Impact of Shelter Diversion

Last registered on November 01, 2023

Pre-Trial

Trial Information

General Information

Title
Impact of Shelter Diversion
RCT ID
AEARCTR-0012368
Initial registration date
October 26, 2023

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
November 01, 2023, 3:49 PM EDT

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

Locations

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Primary Investigator

Affiliation
University of Notre Dame

Other Primary Investigator(s)

PI Affiliation
University of Colorado Boulder
PI Affiliation
University of Nebraska-Lincoln

Additional Trial Information

Status
In development
Start date
2023-10-26
End date
2027-04-26
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Family Promise of West Michigan, Family Promise of Spokane, and the Lord’s Place (located in West Palm Beach) are three nonprofit organizations dedicated to fighting homelessness in their local communities. As part of this mission, these organizations participate in diversion conversations with clients who are experiencing housing crises, searching for solutions that could keep them out of homeless shelters. These organizations and LEO want to examine the impact of supplementing these conversations with additional support and resources. In a randomized controlled trial, eligible clients will be randomly assigned to receive either a diversion conversation alone, a diversion conversation with flexible financial assistance available, or a diversion conversation, flexible financial assistance, and proactive follow-up case management. Researchers will track the outcomes of those in each treatment group who receive additional support and those in the control group who receive only the standard diversion conversation in order to make conclusions about the effectiveness of these new support services.
External Link(s)

Registration Citation

Citation
Billings, Stephen, william evans and Daniel Tannenbaum. 2023. "Impact of Shelter Diversion." AEA RCT Registry. November 01. https://doi.org/10.1257/rct.12368-1.0
Experimental Details

Interventions

Intervention(s)
When a staff member from a partner organization comes into contact with a new client who is experiencing a housing crisis, they will speak with them to assess their situation and needs. If the staff member determines that the client could potentially be diverted and that financial assistance could have a positive impact on the likelihood of their being diverted, they will inform them about the study and possible availability of resources. If these eligible clients consent, they will be enrolled into the study. Participation in the study is completely voluntary and will not affect a client’s access to standard care. Whether or not these clients give their consent to participate in the study, partner staff will use a randomizer provided by the research team to assign them to either receive the standard diversion conversation with no additional resources, a diversion conversation with flexible financial resources available, or a diversion conversation with both flexible financial resources and follow-up case management. Clients are randomized regardless of their consent so that all eligible clients have the same chances of receiving additional resources, but only those who consent will be enrolled in the study for researchers to track their outcomes. Consent, enrollment, and randomization will take place either during the initial intake conversation or during another conversation shortly following it. After randomization, the diversion conversation will continue as usual, with the only change being that clients in the treatment groups will be offered flexible financial assistance. This assistance will initially be capped at $500, although more will be offered in some circumstances. If clients are assigned to receive proactive case management, partner staff will reach out to them once a week for up to 60 days after they have been diverted from shelter. Staff will not reach out to clients who are not assigned to proactive case management, but these clients may reach out to the providers for additional resources and will receive the support they request.
Intervention Start Date
2023-10-26
Intervention End Date
2026-04-26

Primary Outcomes

Primary Outcomes (end points)
Homelessness and shelter diversion
Primary Outcomes (explanation)
Outcomes of homelessness and shelter diversion will be constructed using HMIS data, at 2, 6, and 12 months following an initial diversion conversation, to measure (i) any contact with homeless service providers publicly contracted with the regional CoCs and (ii) emergency shelter entry.

Secondary Outcomes

Secondary Outcomes (end points)
Short- and long-term housing stability
Creditworthiness
Benefits usage
Income
Employment
Criminal justice
Secondary Outcomes (explanation)
Measurements of housing stability will be constructed using recorded address changes from Infutor. Creditworthiness will be constructed using credit score and total balance in delinquent accounts using data from Experian. Benefits usage, income, employment, and criminal justice outcomes will come from various administrative sources within each state, pending approval, that will be specified in a pre-analysis plan.

Experimental Design

Experimental Design
Using a randomized controlled trial design, LEO and its partner organizations hope to answer the research question: what is the impact of offering flexible financial assistance during diversion conversations, with and without proactive follow-up case management, on whether individual are diverted from shelter, short- and long-term housing stability, and long-term outcomes such as benefits usage, income, and employment? Study enrollment will occur starting in October 2023 and continuing through April 2026. Partner staff will screen new clients for study eligibility during their initial intake conversation, before carrying out a full diversion conversation with clients. Clients will be eligible to participate in the study if the staff member completing their intake determines in this conversation that they could potentially be diverted and that financial assistance could have a positive impact on the likelihood of them being diverted. Once partner staff have determined that a client is eligible, they will inform them about the study, give them the opportunity to consent to research, and, whether or not they consent, randomly assign them to a treatment or control group before continuing with their diversion conversation. Randomization odds are 50:25:25 for control and each of the treatment arms, respectively. All clients will have the same likelihood of receiving the treatments, whether or not they consent, but they will only be included in the study if they consent to participate. Randomization will take place using Stata and Qualtrics.
The diversion conversation is the standard of care at our partner organizations. While some of the partners have had financial assistance available as part of the diversion conversation in the past, funds have been limited and were not always available to clients. The introduction of randomization, consistent availability of financial assistance for the treatment group, and proactive follow-up case management is experimental. These processes have been instituted as part of the research study. The purpose of this project is to determine the effectiveness of offering additional support along with a diversion conversation for clients experiencing housing crises. The results of this study will help LEO’s partner organizations decide where they should allocate their resources and what types of support will make the largest impact for their clients. Should flexible financial assistance alone or in combination with proactive follow-up case management be effective in increasing diversions from homeless shelters and future housing stability, it will provide each organization the opportunity to scale up these support services. The results from this study will also contribute to the general scientific knowledge on which interventions effectively prevent homelessness. Partner organizations will send a list of clients who are participating in the study and baseline data on clients that they gather during the diversion conversation to the research team, who will use this data to track participants’ outcomes using administrative data from applicable state agencies.
Experimental Design Details
Not available
Randomization Method
Stata and Qualtrics
Randomization Unit
Household
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
3,200 households
Sample size: planned number of observations
3,200 households
Sample size (or number of clusters) by treatment arms
1,600 households control (diversion conversation)
800 households treatment 1 (diversion conversation, flexible financial assistance)
800 households treatment 2 (diversion conversation, flexible financial assistance and proactive case management)
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
The study will initially carry out 2.5 years of enrollment, though we also plan to track interim outcomes while the study is still enrolling. We primarily plan to compare outcomes between clients who had access to flexible financial assistance and those who did not. 2.5 years of enrollment will generate a sample size of approximately 3,200 households for this comparison. We assume that an average of 40 percent of clients who are not offered flexible financial assistance remain out of homeless shelters for the next 60 days. After 2.5 years of enrollment, with our expected take-up rate of 90% for financial assistance, we will be able to detect a 5.11 percentage point increase in the proportion of clients who are successfully diverted and remain out of homeless shelters for the next 60 days. We will also compare outcomes between clients who received organization-oriented case management and clients who received client-initiated case management to determine the impact of organization-oriented case management. 2.5 years of enrollment will give us a sample size of 1,600 for this comparison. We assume that on average 90 percent of clients who are offered financial assistance and client-initiated case management will remain out of homeless shelters for 60 days. After 2.5 years of enrollment, with our expected take-up rate of 60% for organization-initiated case management, we will be able to detect a 6.64 percentage point increase in the proportion of clients who are successfully diverted and remain out of homeless shelters for the next 60 days.
Supporting Documents and Materials

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IRB

Institutional Review Boards (IRBs)

IRB Name
University of Notre Dame Institutional Review Board
IRB Approval Date
2023-10-10
IRB Approval Number
23-09-8087