CICH clients (Treatment group)
During the first two years of program operation (i.e., through April 2006), 1,430 homeless people were formally screened for enrollment in CICH, with substantial variation between sites ranging from 49 in Ft. Lauderdale to 476 in Martinez (Table 2). Of these, 1,242 (87%) were identified as having been enrolled into the CICH clinical program, with enrollments rates ranging from 38% in New York to 100% in Denver, Ft. Lauderdale and Philadelphia. All of those enrolled into CICH were to be invited to participate in the national evaluation. Among the 1,242 enrolled into the program nationally, 734 (59%) gave written informed consent to participate in the national evaluation, again with substantial variation across sites ranging from 11% in Martinez to 98% in Ft. Lauderdale. All those who provided written informed consent participated in data collection for the national evaluation.
Participation in the national evaluation was completely voluntary, and did not influence receipt of housing or services provided through the Initiative. Informed consent procedures were approved by Institutional Review Boards (IRBs) at the parent site and at each participating site.
Usual care individuals (Comparison group)
During the second year of the program, from February 2005 through March 2006, a group of 118 comparison group subjects were recruited from five CICH sites: Chattanooga (N=19), Los Angeles (N=18), Martinez (N=32), New York (N=25), and Portland (N=24). Research staff at each of these sites were able to identify one or two portals of entry into existing housing, case management or supportive services programs serving chronically homeless persons in the same local area served by the CICH program.
The portals of entry for participating sites are identified below:
- Chattanooga: Chattanooga Department of Health's Homeless Health Care Center
- Los Angeles: Edward and Rossmore Skid-Row SRO hotels
- Martinez: Multi-service center of one of the CICH partnering agencies in Richmond
- New York: Project Renewal East 3rd Street shelter in Manhattan
- Portland: JOIN, the homeless outreach center which referred most individuals into the CICH program, and St. Francis dining hall, where many of the homeless in Portland eat and get mail
Local research staff, in cooperation with the staff of the housing and homeless service provider portals of entry identified above, recruited a convenience sample of chronically homeless adults in each of these communities that were intended to be socio-demographically and clinically similar to CICH clients (based on local research staff's experience recruiting CICH clients during the prior year), yet who were receiving some lesser combination of permanent housing, intensive case management, and access to healthcare services provided to CICH clients. Thus, comparison group subjects were intended to be chronically homeless adults receiving "usually available" housing resources and supportive services in each of the five communities.
The recruitment of a comparison group was approved by the same local IRBs which approved the recruitment of CICH clients to participate in the national evaluation. Written informed consent was provided by all comparison group subjects, who received the same remuneration of $15 per interview as CICH client subjects. Also, the same baseline and follow-up assessment forms and data collection procedures were used for both groups.
The remaining six CICH sites were unable to recruit comparison group samples due to local IRB, research staffing, and homeless service provider issues/challenges.