Wednesday, December 11, 2024 12/11/2024

A Pragmatic Randomized Trial Integrating Homelessness Diversion Services into an Emergency Department Discharge System

Award Number: R01MD018213
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary/Abstract The COVID-19 pandemic has shined a spotlight on the long-standing problem of homelessness in the U.S., a major public health concern since homelessness is both a cause and contributor to poor mental and physical health. Rising income inequality and disparate access to services/resources among vulnerable populations has been exacerbated by the pandemic which has resulted in a large population of people who are at-risk of becoming homeless. Primary prevention efforts are required to eliminate homelessness but the science of homelessness prevention is limited with no known scientifically rigorous trials testing the impact of homelessness diversion as an intervention for health and housing. Emergency departments (ED) provide an opportune space to target homeless diversion efforts to maximize the reach to individuals with elevated health and housing needs. Our long-term goal is to inform the knowledge base about homelessness diversion, including understanding whether embedding a homeless diversion program within a hospital ED discharge system has health and wellness benefits for the recipients (individuals) and the organizations who serve them (community). Guided by preliminary work and data, this goal will be accomplished through three specific aims to: 1) Determine whether a homelessness diversion program integrated into a hospital ED discharge system will lower ED use via increased housing retention and wellbeing. Our hypothesis is that relative to individuals receiving standard care, individuals who receive homelessness diversion services will have lower emergency department use via increased housing retention and health-related quality of life. Our approach to testing the working hypothesis will be to perform a pragmatic single-blind randomized trial with 1,000 individuals exiting the ED and analyze outcomes over six months. 2) Determine characteristics of individuals most likely to benefit from homelessness diversion. Our approach will be to conduct secondary analyses of data from our randomized trial to identify sociodemographic and clinical factors related to outcomes from homeless diversion services. 3. Discover opportunities to tailor homeless diversion services to better meet the needs of diverse communities. We will conduct surveys and focus groups with 40 diverse homeless diversion clients followed by consideration of key stakeholders. The findings from this project will provide critical information on the most effective strategies for diverting individuals at imminent risk for homelessness, providing an upstream intervention to addressing health inequities among this vulnerable population.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $250,537 )
2025	2025	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	3	11/26/2024	NON-COMPETING CONTINUATION	$250,537
														Subtotal = $250,537

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	2	6/10/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $680,580 )
2023	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	003	2	5/30/2023	NON-COMPETING CONTINUATION	$680,580
2023	2022	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	002	1	11/15/2022	NEW	$592,812
2023	2022	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	001	1	11/14/2022	NEW	-$592,812
2023	2022	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	1	11/3/2022	NEW	$0
														Subtotal = $680,580

Issue Date FY: 2022 ( Subtotal = $592,812 )
2022	2022	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	1	9/26/2022	NEW	$592,812
														Subtotal = $592,812

Grand Total All Awards = $1,523,929

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A Pragmatic Randomized Trial Integrating Homelessness Diversion Services into an Emergency Department Discharge System

Award Number: R01MD018213

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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