What are the aims of this project?
‘Housing is a new model for delivering an integrated and enhanced housing service to council house customers in Sheffield. The overall aim is to explore whether, and how, the Housing+ service may achieve improvements in health and wellbeing of council housing customers, in comparison to the current service, and identify the associated direct and indirect costs.
The project objectives are to:
- To describe the intervention elements, identify any relevant existing empirical or theoretical research describing or explaining the impact of similar programmes and use this information to develop a logic model for potential pathways between intervention and outcomes.
- To decide on, collect and analyse both routinely collected quantitative data, which will be used to monitor and evaluate the programme as a whole, and survey data collected from tenants in both pilot and matched comparison areas to measure the potential impact of Housing+ on health and wellbeing.
- To conduct a qualitative process evaluation using in-depth interviews and focus group discussions with managers, housing officers, other staff and customers.
- To collect and analyse resource use data, including staff and training costs, to allow estimation of cost-effectiveness relative to current service provision in areas prior to the introduction of Housing + services.
Why is this important?
The potential role of providers of social housing in reducing health inequalities and improving the wellbeing of tenants has led to a range of innovative and holistic interventions. This evaluation provides an opportunity to explore the extent to which changing the organisation and delivery of services to council tenants can have a cost-effective impact on the sustainability of tenancies and the health and wellbeing of tenants. If the findings are positive, there will be generalizable findings that will be useful to other housing providers, both councils and housing associations, developing similar services and wanting to deliver more holistic services for their tenants.
How will the research be carried out?
An effectiveness and process evaluation employing mixed methods and including an economic appraisal. Since the intervention is still being modified to address issues identified during the initial pilot scheme, particularly in relation to staff roles and training, methods will be appropriate to a “pragmatic formative” process evaluation as described by Evans et al (2015). The study will involve four components:[i] Documenting of the intervention as it is delivered and developing a logic model to map the range of potential pathways and activities between introduction of the new service, annual visits, and changes to the health and wellbeing of customers. This will be informed both by detailed consultation exercises with stakeholders (housing staff, Tenant & Resident Associations (TARAs), customers and other partner agencies) and a review of relevant literature, identified in consultation with topic experts. [ii] Effectiveness evaluation to quantitatively assess impact on key outcomes, by comparing outcomes for clients in areas where the intervention is already being delivered with areas where it has not yet been rolled out, using both routine data from an integrated housing database and a cross-sectional telephone surveys of council tenants in both pilot and control areas, conducted in year 1 and repeated in year 2, to collect potential explanatory, confounding, mediating and effect modifying variables as well as key outcomes. [iii] Process evaluation to explore aspects of implementation and experiences of staff and clients. This would include the potential impact on health inequalities in vulnerable groups, exploring how the impact might vary between customer groups and the impact on staff of changing roles and responsibilities. [iv] An economic appraisal to assess costs and wider resource implications including those related to staff training and costs of referrals to other services (cost-consequence analysis).
The project will be completed by the end of March 2018.
Who is undertaking the research?
The research is being carried out by a team of researchers across ScHARR and the Department of Urban Studies and Planning, in collaboration with Sheffield City Council.
How are stakeholders being engaged?
The original proposal for an evaluation of this programme came from local public health practitioners and their council colleagues in Housing Services. The project is supported by public health commissioners and has synergies with a wider strategy of staff role development and “Making Every Contact Count” initiatives within Sheffield City Council. The collaborative nature of the project will ensure that the research is responsive to the needs and interests of both local authority and wider stakeholders. Tenant & Resident Associations (TARAs) will be consulted at all stages in the evaluation and community members may also potentially be involved in consultations and data collection from customers
The research team has establish a Project Advisory Group (PAG) with an independent chair and an invited membership of external researchers in Housing and Health, public health and housing practitioners and lay representatives identified by local tenant associations to represent the service customers. The PAG will provide advice on the scope and design of the evaluation, implementation, data collections methods and settings and interpretation of results. They will also contribute to ensuring the appropriate dissemination of research outputs to all relevant audiences including both housing services and council housing customers.
What will be the outputs from the study?
The main outputs will be a report for the Council, a paper for a public health or housing topic-specific journal and a guide for commissioners and providers describing how similar programmes can both be effectively delivered and monitored/evaluated.
The results from work will also be disseminated through submitting abstracts for presentation (oral and/or poster) at relevant national (and international) conferences. Additional opportunities to present the work will also be sought within local and national networks in relation to public health and housing, as well as at SPHR meetings and conferences. Results will also be shared with Public Health England and the Housing Association-related organisations with interest in Housing and Health interventions.
Opportunities to disseminate our findings through these organisations will be sought as well as advice on dissemination opportunities. We will also produce a video/audio abstract for each publication arising in order to reach less academic audiences, and publicise this and related publications through social networks such as Twitter, allowing for wide dissemination to practitioners, policy makers, local/national government.
To find out more contact Lindsay Blank: firstname.lastname@example.org
References: Evans R, Scourfield J, Murphy S. Pragmatic, formative process evaluations of complex interventions and why we need more of them. J Epidemiol Community Health 2015;69:925–926. doi:10.1136/jech-2014-204806 925