, Viveiros J, Handelman E. Housing and services needs of our changing veteran population. Washington, DC: National Housing Conference and Center for Housing Policy; 2015.

2 Castle 2016 - Castle N, Resnick N. Service-enriched housing: The staying at home program. Journal of Applied Gerontology. 2016;35(8):857-877.

3 Brown 2013b - Brown RT, Thomas ML, Cutler DF, Hinderlie M. Meeting the housing and care needs of older homeless adults: A permanent supportive housing program targeting homeless elders. Seniors Housing & Care Journal. 2013;21(1):126-135.

4 NASEM 2018 - National Academies of Sciences, Engineering, and Medicine (NASEM). Permanent supportive housing: Evaluating the evidence for improving health outcomes among people experiencing chronic homelessness. Washington, D.C.: The National Academies Press; 2018.

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.