What evidence is there for housing interventions being effective at improving the wellbeing (both current and future, and community wellbeing) of housing- vulnerable adults? Where there is evidence of interventions’ effectiveness, what evidence is there of their cost effectiveness?
Which housing security and wellbeing outcomes are experienced by which groups of people including people from different socio-economic backgrounds, different demographics (such as ethnicity, age or gender) or with different circumstances (drawing upon UK anti-discrimination law categories where relevant to the studies identified e.g. disability, sexual orientation, religion etc.)?
How do housing security and wellbeing outcomes achieved relate to particular circumstances, context and time periods of the delivery of the interventions?
We will search for evidence published in English from 2005 to present. The search will have a number of stages:
1. Targeted searches of databases. Databases to be searched are MEDLINE, EMBASE, EconLit and PsycINFO via OVID, ASSIA via ProQuest and Social Sciences Citation Index via Web of Science.
2. Scrutiny of the introduction/background/reference list of papers retrieved to identify additional papers.
3. Citation searching of particularly relevant papers retrieved though Stages 1-2
4. Identification of grey literature, likely to be mostly through topic experts, the Review Advisors and contacts through the What Works Centre for Wellbeing
5. Search of topic relevant UK websites which potentially contain relevant evidence
• Joseph Rowntree Foundation
• Housing LIN
• King’s Fund
• NHS Alliance ‘Housing for Health’
• National Housing Federation
• Homeless link
• Rethink Mental Illness
• Local Government Association (including Homes and Communities Agency)
• Development for Communities and Local Government
• National Development Team for Inclusion (NDTi)
• Chartered Institute of Housing (CIH)
• Mayday Trust
• Family Mosaic
• Young Foundation
• The Bromford Deal
• Lankelly Chase
• Housing Diversity Network
• Friends, Families and Travellers: http://www.gypsy-traveller.org/
• The Foyer Federation
• The Housing Plus Academy
6. Search discussion papers, publications and activities of UK university research centres and groups focused on housing research –
• Centre for Housing Policy (York)
• Cambridge Centre for Housing and Planning Research
• Centre for Housing Research (St Andrews)
• Housing and Communities Research Group (Birmingham)
• Institute for Social Policy, Housing, Equalities Research (I-SHERE), Heriot Watt, Edinburgh
• Urban Studies, Glasgow
• Centre for Regional Economic and Social Research (CRESR), Sheffield Hallam
7. Targeted call for evidence through the What Works Centre for Wellbeing to identify missing evidence.
Types of study to be included
We will include studies which use experimental and observational designs, and also qualitative studies and surveys. We will include grey literature from the UK which meets our inclusion criteria. If relevant systematic reviews of reasonable methodological quality are identified, we will include these in the synthesis without quality assessment and data extraction of their individual included studies.
We will exclude studies which provide only descriptive information or opinions, rather than quantitative or qualitative data.
Condition or domain being studied
Housing and wellbeing outcomes associated with housing interventions for vulnerable people
Adults who are housing-vulnerable where an existing vulnerability risks worsening their housing outcomes. This includes the groups listed below.
• Homeless people, rough sleepers, roofless people, living in temporary accommodation, past experience of homelessness/rough sleeping. Including homeless people in rural areas.
• People with experience of poor mental health
• People with a learning disability
• Domestic violence victims
• Asylum seekers, refugees
• Recent immigrants
• Substance users
• Travellers, Gypsies
• Troubled families
• Teenage parents
• Care leavers
• Those with a long term disability, including sensory impairments
• Those with complex needs and multiple disadvantage
• People living in severe overcrowding or with short term tenancies
We will include any housing interventions designed to avoid homelessness or unstable housing. This will include:
• supported housing / accommodation / living
• independent living
• specialist housing
• service-enriched housing
• sheltered accommodation
• community supportive/ supported housing / accommodation
• extra care
• housing-led and housing first models
• transitional living program
• recovery housing/re-housing
• managed alcohol program and housing/re-housing
• homeless and housing/re-housing
• temporary housing support
• floating support
• community investment (from a housing provider)
We will exclude housing interventions for the elderly unless they relate to security of housing status and housing interventions related to physical adaptations to the home
We will include quantitative studies which compare different interventions including those using a before and after design and comparing new versus current practice. Quantitative studies which do not have any comparator will not be included. Qualitative studies without a comparator will be included where they are linked to a particular housing intervention. Studies which draw comparisons to UK population norms will also be included.
We will include studies which have been carried out in the UK, and other countries which are members of the Organisation for Economic Co-operation and Development (OECD). Research in other developed (OECD) countries is likely to have less relevance to the UK context, although we will consider the applicability of the international literature to the UK housing and policy context in the analysis, and highlight any limitations on applicability of individual studies. A judgement of the likely relevance to the UK will be made prior to data extraction. This will include aspects of the comparability of the social security system and welfare state, the comparability of the baseline position of participants prior to interventions and consideration of the broader context of the interventions.
We adopt a broad perspective on the outcomes to be included in the review, and will include studies which report any outcome relating to any of eight domains of wellbeing as defined by the Office for National Statistics (2015). This encompasses outcomes relating to people using housing interventions and/or their family and carers. It includes quantitative (measured) outcomes, and qualitative (views and perceptions) outcomes, together with direct and indirect cost effectiveness outcomes (including housing, health and social care resource use). We include studies which report only intermediate housing outcomes which may indirectly be linked to wellbeing outcomes through separate modelling work. We also include outcomes which can be linked to community wellbeing.
We include studies which report only intermediate housing outcomes which may indirectly be linked to wellbeing outcomes through separate modelling work. We also include outcomes which can be linked to community wellbeing.
Data extraction, (selection and coding)
All titles and abstracts will be screened by one reviewer with a subset (about 10%) of the titles and abstracts being screened by a second. A calculation of inter-rater agreement will be made. Any queries will be resolved by discussion. A similar process will be followed for final decisions on inclusion/exclusion based on full-text documents.
Data extraction of each full paper into a pre-agreed evidence table will be undertaken by one reviewer and checked for accuracy by another. Periodically throughout the process of data extraction, a random selection will be considered independently by two people (that is, double assessed). At least 10% of the studies will be double-assessed. Any differences will be resolved by discussion or recourse to a third reviewer.
Data to be extracted will include study design; country and setting; population and sample size; details of the intervention; study duration; outcomes assessed; and main findings/conclusions. Similar data will be extracted for qualitative studies.
The review team are aware that there may be data in graphical form to be extracted, for example, logic models. These will be extracted in order to inform development of our conceptual pathway and used in the evidence synthesis.
Risk of bias (quality) assessment
We will conduct quality assessment of all studies (or individual aspects of studies) using the appropriate checklist following the formal rating methodology recommended by the What Works: Wellbeing Methods Guide. Each full paper will be assessed by one reviewer. Periodically a random selection will be considered independently by two people with at least 10% of the studies being double-assessed. Any differences in quality grading will be resolved by discussion or recourse to a third reviewer.
In this review we propose to be inclusive and use studies that are of low quality, explicitly describing the implications of including them. Risk of bias assessment will influence the synthesis through its role as part of the tools we will use to assess the overall strength of evidence for each outcome
Strategy for data synthesis
A narrative synthesis of the findings will be undertaken. We will attempt to produce a conceptual pathway of how wellbeing is related to housing for vulnerable people, based on the evidence retrieved.
We will also generate an evidence map, which tabulates the identified evidence in terms of which dimensions of wellbeing and which aspects of housing for vulnerable people they address.
We will provide a judgement on the overall quality of the evidence for each individual finding in the review, adopting the GRADE rating for quantitative evidence and CERQual approaches for qualitative evidence. If studies are identified for which meta-analysis could be appropriately used to combine findings, we will do so.
Using the GRADE approach we will identify implications for practice based on the review findings. We will keep an evidence gap register and make recommendations about how gaps can be filled and where further research is required.
Analysis of subgroups or subsets
Studies conducted in UK settings will be analysed separately
We will publish the review report via the What Works Centre for Wellbeing, including a summary document in plain English. We also plan to present the findings to groups of relevant stakeholders, including housing professionals, policy-makers and service users. We may publish a peer-reviewed journal article or articles summarising the findings
Contact details for further information
Section of Public Health
University of Sheffield
Regent Court, 30 Regent Street
Sheffield, S1 4DA
Organisational affiliation of the review
What Works Centre for Wellbeing
Mr Duncan Chambers, ScHARR, University of Sheffield Ms Anna Cantrell, ScHARR, University of Sheffield Dr Louise Preston, ScHARR, University of Sheffield Dr Tessa Peasgood, ScHARR, University of Sheffield Mr Mark Clowes, ScHARR, University of Sheffield Dr Suzy Paisley, ScHARR, University of Sheffield
Anticipated or actual start date
03 January 2017
Anticipated completion date
29 September 2017
What Works Centre for Wellbeing
Conflicts of interest
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Adult; Housing; Humans
Stage of review
Date of registration in PROSPERO
02 March 2017
Date of publication of this revision
02 March 2017
Stage of review at time of this submission
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Risk of bias (quality) assessment
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.