Prioritization of Homelessness Programming with the South Alamo Regional Alliance for the Homeless

Last registered on January 03, 2023

Pre-Trial

Trial Information

General Information

Title
Prioritization of Homelessness Programming with the South Alamo Regional Alliance for the Homeless
RCT ID
AEARCTR-0010324
Initial registration date
December 13, 2022

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
January 03, 2023, 4:05 PM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
January 03, 2023, 4:18 PM EST

Last updated is the most recent time when changes to the trial's registration were published.

Locations

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Primary Investigator

Affiliation
University of Notre Dame

Other Primary Investigator(s)

PI Affiliation
University of Notre Dame
PI Affiliation
Princeton University

Additional Trial Information

Status
On going
Start date
2022-12-05
End date
2025-12-31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
The South Alamo Regional Alliance for the Homeless (SARAH) is the lead agency empowered to prevent and end homelessness in the San Antonio/Bexar County (Texas) Continuum of Care. Together with the Wilson Sheehan Lab for Economic Opportunities (LEO), SARAH has developed a simplified assessment tool to connect people experiencing homelessness to appropriate housing options and assistance. The tool replaces the current Vulnerability Index - Service Prioritization Decision Assistance Tool (VI-SPDAT) used in SARAH’s Homeless Management Information System (HMIS) system. The research team will launch a randomized controlled trial evaluation to measure the impact of different prioritization rules on housing stability. The goal of the study is to serve 4,000 clients and randomize them equally inside HMIS into data-driven and case-worker-rating prioritization systems that operate on the same numerical scale. After receiving their score, a client will be placed on one central prioritization list for all clients. When new slots open up, clients will be drawn from this list in order of priority, with the most vulnerable clients offered services first. Outcomes measured in HMIS and administrative records will include housing stability, creditworthiness and use of credit, criminal justice involvement, employment, and income.
External Link(s)

Registration Citation

Citation
Cassidy, Michael, Robert Collinson and David Phillips. 2023. "Prioritization of Homelessness Programming with the South Alamo Regional Alliance for the Homeless." AEA RCT Registry. January 03. https://doi.org/10.1257/rct.10324-1.1
Experimental Details

Interventions

Intervention(s)
The actual services that clients receive are all standard care. These include permanent supportive housing, rapid re-housing, and transitional housing programs, all of which already exist and are common in San Antonio and around the country. The experimental portion of the study is to change the prioritization system that determines which people are offered services and test the effectiveness of different versions of that new prioritization system.

All clients will undergo the same assessment process, which will feature a combination of: (1) HUD-mandated data element collection, (2) a minimal number of additional, empirically validated questions that will be used to inform the data-driven tool, and (3) a subjective case worker rating of client vulnerability (4) a brief survey of client preferences for particular program and provider characteristics. Randomization will take place after intake so that both clients and case workers remain blinded to which treatment arm they are assigned. Clients will be automatically randomized inside HMIS into data-driven and case-worker-rating prioritization systems that operate on the same numerical scale. After being rated, they will be placed on one central prioritization list for all clients that is updated weekly on Mondays. When new slots open up, clients will be drawn from this list in order of priority, with the most vulnerable clients offered services first.
Intervention Start Date
2022-12-05
Intervention End Date
2023-12-05

Primary Outcomes

Primary Outcomes (end points)
Returns to HMIS
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Employment
Income
Credit score
Recidivism
Housing stability
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Individuals seeking housing assistance from a (HMIS-connected) coordinated entry access point will undergo an initial screening, during which they will be determined potentially eligible for services. Eligible clients will be consented into the study if they voluntarily choose to participate after completing an assessment. Non-consenting individuals will remain outside the study and data collection but will still be enrolled in services using the same prioritization system as people in the study.
Experimental Design Details
Not available
Randomization Method
Randomization will be done automatically inside of HMIS. Randomization will take place after intake so that both clients and case workers remain blinded to which treatment arm they are assigned. Each client will have a 50-50 chance of being prioritized according to either their data-based or case-worker score.
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
The sample will cover all clients that complete an assessment over a year. Historic HMIS records provided by SARAH from 2016 to 2019 show approximately 6,000 clients come through on average annually. Since we are not certain how often the two systems will disagree, and how much that will reduce the sample, we do not have a planned number of clusters at this time.
Sample size: planned number of observations
We plan to have as many observations as we do clusters.
Sample size (or number of clusters) by treatment arms
Half of all individuals served by SARAH will be prioritized by their case-worker score and the other half will be prioritized by their data-based score.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
The University of Notre Dame Institutional Review Board
IRB Approval Date
2022-10-10
IRB Approval Number
22-08-7359
Analysis Plan

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