BUSSW researchers will evaluate HHS multisite initiative to improve HIV health outcomes through coordination of supportive employment and housing services

Wednesday, January 31, 2018

Up to $700,000 annually over three years to provide evaluation and technical assistance for 12 demonstration sites nationwide serving low-income racial and ethnic minority communities

Providing effective HIV care for communities at the greatest risk for poor health care outcomes involves addressing structural factors, such as poverty, lack of education, unemployment/underemployment, homelessness, and other social determinants of health. Researchers from the Center for Innovation in Social Work and Health (CISWH) at Boston University School of Social Work (BUSSW) have the opportunity to explore innovative strategies for integrating supportive services for two of those factors—housing, and employment services—into a coordinated HIV care intervention. These researchers and their partners will serve as the Evaluation and Technical Assistance Provider (ETAP) to 12 demonstration programs to develop, implement, and evaluate models of care that coordinate health, housing, and employment services to reduce barriers to HIV care and improve health outcomes. The Health Resources & Services Administration (HRSA) HIV/AIDS Bureau made the award through its Special Projects of National Significance (SPNS) Program. Up to $700,000 will be awarded annually over three years as part of the national initiative Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services.

Serena Rajabiun, senior project director, CISWH, will serve as principal investigator, with Jane Fox, senior project director, CISWH, and Thomas Byrne, assistant professor, BUSSW, as co-principal investigators. Byrne, together with Howard Cabral, professor of biostatistics, Boston University School of Public Health, will serve as evaluators for the project. The BU team will draw on the expertise of several consulting partners to provide support to the clinical sites as they develop their models, including:

  • Boston Health Care for the Homeless for guidance around HIV primary care, housing support, and employment services
  • University of California San Francisco (UCSF) and University of California Los Angeles (UCLA) for evaluation and employment expertise
  • Harvard Law School Center for Health Law & Policy Innovation for support on legal issues related to housing, employment, and care of people living with HIV
  • Impact Marketing for marketing and publication design
  • Boston University School of Public Health Biostatistics and Epidemiology Data Analytics Center (BEDAC) for data collection, reporting, and analysis
  • Consumer advisors for expertise in training, culturally appropriate materials development, and consumer involvement in design of service delivery models
  • Consultants in employment training and housing support for people experiencing homelessness

The ETAP will provide technical assistance to 12 clinical sites nationwide as they implement demonstration projects that will coordinate HIV treatment, housing, and employment services to improve HIV health outcomes for the low-income racial and ethnic minority communities they serve. Grantees are current recipients of HOPWA (Housing Opportunities for Persons with AIDS) and Ryan White HIV/AIDS Program funding and are geographically distributed across all regions of the continental U.S. Working with the sites, the ETAP will develop resources, such as implementation manuals and peer-reviewed articles, to share key findings. These materials will be disseminated to organizations who wish to improve the health outcomes of people living with HIV in the communities they serve.

Demonstration sites include:

  • AIDS Foundation of Chicago, Chicago, IL
  • Avenue 360 Health & Wellness (formerly Houston Area Community Services), Houston, TX
  • Bexar County Hospital District, San Antonio, TX
  • Family Health Centers of San Diego, San Diego, CA
  • Fenway Community Health Center, Boston, MA
  • Gay Men’s Health Crisis, Inc., New York, NY
  • City of Kansas City, Missouri, Kansas City, MO
  • City of Pasadena Public Health Department, Pasadena, CA
  • City of Paterson, NJ, Paterson, NJ
  • Positive Impact Health Center, Inc., Duluth, GA
  • Positive Resource Center, San Francisco, CA
  • Yale University, New Haven, CT

“In a previous multisite evaluation that we conducted, we noted employment as a secondary effect among participants—people who wanted to work received support to become employed, which led to an improved ability to maintain stable housing,” said Rajabiun. “Research indicates that access to housing and employment services has a positive association with health status and quality of life. Yet little research exists on the efficacy and implementation of these supportive services and their impact on engagement and retention in HIV care among people who use them. This project gives us the opportunity to research innovative approaches to improving HIV care that incorporate housing and employment services, two key social determinants of health.”

“A coordinated approach to delivering medical care, mental health services, substance use treatment, housing, and employment services at the individual, organization, and community level is essential if health disparities are to be eliminated among low-income people living with HIV from racial and ethnic minority communities,” said Sara S. Bachman, Paul Farmer professor at BUSSW, research professor of Health Law Policy and Management at BUSPH, and director of the CISWH. “This project exemplifies the use of a multifaceted wide-lens public health social work approach to investigate social factors as causes of poor health and advocate for structural and systemic change to achieve health equity.”

“This important work will offer new insights into the effectiveness of models of care and interventions that seek to address some of the social determinants of health associated with HIV health-related disparities,” said Jorge Delva, dean and professor, BUSSW. “It attests to the BUSSW’s commitment to promoting racial, social, and economic justice.”

Learn more about the Evaluation and Technical Assistance Provider (ETAP) for the SPNS Initiative Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U90HA31449 (Special Projects of National Significance (SPNS) Initiative Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services- Evaluation and Technical Assistance Provider, in the amount of $700,000) awarded annually to Trustees of Boston University. No percentage of this project was financed with nongovernmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.