HIV-specific housing in the changing world of HIV and housing
Abstract Format : Background: The community-based research team identified a need for outcome measures and outcome evaluation to support program delivery and sustain funding for HIV supported housing services, particularly for services for people living with HIV with complex needs (i.e., those best served with high tolerance, low barrier HIV supported housing). The aim of the project was to support HIV supported housing agencies in western Canada to collaboratively develop outcome measures and tools for high tolerance, low barrier HIV supported housing, so that these measures and tools may be used in program evaluation and services improvement.
Methods : Methods: The project used a participatory program evaluation approach, and aimed not to impose measures from a preconceived framework, but to build measures that are relevant and useful to service users and HIV supported housing services staff. Our team consisted of service providers, peer researchers (i.e., people living with HIV), and academic and community-based researchers and evaluators. As part of the developmental work for the project, the team conducted key informant interviews (including with service providers and residents of HIV supported housing services) in participating communities to create HIV housing service maps, fact sheets and supporting tables. In order to develop the outcome tool, we: a) held a team workshop to identify key client outcomes based on current tools used by participating agencies as well as a literature search and an environmental scan of relevant tools; b) conducted interviews with residents and family members to identify outcomes of importance to them; c) held a second team meeting to develop the common outcome tool; d) pilot tested the preliminary tool with 5 residents in 3 participating agencies; e) produced a final tool and Guide for Administration of the tool.
Results : Results: We developed two tools, a baseline (on entry) tool, and a follow-up tool, which is intended to be used at regular intervals (e.g., annually). The final baseline tool consists of approximately 75 items in 8 categories, including physical health (e.g., at your last visit to your doctor, what was your viral load?), substance use (e.g., do you have an active substance use challenge?), housing history (in the past 12 months, have you experienced homelessness?), and quality of life (how would you rate your overall quality of life?). The final follow-up tool consists of 90 (follow-up) items in 9 categories, with the addition of a community engagement category (e.g., Since moving to the program, I feel like I have made progress towards my goals). It was important to consider several factors when designing the tools, including the domains of interest, potential stigmatizing language, triggers, sensitivity around continuing substance use, and reframing ideas of ‘success’ based on client feedback. This tool is designed to be easily integrated into regular program functioning, to generate discussion of issues with clients, and to aid in program evaluation.
Conclusions : Conclusions: Participating agencies in western Canada will use the outcome tools to directly inform HIV supported housing services program delivery, and the outcome tools will also will create the foundation for outcome studies in participating HIV supported housing services.