Evolving an evidence-based model for homelessness prevention

Health Soc Care Community. 2020 Sep;28(5):1754-1763. doi: 10.1111/hsc.13000. Epub 2020 Apr 23.

Abstract

While some progress has been made in addressing chronic homelessness through supportive models, a comprehensive solution for housing loss must include prevention. The purpose of this article is twofold: to conduct a review of the literature on the domains of the Framework for Homelessness Prevention; and to use literature on the concept of quaternary prevention, preventing the harms of service provision, to theorise an additional domain. The Framework for Homelessness Prevention draws upon theory from public health exploring primary, secondary and tertiary prevention, and also integrates primordial prevention. This leads to a typology of homelessness prevention that incorporates the following five domains: (a) Structural prevention; (b) Systems prevention; (c) Early intervention; (d) Eviction prevention; and (e) Housing stability. By systematically reviewing the literature we build out the evidence-base supporting these domains. The team used research databases, internet searches and retrospective reference list reviews to identify high-quality journal articles on prevention, which were then sorted by level of prevention. Through this process, we evolved our thinking on the Framework in considering that quaternary prevention was not initially included. Therefore, we explored the literature related to quaternary prevention in the context of homelessness and offer a sixth domain for the Framework: Empowerment. Ultimately, a comprehensive Framework for Homelessness Prevention will support communities and governments to more effectively prevent homelessness through upstream approaches.

Keywords: empowerment; framework; homelessness; homelessness prevention; housing first; prevention.

Publication types

  • Systematic Review

MeSH terms

  • Housing / organization & administration*
  • Humans
  • Ill-Housed Persons*
  • Retrospective Studies
  • Social Problems
  • Social Work / organization & administration*