Hi everyone, Justin at CARES recommended the group so thought that I would post some details of an up-and-coming study that may be of interest. My background and day job is in policy consultancy but I am also a student at London University (UCL EOI). Job wise, I am currently supporting a council just outside London with the development of its homelessness prevention work. I have encouraged them to commission a realist study as, in common with most councils, they struggle to address homelessness in a strategic, coherent way. It seems that this is largely because there is little understanding of the mechanisms of cause and factors of context associated with homelessness prevention outcomes and their variation. This makes it difficult to establish the effectiveness of prevention activity and to establish its validity and reliability. While prevention has been widely adopted within homelessness services, it suffers from an absence of work to understand the causal mechanisms for homelessness per se at the micro, meso and macro contextual levels and there is a pressing local need to address questions such as “why do some households who are economically disadvantaged become homeless and others do not?”. It seems likely, therefore, that the study will need to adopt a balanced approach to understanding the causal mechanisms by which homelessness is produced and relieved, including through temporary accommodation, and understanding the mechanisms associated with its prevention and the effectiveness of the homelessness prevention team.

My thinking in encouraging a realist study is informed by the view of Bernadette Pauly and colleagues (2014)  that theory driven approaches to evaluation are well suited to understanding the effectiveness of  homelessness interventions. A realist study of homelessness prevention might also support the development of realist work in social welfare advice. This currently includes a study of the role of the advice sector in enabling improved health but not, I believe, homelessness outcomes (Forster et al 2016). I found the social welfare study Gill Westhorp and colleagues (2016) undertook using realist action research really valuable and helpful and the council are keen to incorporate realist action research to support the  development of the homelessness prevention team. It also it seems to me that a realist study of homelessness prevention might advance understanding of the interconnected policy priority areas of housing, welfare and work and support the development of realist public health work in general.

It seems likely that some synthesis will be needed to identify the patterns of context and outcomes in the literature on homelessness prevention and explain the mechanisms through which outcomes occur and then develop an explanatory framework. Possible candidate theories to test include solution focussed theory, the theory of self-efficacy/empowerment, the theory of self-sufficiency, behaviour theories of choice, the theory of motivational interviewing, the theory of patient activation and the theory of reflective practice. Method wise would a quasi-experimental design compatible with realist methodology such as Interrupted Time Series (ITS) observations also be possible? 

Anyway, at risk of too long a post any initial comments, thoughts and expressions of interest would be very welcome. This will be a 2 year study to start in the next financial year. DCLG have provided initial some funding as although this is a local evaluation the council is a DCLG ‘trailblazer’ homelessness prevention site and they will be interested in generalisable knowledge.

Thanks

Best wishes

Larraine

Forster N, Dalkin SM, Lhussier M,Hodgson P, Carr SM et al (2016) Exposing the impact of Citizens Advice Bureau services on health: a realist evaluation protocol et al.  BMJ Open 6 e009887.

doi:10.1136/bmjopen-2015- 009887

Pauly B, Wallace B, Perkin K (2014) Approaches to evaluation of homelessness interventions, Housing Care and Support, 17 (4) 177-187, Emerald Group Publishing, UK

Westhorp G, Stevens K, Rogers P (2016). Using realist action research for service redesign, Evaluation, 22(3) 361–379, Sage, UK