The At Home/Chez Soi Canadian Study of Housing First for people who are homeless and mentally ill: study design and baseline data for the Montreal site
Notice bibliographique
Résumé
Background/Objectives: The „Pathways to Housing“ service model for helping people who are homeless and severely mentally ill, developed in New York City, involves providing immediate access to a choice of subsidized, scattered site apartments, together with a recovery-oriented adaptation of Assertive Community Treatment. U.S. evidence suggests that this variant of the „Housing First“ approach is more effective than traditional, step-wise services at helping people to become and remain housed, while increasing perceived choice with regards to housing. It has not yet been experimentally evaluated outside the United States, however. There is even less evidence concerning how this model can be adapted to homeless persons with less severe mental illness. A CAN$110-million, 5-year experimental study of both the Pathways version of Housing First, and an Intensive Case Management (ICM) adaptation for people with less severe mental illness, has been mounted in Canada. Called „At Home/Chez Soi“, the study is being carried out simultaneously in 5 Canadian cities: Vancouver, Winnipeg, Toronto, Montreal, and Moncton. After a brief description of the genesis and organization of the study, the experimental approaches being tested in each city will be described. The common screening and psychometric instruments that form the core batteries being used in each city will be described. Implementation and sub-studies at the Montreal site will be described in more detail. Baseline data on the participant sample in Montreal will be provided. Methods: Recruitment and randomisation to experimental conditions and treatment as usual began in October 2009. By June 2011 about 2,300 participants, including 500 in Montreal, are expected to have been recruited. A common data collection protocol, involving both quantitative and qualitative measures, spanning many dimensions including recovery, with a follow-up period of 2 years, is being administered in each city. An algorithm assigns recruited participants to a high needs (Housing First + ACT) or moderate needs (Housing First + ICM) group based on their diagnoses (including concurrent substance use disorders) and functional difficulties. Results: To date, over 300 participants have been recruited in Montreal, of whom 71% are male, with an average age of 44 years. Baseline data and correlational analyses on the entire sample will be presented, spanning the following domains: sociodemographics, housing history, Axis I mental health diagnoses, substance use disorders, symptoms (Colorado Symptom Index), functioning (Multnomah Community Ability Scale), physical and mental health (SF-12), health-related quality of life (EQ-5D and SF-6D), recovery (Recovery Assessment Scale), employment status, income, and health and justice service use. Discussion/Conclusions: The At Home/Chez Soi study is an ambitious study of Housing First approaches for homeless people with mental illness. It is currently proceeding as planned. Challenges associated with implementation will be discussed. Funding: Mental Health Commission of Canada.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,011 | 0,002 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,004 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».