Abstract
A systematic review was conducted. A search located 14 studies that met inclusion criteria. Six studies examined occupational needs, and eight studies measured success of interventions. Each was appraised using the McMasters Guidelines. Levels of evidence were also determined. Preliminary analysis indicated three studies at high levels of evidence and six of eight intervention studies having statistically significant findings that support the role of OT working with this population.
Primary Author and Speaker: Joseph Cipriani
Additional Authors and Speakers: Orley Templeton
According to the National Alliance to End Homelessness in America (2018), 17 in every 10,000 individuals in the United States are homeless. Occupational therapists are skilled professionals that can offer unique skills to help individuals who experience homelessness improve their occupational participation and ability to maintain more independent forms of housing. Thomas, Gray, and McGinty (2011) conducted a systematic review of the published literature from 1990-2008 of occupational therapy interventions of persons who are homeless. Thomas et al. concluded that the literature suggests occupational therapy has an appropriate role for persons who are homeless. No systematic reviews of the literature since this study were located. The purpose of our study was to conduct a systematic review of published literature from 2009-2017 on occupational therapists’ role in working with individuals who experience homelessness.
Through a comprehensive search of electronic databases and via a manual search, 22 research articles published between 2009 and 2017 were located, of which 14 met the inclusion criteria for our study (published between 2009-2017, quantitative analysis, domain of investigation within scope of occupational therapy practice). The McMasters University Guidelines and Appraisal Forms for Critical Review of Quantitative Research (Law et al., 1998) were used to review each study. Two researchers independently critiqued each article using the guidelines, and the met until consensus was reached on every area for each study.
Our research work is in progress, and to date, we have conducted a preliminary analysis of our results. Ten of the articles were determined to be at level III research (U.S. Preventive Services Task Force, 2012), two were level II research, one was level I and one was at level V. Six articles examined the occupational needs of homeless individuals whereas the remaining eight determined the effectiveness of interventions (with six finding statistically significant results for at least one dependent variable).
As this is submitted as a poster, we do not plan on presenting a comprehensive review of each study via the use of evidence tables. Instead, as our goal is to facilitate interaction and discussion with the viewer, we will focus on the key findings across studies and applicability to the practitioner, having more comprehensive evidence available on site as supplementary materials. Upon completion of the analysis, we also will provide a determination of strength of evidence or level of certainty (strong, moderate or low) within the time parameters of our review. Our conclusions can therefore follow. We will focus on the strength of the evidence to date, recommendations for future research, and implications for practice.
Identifying the occupational needs of individuals who are homeless as well as the effectiveness of currently established programs, can impact practice by guiding occupational therapists in helping clients set occupationally focused goals and in developing relevant programs with effective interventions. In addition, use of this research can aid occupational therapists to advocate for programs that increase the transition to permanent housing among individuals who are homeless.
Law, M., Stewart, D., Pollock, N., Letts, L., Bosch, J., & Westmorland, M. (1998). Guidelines for critical review form: Quantitative studies. Retrieved from http://www.srs-mcmaster.ca/Portals/20/pdf/ebp/quanguidelines.pdf
National Alliance to End Homelessness. (2018). The state of homelessness in America. Retrieved from https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness-report/
Thomas, Y., Gray, M., & McGinty, S. (2011). A systematic review of occupational therapy interventions with homeless people. Occupational Therapy in Health Care, 25(1), 38-53, DOI: 10.3109.07380577.2010.528554
U.S. Preventive Services Task Force. (2012). Grade definitions. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.uspreventiveservicetaskforce.org/uspstf/grades.htm