Homeless Health Guidelines

 homeless health

Investigators:

Kevin Pottie (NPI), Claire Kendall, Gary Bloch, Vivian Welch, Vicky Stergiopoulos, Ann Anderman, Peter Tugwell and colleagues received funding from the Inner City Health Associates, Employment and Social Development Canada, Canadian Medical Association, Public Health Agency of Canada to develop Canadian evidence based guidelines to improve health of homeless and vulnerably housed persons.

Who are we?

We have established an evidence-based Homeless Health Research Network (HHRN) in collaboration with researchers, clinical and public health practitioners, people with lived experience of homelessness, medical and public health students, and social and health policy makers. We have developed a homeless health guidelines for Canada. Homeless health guidelines are a set of evidence-based recommendations on how to best address the needs of homeless and vulnerably housed populations in Canada.

Guidelines and Tools

  • CMAJ Guideline: Pottie, K., Kendall, C. E., Aubry, T., Magwood, O., Andermann, A., Salvalaggio, G., Ponka D, Bloch G, Brcic V, Agbata E, Thavorn K, Hannigan T, Bond A, Crouse S, Goel R, Shoemaker E, Zhou Jung J, Mott S, Kaur H, Mathew C, Arya N, Kozloff N, Beder M, Guenter D, Muckle W, Hwang S, Stergiopoulos V, Tugwell P. (2020). Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience. CMAJ: Canadian Medical Association Journal, 192(10), E240. https://doi.org/10.1503/cmaj.190777
  • Family Medicine: Andermann, A., Bloch, G., Goel, R., Brcic, V., Salvalaggio, G., Twan, S., Kendall CE, Ponka D & Pottie, K. (2020). Caring for patients with lived experience of homelessness. Canadian Family Physician, 66(8), 563-570. Available here.
  • H.O.U.S.E. MNEMONIC for Primary Care: Mathies N*, Saad A*, Magwood O, Lee A, Tugwell P, Pottie K on behalf of the Homeless Health Research Network. The Fifth Vital Sign: ‘H.O.U.S.E,’ a practical medical mnemonic that puts ‘housing-first’ and includes social determinants of health for current and post-COVID-19 Emergency and Primary Health Care. Cochrane Equity Methods. January 26, 2021. Available here.

Systematic Reviews

  • Housing and income interventions: Aubry, T., Bloch, G., Brcic, V., Saad, A., Magwood, O., Abdalla, T., Xie E, Mathew C, Hannigan T, Costello C, Thavorn K, Stergipoulos V, Tguwell P, Pottie K. (2020). Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review. The Lancet Public Health, 5(6), e342-e360. https//doi.org/10.1016/S2368-2667(20)30055-4
  • Trust, Safety and Lived Experiences SR: Magwood O, Leki VY, Kpade V, Saad A, Alkhateeb Q, Gebremeskel A,  Rehman A, Hannigan T, Pinto N, Huriu S, Kendall C, Kozloff N, Tweed EJ, Ponka D, Pottie K. (2019) Common trust and personal safety issues: A systematic review on the acceptability of health and social interventions for persons with lived experience of homelessness. PLoS ONE 14(12): e0226306.https://doi.org/10.1371/journal.pone.0226306
  • Case Management SR: Ponka D, Agbata E, Kendall C, Stergiopoulos V, Mendonca O, Magwood O, Saad A, Larson B, Sun AH, Arya N, Hannigan T, Thavorn K, Andermann A, Tugwell P, Pottie K. (2020) The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: A systematic review. PLoS ONE 15(4): e0230896. https://doi.org/10.1371/journal.pone.0230896
  • Campbell Collaboration International Systematic Review: Moledina A, Magwood O, Agbata E, Hung JH, Saad A, Thavorn K, Pottie K. A comprehensive review of prioritized interventions to improve the health and wellbeing of persons with lived experience of homelessness. Campbell Systematic Reviews (2021) https://www.campbellcollaboration.org/better-evidence/prioritised-interventions-people-with-lived-experience-of-homelessness.html
  • Harm Reduction and Substance Use SR: Magwood O, Salvalaggio G, Beder M, Kendall C, Kpade V, Daghmach W, Habonimana G, Marashall Z, Snyder E, O’Shea T, Lennox R, Hsu H, Tugwell P, Pottie K (2020) The effectiveness of substance use interventions for homeless and vulnerably housed persons:  A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder. PLoS ONE 15(1): e0227298. https://doi.org/10.1371/journal.pone.0227298
  • Interventions for Youth SR: Wang, J.Z., Mott, S., Magwood, O.Mathew C, McLellan A, Kpade V, Gaba P, Kozloff N, Pottie K, Andermann A . The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: a systematic review. BMC Public Health 19, 1528 (2019). https://doi.org/10.1186/s12889-019-7856-0
  • Interventions for women: Andermann A, Mott S, Mathew CM, Kendall C, Mendonca O, Harriott D, McLellan A, Riddle A, Saad A, Iqbal W, Magwood O, Pottie K. Evidence-informed interventions and best practices for supporting women experiencing or at risk of homelessness: a scoping review with gender and equity analysis. Health Promot Chronic Dis Prev Can. 2021 Jan;41(1):1-13. English, French. doi:10.24095/hpcdp.41.1.01 
  • Lived experience of migrants: Kaur H, Saad A, Magwood O, Alkhatesh Q, Mathew C, Khalaf G, Pottie K. Understanding the health and housing experiences of refugees and other migrant populations experiencing homelessness or vulnerable housing: A systematic review using GRADE CERQual. 2021, CMAJ Open 20219 (2) E681-E692.  DOI: 10.9778/cmajo.20200109 https://www.cmajopen.ca/content/9/2/E681 
  • Magwood O, Salvalaggio G, Pottie K et al. (2019). Harm reduction and pharmacotherapeutic interventions for the homeless and vulnerably housed: An empty systematic review. Cochrane Equity Methods. [PDF]

Education and Implementation Initiatives

  • Medical Education Curriculum:  Hashmi, S. S., Saad, A., Leps, C., Gillies-Podgorecki, J., Feeney, B., Hardy, C., Falzone N, Archibald D, Hoang T, Bond A, Wang J ,Alkhateeb Q, Penney D, DeFalco Amanada, Pottie K. (2020). A student-led curriculum framework for homeless and vulnerably housed populations. BMC Medical Education, 20(1), 1-7. https://doi.org/10.1186/s12909-020-02143-z

  • Homeless Health Prioritization, Delphi:  Shoemaker ES, Kendall CE, Mathew C, Crispo S, Welch V, Andermann A, Mott S, Lalonde C, Bloch G,  Mayhew A, Aubry T, Tugwell P, Stergiopoulos V, Pottie K. (2020) Establishing need and population priorities to improve the health of homeless and vulnerably housed women, youth, and men: A Delphi consensus study. PLoS ONE 15(4): e0231758. https://doi.org/10.1371/journal.pone.0231758

  • Homeless Guideline Implementation: Magwood, O., Hanemaayer, A., Saad, A., Salvalaggio, G., Bloch, G., Moledina, A., Pinto N, Ziha L, Geurguis M, Aliferis A, Kapade V, Ayra N, Aubry T, Pottie K. (2020). Determinants of Implementation of a Clinical Practice Guideline for Homeless Health. International Journal of Environmental Research and Public Health, 17(21), 7938. https://doi.org/10.3390/ijerph17217938

  • HOUSE Manual for Medical Students  (2021) Lee A,  Baek S. Aubry T, Pottie K (pdf in press)

  • HOUSE CSL Leaders Guide for Medical Students (2021) Baek S, Lee A, Aubry T, Pottie K  (pdf In press)- for CFMS dissemination for all medical school for CSL programs

  • Engagement tools: Pinto N. (2019). Assessing perceptions: A scoping review of qualitative research tools for engaging with vulnerable populations. Cochrane Equity Methods. [PDF]

Forthcoming:.

  • Canadian Association of Emergency Physicians (CAEP) Position Statement: Improving Emergency Care for Patients Experiencing Homelessness (In progress)

PROJECT OVERVIEW

Objective 1 Conduct Delphi consensus processes to prioritize evidence gaps

Objective 2 Conduct systematic reviews with equity considerations on identified priorities and related interventions for the health of people who are homeless and vulnerably housed 

Objective 3 Produce GRADE evidence based recommendations for the health of homeless and vulnerably housed people consideration acceptability, feasibility and local contexts.

Road Map to Our Project:

Road map

Newsletters:

Homeless Guidelines News: Volume 1, Issue 4, May 2019

Homeless Guidelines News: Volume 1, Issue 3, December 2018

Homeless Guidelines News: Volume 1, Issue 2, September 2018

Homeless Guidelines News: Volume 1, Issue 1, April 2018
Le point sur les lignes directrices concernant les sans-abri: Volume 1, numéro 1, avril 2018

PROTOCOL 1:

May 15, 2018: The experiences of homeless and vulnerably housed persons around health and social services. A protocol for a systematic review of qualitative studies. PDF 

PROTOCOL 2:

Campbell protocol:  Pottie et al. A comprehensive review of prioritized interventions to improve the health and wellbeing of persons with lived experience of homelessness. Campbell Systematic Reviews. 2019;15(3):e1048.

PROTOCOL 3: 

July 31, 2018: Harm reduction and pharmacotherapeutic interventions for persons with substance use disorders: A protocol for a systematic review of reviews. PDF

PROTOCOL 4: 

August 10, 2018: Impact of Interventions for Homeless Youth: A Narrative Review using Health, Social, Gender, and Equity Outcomes. PDF