Homelessness, Youth
Conditions
Brief summary
This project builds upon initial proof of concept work examining the optimal set of supports for youth who have recently exited homelessness - an intervention comprised of mental health and peer supports alongside transitional case management. This collaborative model will be tested as a proof-of-concept in Thunder Bay with Indigenous youth and a trial will be conducted in Toronto to optimize and determine the effectiveness of the existing model of support.
Detailed description
In response to the challenges outlined above, and with the support of a grant from the Ontario Ministry of Child and Youth Services, the investigators developed and tested a tertiary prevention strategy called the Housing Outreach Program Collaborative (HOP-C) which launched in the summer of 2015. In this approach the investigators focused on collaborations and interventions that have the greatest potential to be effective with this population. The investigators brought together partners from a number of sectors in the GTA and have tested a 3-pronged set of supports (intervention described in detail in the methods): * Transitional Case Management * Mental Health Interventions: Group, individual, family * Peer Support This is an intensive, 6-month critical time intervention - one that jointly addresses many points of vulnerability (mental health crises, housing instability, justice involvement) while fostering resilience and connection with resources in employment, education and training domains. It is unique in both content comprehensiveness and integrated process of delivery. Also important was the development of a collaborative and responsive partnering process, to facilitate effective organizational interfaces and seamless service integration so participants can experience a tailored and coherent set of supports. With CAMH, the Centre for Mindfulness Studies, Covenant House, LOFT, and SKETCH at the service level and the Wellesley Institute leading evaluation, the investigators have carefully attended to a collective impact framework. This initiative has proven feasible and is demonstrating good outcomes - with excellent youth engagement, reports of lower social isolation, improved mental health, and engagement with resources, and spin-off benefits of closer collaboration between organizations. The investigators successfully met the target of youth engagement, with a total of 31 youth participating, minimal attrition (n=2), and the investigators observed no indications that HOP-C resulted in risk of any form, both with respect to the intervention itself and the mixed methods research methodology. This promising feasibility work formed the foundation from which the investigators were successful in obtaining a grant from the Local Poverty Reduction Fund to support the study described in this proposal. Current Project Determine through a randomized trial in Toronto if the positive outcomes the investigators are observing are due solely or primarily to transitional case management and if the additional peer and mental health components are necessary. Engaging in intensive, tertiary prevention shows clear promise in disrupting a cycle of poverty and marginalization at a critical time - if proven and scaled a key driver of chronic homelessness would be addressed. Research Questions The objective of this two-part project is to examine the effectiveness and transferability of the Housing Outreach Program-Collaboration (HOP-C) transitional intervention. HOP-C has proven to be feasible with promising outcomes in the Toronto proof-of-concept work currently underway. 1\. Are the benefits of the complex HOP-C intervention with all components in place greater than transitional case management in isolation? • It is hypothesized that the full model will provide benefit in domains of housing stability, mental health, and quality of life that are significantly greater than case management alone. The investigators have data in hand from their recent national work in the area which provides data on 'treatment as usual' or the outcomes that attend typically available supports. The proposed trial will unpack benefit and be essential in economic and viability arguments to be made going forward.
Interventions
BEHAVIORALHOP-C
Service provision will be provided by Loft and Covenant House for the transitional case management component, the peer component will be supported through Sketch Arts, and the mental health component will be provided by a post-doctoral fellow clinical psychologist and a mindfulness therapist from the Centre for Mindfulness Studies, supervised by Dr. Sean Kidd.
BEHAVIORALTransitional Case Management Only
Participants in this arm will be provided with a transition-focused community support worker who will assist in areas ranging from general support and encouragement to assistance in navigating relevant systems. They will have weekly contacts with participants by phone, informal contact via text and email, and at least twice per month will visit the participant where they are residing. It is expected that all participants will engage a community support worker. The transitional case manager hired into this role will be highly experienced in case management for youth.
Sponsors
Centre for Addiction and Mental Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
16 Years to 26 Years
Healthy volunteers
No
Inclusion criteria
* between the ages of 16 and 26 * have obtained secure housing in a time period up to 12 months previously
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Housing | Change from Baseline to 6 months | Participants coded in a binary manner as having gained or sustained housing (binary positive) or lost (binary negative) based on assessment of the participant's trajectory from baseline to 6 months. |
| Employment/Education | Change from baseline to 6 months | Participants coded in a binary manner as having gained or sustained education or employment (binary positive) or lost (binary negative) based on assessment of the participant's trajectory from baseline to 6 months. |
| Mental Health | Change from baseline to 6 months | Participants coded in a binary manner as having gained or sustained mental health status without crises (binary positive) or experienced a crises that impacted major life domains (binary negative) based on assessment of the participant's trajectory from baseline to 6 months. |
| Housing Security Scale | Change from Baseline to 6 months | The Housing Security Scale contains 12 items on a 5 point likert scale (Frederick et al., 2014). Scores range from strongly disagree (minimum = 1) to strongly agree (maximum = 5). Higher scores indicate better outcomes. Mean item range is 1-5 with pre-post difference reported. |
| Housing Security Scale (Subjective Housing Stability Subscale) | Change from Baseline to 6 months | The Housing Security Scale contains a 4 item subscale that measures subjective housing satisfaction and perception of housing stability (Frederick et al., 2014). Scores range from strongly disagree (minimum = 1) to strongly agree (maximum = 5). Higher scores indicate better outcomes with a mean range of 1-5 with pre-post change reported. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adults Hope Scale | Change from baseline to 6 months | Adult Hope Scale, a cognitive measure of hope, was employed. This self-report questionnaire contains 8 questions that are each scored on an 8 point Likert scale with scores ranging from Definitely False to Definitely True. Higher scores indicate better outcomes. Mean item range is minimum 1 to maximum 8 with pre-post mean differences reported. |
| GAIN Short Screener (CAMH Modified) | Change from baseline to 6 months | Mental health (and addictions) was measured using the Global Assessment of Individual Needs Short Screener, which includes 22 items scored on a 5 point scale ranging from never (0) as the minimum score and past month (4) as the maximum score. Higher scores indicate worse outcomes. Mean item range is 0-4 with pre-post mean change reported. |
| Resilience Scale | Change from baseline to 6 months | Resilience will be measured using the 10-item Resilience Scale. Each item score ranges from, at minimum, Not true at all (0) to, at maximum, True nearly all the time (4) with higher scores indicating better outcomes. Mean item range is from 0-4 with pre-post change in means reported. |
| World Health Organization Quality of Life Scale - BREF | Change from baseline to 6 months | The brief World Health Organization Quality of Life Scale - BREF contains 26 items, each scored from 1 to 5 with various labels for each score (e.g. 1= very poor for item 1 and 1= very dissatisfied for item 2). Higher scores indicate better outcomes with a mean item range of 1-5 with pre-post mean change reported. |
| Medical Outcomes Study (MOS) Social Support Survey | Change from baseline to 6 month | We used a modified version of the Medical Outcomes Study Social Support Survey to measure social support. It is a 15-item 5-point Likert-type scale. The maximum score is all of the time (5) and the minimum score is none of the time (1). Higher score indicates better outcome. Item mean range is 1-5 with pre-post mean difference reported. |
| Mental Health Continuum - Short Form | Change from baseline to 6 month | Mental Health Continuum - Short Form assess mental health and addictions by measuring emotional, psychological and social well-being. It contains 14 items on a 6 point scale ranging from at minimum never (0) to, at maximum, every day (5). Higher scores indicate better outcomes. Range is 0-5 (means) with pre-post differences reported. |
| Cognitive and Affective Mindfulness Scale | Change from baseline to 6 months | Cognitive and Affective Mindfulness Scale Revised was used to measure mindfulness and has demonstrated acceptable reliability (Feldman, Hayes, Kumar, Greeson, & Laurenceau, 2007). It contains 10 items. The minimum score is rarely/Not at all (1) and the maximum score is almost always (4). Higher scores indicate better outcomes with a mean item range from 1-4 with pre-post mean change reported. |
| Community Integration Scale | Change from baseline to 6 months | Behavioural and psychological aspects of community integration was examined using Community Integration Scale The scale contains 7 dichotomous questions with higher scores indicating greater community integration (better outcomes). Mean item range is 0-1 with mean change reported. |
| Community Integration Measure | Change from baseline to 6 months | Behavioural and psychological aspects of community integration were examined using the Community Integration Measure. The measure contains 6 items scored on a 5 point scale ranging from, at minimum, always disagree (1) to, at maximum, always agree (5). Higher scores indicating better outcomes with an item mean range from 1-5 with mean pre-post differences reported. |
Countries
Canada
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Transitional Case Management Only Transitional Case Management Only: Participants in this arm will be provided with a transition-focused community support worker who will assist in areas ranging from general support and encouragement to assistance in navigating relevant systems. They will have weekly contacts with participants by phone, informal contact via text and email, and at least twice per month will visit the participant where they are residing. | 31 |
| Full HOP-C Service HOP-C: Service provision will be provided by Loft and Covenant House for the transitional case management component, the peer component will be supported through Sketch Arts, and the mental health component will be provided by a post-doctoral fellow clinical psychologist and a mindfulness therapist from the Centre for Mindfulness Studies, supervised by Dr. Sean Kidd. | 34 |
| Total | 65 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 2 | 4 |
| Overall Study | Withdrew due to high acuity | 1 | 0 |
Baseline characteristics
| Characteristic | Transitional Case Management Only | Total | Full HOP-C Service |
|---|---|---|---|
| Age, Continuous | 21.74 years STANDARD_DEVIATION 2.03 | 21.75 years STANDARD_DEVIATION 2.07 | 21.76 years STANDARD_DEVIATION 2.14 |
| Highest Education Completed High School | 7 Participants | 18 Participants | 11 Participants |
| Highest Education Other/Not Specified | 4 Participants | 9 Participants | 5 Participants |
| Highest Education Some High School | 14 Participants | 21 Participants | 7 Participants |
| Highest Education Transitional Program | 6 Participants | 17 Participants | 11 Participants |
| Homelessness - Lifetime Length 1-2 years | 10 Participants | 16 Participants | 6 Participants |
| Homelessness - Lifetime Length 2-3 years | 1 Participants | 11 Participants | 10 Participants |
| Homelessness - Lifetime Length 3+ years | 13 Participants | 20 Participants | 7 Participants |
| Homelessness - Lifetime Length 6-12 Months | 7 Participants | 18 Participants | 11 Participants |
| NEET - Not in Employment, Education or Training | 14 Participants | 24 Participants | 10 Participants |
| Race/Ethnicity, Customized Black - African | 5 Participants | 8 Participants | 3 Participants |
| Race/Ethnicity, Customized Black - Caribbean | 3 Participants | 7 Participants | 4 Participants |
| Race/Ethnicity, Customized Mixed Heritage | 2 Participants | 6 Participants | 4 Participants |
| Race/Ethnicity, Customized Other/Not Specified | 16 Participants | 34 Participants | 18 Participants |
| Race/Ethnicity, Customized White - North American | 5 Participants | 10 Participants | 5 Participants |
| Sex/Gender, Customized Female | 14 Participants | 26 Participants | 12 Participants |
| Sex/Gender, Customized Other | 17 Participants | 39 Participants | 22 Participants |
| Sexual Orientation Bi-Sexual | 3 Participants | 7 Participants | 4 Participants |
| Sexual Orientation Heterosexual | 21 Participants | 43 Participants | 22 Participants |
| Sexual Orientation Other/Not Specified | 5 Participants | 11 Participants | 6 Participants |
| Sexual Orientation Prefer not to answer | 2 Participants | 4 Participants | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 31 | 0 / 34 |
| other Total, other adverse events | 0 / 31 | 0 / 34 |
| serious Total, serious adverse events | 0 / 31 | 0 / 34 |
Outcome results
Primary
Employment/Education
Participants coded in a binary manner as having gained or sustained education or employment (binary positive) or lost (binary negative) based on assessment of the participant's trajectory from baseline to 6 months.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Transitional Case Management Only | Employment/Education | 18 Participants |
| Full HOP-C Service | Employment/Education | 24 Participants |
Comparison: Full HOP-C Service (Treatment) vs. Transitional Case Management Only (Control)p-value: 0.159Regression, Logistic
Comparison: Full HOP-C Service (Treatment) vs. Transitional Case Management Only (Control)p-value: 0.2Regression, Linear
Primary
Housing
Participants coded in a binary manner as having gained or sustained housing (binary positive) or lost (binary negative) based on assessment of the participant's trajectory from baseline to 6 months.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Transitional Case Management Only | Housing | 25 Participants |
| Full HOP-C Service | Housing | 28 Participants |
Comparison: Full HOP-C Service (Treatment) vs. Transitional Case Management Only (Control)p-value: 0.354Regression, Logistic
Comparison: Full HOP-C Service (Treatment) vs. Transitional Case Management Only (Control)p-value: 0.465Regression, Logistic
Primary
Housing Security Scale
The Housing Security Scale contains 12 items on a 5 point likert scale (Frederick et al., 2014). Scores range from strongly disagree (minimum = 1) to strongly agree (maximum = 5). Higher scores indicate better outcomes. Mean item range is 1-5 with pre-post difference reported.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Housing Security Scale | 0.017 score on a scale | Standard Error 0.129 |
| Full HOP-C Service | Housing Security Scale | 0.153 score on a scale | Standard Error 0.098 |
p-value: 0.899Regression, Linear
p-value: 0.128Regression, Linear
Primary
Housing Security Scale (Subjective Housing Stability Subscale)
The Housing Security Scale contains a 4 item subscale that measures subjective housing satisfaction and perception of housing stability (Frederick et al., 2014). Scores range from strongly disagree (minimum = 1) to strongly agree (maximum = 5). Higher scores indicate better outcomes with a mean range of 1-5 with pre-post change reported.
Time frame: Change from Baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Housing Security Scale (Subjective Housing Stability Subscale) | -0.259 score on a scale | Standard Error 0.196 |
| Full HOP-C Service | Housing Security Scale (Subjective Housing Stability Subscale) | 0.422 score on a scale | Standard Error 0.167 |
p-value: 0.198Regression, Linear
p-value: 0.017Regression, Linear
Primary
Mental Health
Participants coded in a binary manner as having gained or sustained mental health status without crises (binary positive) or experienced a crises that impacted major life domains (binary negative) based on assessment of the participant's trajectory from baseline to 6 months.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Transitional Case Management Only | Mental Health | 20 Participants |
| Full HOP-C Service | Mental Health | 27 Participants |
Comparison: Full HOP-C Service (Treatment) vs. Transitional Case Management Only (Control)p-value: 0.121Regression, Logistic
Comparison: Full HOP-C Service (Treatment) vs. Transitional Case Management Only (Control)p-value: 0.134Regression, Logistic
Secondary
Adults Hope Scale
Adult Hope Scale, a cognitive measure of hope, was employed. This self-report questionnaire contains 8 questions that are each scored on an 8 point Likert scale with scores ranging from Definitely False to Definitely True. Higher scores indicate better outcomes. Mean item range is minimum 1 to maximum 8 with pre-post mean differences reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Adults Hope Scale | 0.218 score on a scale | Standard Error 0.276 |
| Full HOP-C Service | Adults Hope Scale | -0.038 score on a scale | Standard Error 0.099 |
p-value: 0.436Regression, Linear
p-value: 0.706Regression, Linear
Secondary
Cognitive and Affective Mindfulness Scale
Cognitive and Affective Mindfulness Scale Revised was used to measure mindfulness and has demonstrated acceptable reliability (Feldman, Hayes, Kumar, Greeson, & Laurenceau, 2007). It contains 10 items. The minimum score is rarely/Not at all (1) and the maximum score is almost always (4). Higher scores indicate better outcomes with a mean item range from 1-4 with pre-post mean change reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Cognitive and Affective Mindfulness Scale | 0.226 score on a scale | Standard Error 0.099 |
| Full HOP-C Service | Cognitive and Affective Mindfulness Scale | 0.176 score on a scale | Standard Error 0.058 |
p-value: 0.03Regression, Linear
p-value: 0.005Regression, Linear
Secondary
Community Integration Measure
Behavioural and psychological aspects of community integration were examined using the Community Integration Measure. The measure contains 6 items scored on a 5 point scale ranging from, at minimum, always disagree (1) to, at maximum, always agree (5). Higher scores indicating better outcomes with an item mean range from 1-5 with mean pre-post differences reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Community Integration Measure | -0.006 score on a scale | Standard Error 0.239 |
| Full HOP-C Service | Community Integration Measure | -0.051 score on a scale | Standard Error 0.163 |
p-value: 0.98Regression, Linear
p-value: 0.758Regression, Linear
Secondary
Community Integration Scale
Behavioural and psychological aspects of community integration was examined using Community Integration Scale The scale contains 7 dichotomous questions with higher scores indicating greater community integration (better outcomes). Mean item range is 0-1 with mean change reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Community Integration Scale | -0.108 score on a scale | Standard Error 0.075 |
| Full HOP-C Service | Community Integration Scale | 0.008 score on a scale | Standard Error 0.045 |
p-value: 0.163Regression, Linear
p-value: 0.865Regression, Linear
Secondary
GAIN Short Screener (CAMH Modified)
Mental health (and addictions) was measured using the Global Assessment of Individual Needs Short Screener, which includes 22 items scored on a 5 point scale ranging from never (0) as the minimum score and past month (4) as the maximum score. Higher scores indicate worse outcomes. Mean item range is 0-4 with pre-post mean change reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transitional Case Management Only | GAIN Short Screener (CAMH Modified) | Internalizing | -0.124 score on a scale | Standard Error 0.236 |
| Transitional Case Management Only | GAIN Short Screener (CAMH Modified) | Externalizing | -0.151 score on a scale | Standard Error 0.15 |
| Transitional Case Management Only | GAIN Short Screener (CAMH Modified) | Substance Use | -0.308 score on a scale | Standard Error 0.184 |
| Full HOP-C Service | GAIN Short Screener (CAMH Modified) | Internalizing | -0.265 score on a scale | Standard Error 0.191 |
| Full HOP-C Service | GAIN Short Screener (CAMH Modified) | Externalizing | -0.212 score on a scale | Standard Error 0.171 |
| Full HOP-C Service | GAIN Short Screener (CAMH Modified) | Substance Use | -0.291 score on a scale | Standard Error 0.147 |
Comparison: Internalizingp-value: 0.604Regression, Linear
Comparison: Internalizingp-value: 0.177Regression, Linear
Comparison: Externalizingp-value: 0.325Regression, Linear
Comparison: Externalizingp-value: 0.227Regression, Linear
Comparison: Substance Usep-value: 0.106Regression, Linear
Comparison: Substance Usep-value: 0.058Regression, Linear
Secondary
Medical Outcomes Study (MOS) Social Support Survey
We used a modified version of the Medical Outcomes Study Social Support Survey to measure social support. It is a 15-item 5-point Likert-type scale. The maximum score is all of the time (5) and the minimum score is none of the time (1). Higher score indicates better outcome. Item mean range is 1-5 with pre-post mean difference reported.
Time frame: Change from baseline to 6 month
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transitional Case Management Only | Medical Outcomes Study (MOS) Social Support Survey | Emotional Supports | 0.043 score on a scale | Standard Error 0.247 |
| Transitional Case Management Only | Medical Outcomes Study (MOS) Social Support Survey | Tangible Supports | 0.110 score on a scale | Standard Error 0.264 |
| Transitional Case Management Only | Medical Outcomes Study (MOS) Social Support Survey | Affectionate Supports | -0.115 score on a scale | Standard Error 0.297 |
| Full HOP-C Service | Medical Outcomes Study (MOS) Social Support Survey | Emotional Supports | 0.174 score on a scale | Standard Error 0.196 |
| Full HOP-C Service | Medical Outcomes Study (MOS) Social Support Survey | Tangible Supports | -0.003 score on a scale | Standard Error 0.194 |
| Full HOP-C Service | Medical Outcomes Study (MOS) Social Support Survey | Affectionate Supports | 0.333 score on a scale | Standard Error 0.227 |
Comparison: Emotional Supportsp-value: 0.862Regression, Linear
Comparison: Emotional Supportsp-value: 0.382Regression, Linear
Comparison: Tangible Supportsp-value: 0.68Regression, Linear
Comparison: Tangible Supportsp-value: 0.988Regression, Linear
Comparison: Affectionatep-value: 0.701Regression, Linear
Comparison: Affectionatep-value: 0.154Regression, Linear
Secondary
Mental Health Continuum - Short Form
Mental Health Continuum - Short Form assess mental health and addictions by measuring emotional, psychological and social well-being. It contains 14 items on a 6 point scale ranging from at minimum never (0) to, at maximum, every day (5). Higher scores indicate better outcomes. Range is 0-5 (means) with pre-post differences reported.
Time frame: Change from baseline to 6 month
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Mental Health Continuum - Short Form | 0.276 score on a scale | Standard Error 0.157 |
| Full HOP-C Service | Mental Health Continuum - Short Form | 0.077 score on a scale | Standard Error 0.141 |
p-value: 0.091Regression, Linear
p-value: 0.591Regression, Linear
Secondary
Resilience Scale
Resilience will be measured using the 10-item Resilience Scale. Each item score ranges from, at minimum, Not true at all (0) to, at maximum, True nearly all the time (4) with higher scores indicating better outcomes. Mean item range is from 0-4 with pre-post change in means reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transitional Case Management Only | Resilience Scale | 0.252 score on a scale | Standard Error 0.159 |
| Full HOP-C Service | Resilience Scale | 0.093 score on a scale | Standard Error 0.065 |
p-value: 0.124Regression, Linear
p-value: 0.168Regression, Linear
Secondary
World Health Organization Quality of Life Scale - BREF
The brief World Health Organization Quality of Life Scale - BREF contains 26 items, each scored from 1 to 5 with various labels for each score (e.g. 1= very poor for item 1 and 1= very dissatisfied for item 2). Higher scores indicate better outcomes with a mean item range of 1-5 with pre-post mean change reported.
Time frame: Change from baseline to 6 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transitional Case Management Only | World Health Organization Quality of Life Scale - BREF | Physical Health | 0.201 score on a scale | Standard Error 0.552 |
| Transitional Case Management Only | World Health Organization Quality of Life Scale - BREF | Psychological | -0.117 score on a scale | Standard Error 0.432 |
| Transitional Case Management Only | World Health Organization Quality of Life Scale - BREF | Social | 0.308 score on a scale | Standard Error 0.869 |
| Transitional Case Management Only | World Health Organization Quality of Life Scale - BREF | Environment | 0.124 score on a scale | Standard Error 0.596 |
| Full HOP-C Service | World Health Organization Quality of Life Scale - BREF | Environment | 0.843 score on a scale | Standard Error 0.407 |
| Full HOP-C Service | World Health Organization Quality of Life Scale - BREF | Physical Health | 0.717 score on a scale | Standard Error 0.484 |
| Full HOP-C Service | World Health Organization Quality of Life Scale - BREF | Social | 0.099 score on a scale | Standard Error 0.376 |
| Full HOP-C Service | World Health Organization Quality of Life Scale - BREF | Psychological | 0.086 score on a scale | Standard Error 0.355 |
Comparison: Physical Healthp-value: 0.719Regression, Linear
Comparison: Physical Healthp-value: 0.15Regression, Linear
Comparison: Psychologicalp-value: 0.789Regression, Linear
Comparison: Psychologicalp-value: 0.811Regression, Linear
Comparison: Socialp-value: 0.726Regression, Linear
Comparison: Socialp-value: 0.795Regression, Linear
Comparison: Environmentp-value: 0.837Regression, Linear
Comparison: Environmentp-value: 0.048Regression, Linear