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- Factors associated with providers’ work engagement and burnout in homeless services: A cross‐national studyPublication . Lenzi, Michela; Santinello, Massimo; Gaboardi, Marta; Disperati, Francesca; Vieno, Alessio; Calcagnì, Antonio; Greenwood, Ronni; Rogowska, Aleksandra; Wolf, Judith; Loubiere, Sandrine; Beijer, Ulla; Bernad, Roberto; Vargas-Moniz, Maria; Ornelas, José; Spinnewijn, Freek; Shinn, MarybethThe complexity of homeless service users' characteristics and the contextual challenges faced by services can make the experience of working with people in homelessness stressful and can put providers' well-being at risk. In the current study, we investigated the association between service characteristics (i.e., the availability of training and supervision and the capability-fostering approach) and social service providers' work engagement and burnout. The study involved 497 social service providers working in homeless services in eight different European countries (62% women; mean age = 40.73, SD = 10.45) and was part of the Horizon 2020 European study "Homelessness as Unfairness (HOME_EU)." Using hierarchical linear modeling (HLM), findings showed that the availability of training and supervision were positively associated with providers' work engagement and negatively associated with burnout. However, results varied based on the perceived usefulness of the training and supervision provided within the service and the specific outcome considered. The most consistent finding was the association between the degree to which a service promotes users' capabilities and all the aspects of providers' well-being analyzed. Results are discussed in relation to their implications for how configuration of homeless services can promote social service providers' well-being and high-quality care.
- Homeless adults’ recovery experiences in housing first and traditional services programs in seven european countriesPublication . Greenwood, Ronni Michelle; Manning, M; O' Shaughnessy, Branagh; Moniz, Maria João Vargas; Loubiere, Sandrine; Spinnewijn, Freek; Lenzi, Michela; Wolf, Walter; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Ornelas, José; Monteiro, Maria Fátima Jorge; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Rivero, Borja; Julián, Martin; Zmaczynska–Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; Van Loenen, Tessa; Raben, Liselotte; Beijer, Ulla; Blid, Mats; Bispo, Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Leon; Tinland, AurelieAcross Europe, as governments turn to housing-led strategies in attempts to reverse rising rates of homelessness, increasing numbers of Housing First (HF) programs are being implemented. As HF programs become more widespread, it is important to understand how service users experience them compared to the more prevalent traditional treatment-first approach to addressing long-term homelessness. Although there is a large body of research on service users' experiences of Housing First compared to treatment-first in North American contexts, comparatively less is known about how these two categories of homeless services are experienced in the European context. In a correlational and cross-sectional study, part of a larger examination of homelessness in Europe, participants (n = 520) engaged with either HF (n = 245) or traditional services (TS; n = 275) programs in seven countries completed measures of their experiences of services (consumer choice, housing quality, and service satisfaction) and recovery (time in independent housing, psychiatric symptoms, and community integration). Across the seven countries, participants engaged with HF programs reported experiencing more consumer choice, better perceived housing quality, and more satisfaction with services than participants engaged in TS programs. Participants in HF programs also reported a greater proportion of time in independent accommodation, fewer psychiatric symptoms, and more community integration. Varying patterns of association between experiences of services and recovery outcomes were observed. Findings indicate HF consistently predicts greater recovery than TS across diverse sociopolitical and economic contexts. Implications of findings for configurations of homeless services and homeless services policy are discussed.
- Working with people experiencing homelessness in EuropePublication . Gaboardi, Marta; Santinello, Massimo; Disperati, Francesca; Lenzi, Michela; Vieno, Alessio; loubiere, sandrine; João Vargas Moniz, Maria; Spinnewijn, Freek; Greenwood, Ronni Michelle; Wolf, Judith R.; Bokszczanin, Anna; Bernad, Roberto; Blid, Mats; Ornelas, José; Shinn, MarybethIn Europe, the widespread transition from the Traditional Staircase (TS) model to the Housing First (HF) model is transforming the way social service providers work with people experiencing homelessness. This study examined social service providers’ perspectives in both models regarding factors that facilitate or hinder their work. Data were collected through 17 photovoice projects involving 81 social service providers from eight European countries. The results show factors affecting social service providers’ work at three levels: systemic, organizational, and individual. Professionals in TS and HF identified similar topics; however, TS providers discussed more obstacles to work. Implications for practice are discussed.
- European public perceptions of homelessness: A knowledge, attitudes and practices surveyPublication . Petit, Junie; Loubiere, Sandrine; Tinland, Aurlie; João Vargas Moniz, Maria; Spinnewijn, Freek; Manning, Rachel; Santinello, Massimo; Wolf, Judith; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Ornelas, José; Auquier, PascalAddressing Citizen's perspectives on homelessness is crucial for the design of effective and durable policy responses, and available research in Europe is not yet substantive. We aim to explore citizens' opinions about homelessness and to explain the differences in attitudes within the general population of eight European countries: France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain, and Sweden.
- Europeans’ willingness to pay for ending homelessness: A contingent valuation studyPublication . Loubiere, Sandrine; Taylor, Owen; Tinland, Aurelie; Moniz, Maria João Vargas; O'Shaughnessy, Branagh R; Bokszczanin, Anna; Källmen, Håkan; Bernad, Roberto; Wolf, Judith R.; Santinello, Massimo; Loundou, Anderson; Ornelas, José.; Auquier, PascalThe purpose of this study is to assess the utility value European citizens put on an innovative social program aimed at reducing homelessness. The Housing First (HF) model involves access to regular, scattered, independent and integrated housing in the community with the support of a multidisciplinary team. Currently, HF is not implemented by most European countries or funded by healthcare or social plans, but randomised controlled trials have stressed significant results for improved housing stability, recovery and healthcare services use. The broader implementation of HF across Europe would benefit from a better understanding of citizens' preferences and "willingness to pay" (WTP) for medico-social interventions like HF. We conducted a representative telephone survey between March and December 2017 in eight European countries (France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain, and Sweden). Respondent's WTP for HF (N = 5631) was assessed through a contingent valuation method with a bidding algorithm. 42.3% of respondents were willing to pay more taxes to reduce homelessness through the HF model, and significant differences were found between countries (p < 0.001); 30.4% of respondents who did not value the HF model were protest zeros (either contested the payment vehicle-taxes- or the survey instrument). Respondents were willing to pay €28.2 (±11) through annual taxation for the HF model. Respondents with higher educational attainment, who paid national taxes, reported positive attitudes about homelessness, or reported practices to reduce homelessness (donations, volunteering) were more likely to value the HF model, with some countries' differences also related to factors at the environmental level. These findings inform key stakeholders that European citizens are aware of the issue of homelessness in their countries and that scaling up the HF model across Europe is both feasible and likely to have public support.
- Home as a base for a Well-Lived Life: Comparing the capabilities of homeless service users in housing first and the staircase of transition in EuropePublication . O' Shaughnessy, Branagh; Manning, Rachel; Greenwood, Ronni; João Vargas Moniz, Maria; Loubiere, Sandrine; Spinnewijn, Freek; Gaboardi, Marta; Wolf, Walter; Bokszczanin, Anna; Bernad, Roberto; Blid, Mats; Ornelas, JoséNussbaum’s Central Capabilities refer to the elements of a well-lived life, and many adults who experience homelessness are deprived of these capabilities. The study aim was to investigate whether service users experience different homeless services as affording or constraining capabilities. We conducted semi-structured interviews with homeless service users (n = 77) in Housing First (HF) and staircase services (SS) in eight European countries. We used thematic analysis to identify three themes: autonomy and dependency, the relational impact of living arrangements, and community interaction and stigma. While SS participants were able to address their bodily integrity and health, their higherorder capabilities were constrained by their homeless situations. HF participants described home as a base from which they could enact a wide range of capabilities indicative of a well-lived life. We conclude that housing-led service models with appropriate supports are key to affording service users’ capabilities. Practical and policy implications are discussed.
- Lifetime, 5-year and past-year prevalence of homelessness in Europe: a cross-national survey in eight European nationsPublication . Taylor, Owen; Loubiere, Sandrine; Tinland, Aurelie; Moniz, Maria João Vargas; Spinnewijn, Freek; Manning, Rachel; Gaboardi, Marta; Wolf, Judith R L M; Bokszczanin, Ana; Bernad, Roberto; Källmen, Håkan; Toro, Paul; Ornelas, José H.; Auquier, PascalObjectives To examine the lifetime, 5-year and past-year prevalence of homelessness among European citizens in eight European nations. Design A nationally representative telephone survey using trained bilingual interviewers and computer-assisted telephone interview software. Setting The study was conducted in France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain and Sweden. Participants European adult citizens, selected from opt-in panels from March to December 2017. Total desired sample size was 5600, with 700 per country. Expected response rates of approximately 30% led to initial sample sizes of 2500 per country. Main outcome measures History of homelessness was assessed for lifetime, past 5 years and past year. Sociodemographic data were collected to assess correlates of homelessness prevalence using generalised linear models for clustered and weighted samples. Results Response rates ranged from 30.4% to 33.5% (n=5631). Homelessness prevalence was 4.96% for lifetime (95% CI 4.39% to 5.59%), 1.92% in the past 5 years (95% CI 1.57% to 2.33%) and 0.71% for the past year (95% CI 0.51% to 0.98%) and varied significantly between countries (pairwise comparison difference test, p<0.0001). Time spent homeless ranged between less than a week (21%) and more than a year (18%), with high contrasts between countries (p<0.0001). Male gender, age 45–54, lower secondary education, single status, unemployment and an urban environment were all independently strongly associated with lifetime homelessness (all OR >1.5). Conclusions The prevalence of homelessness among the surveyed nations is significantly higher than might be expected from point-in- time and homeless service use statistics. There was substantial variation in estimated prevalence across the eight nations. Coupled with the well-established health impacts of homelessness, medical professionals need to be aware of the increased health risks of those with experience of homelessness. These findings support policies aiming to improve health services for people exposed to homelessness.
- EU Citizens and HomelessnessPublication . Taylor, Owen; Loubiere, Sandrine; Tinland, Aurelie; Auquier, PascalThis chapter provides a description of the implementation of the European citizens’ survey, led by the French team from Aix Marseille University, as part of the HOME_EU project. The French team set out to use a telephone survey and quantitative research methods to investigate the opinions and experiences of European citizens in relation to homelessness, in addition to use a contingent valuation method to elicit the value respondents placed on the Housing First model as a potential solution to long-term homelessness. Data collection covered a 10-month period (March to December 2017). The survey produced results for European citizen’s knowledge, attitudes and practices (KAP) in relation to homelessness, willingness to pay (WTP) for the Housing First model, and the prevalence of homelessness among the ‘survey and the WP2 as a whole close the chapter.