Moving on trial: COVID-19 and homelessness
| ISRCTN | ISRCTN69564614 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN69564614 |
| Secondary identifying numbers | CPMS 47728 |
- Submission date
- 03/08/2020
- Registration date
- 16/12/2020
- Last edited
- 24/09/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
As part of the government's response to COVID-19, 15,000 rough sleepers have now been offered self-contained temporary accommodation in England, mainly in hotels. This approach, which has involved the decanting of hostels, shelters and similar shared provision for rough sleepers, is a short-term response.
With lockdown ending, decisions are being taken about how to house former rough sleepers in line with the UK government's commitment to prevent people from going back to the streets - including, potentially, through the re-opening of shelter-type accommodation. Existing temporary accommodation with shared facilities might make it impossible for people to comply with government social distancing advice. So these decisions will impact on the risk of a second wave of infection from COVID-19 and possibly any mutations.
This research will pursue a unique time-limited opportunity to conduct a study to evaluate the effectiveness and cost-effectiveness of permanent housing on the risk of COVID-19 infection and housing stability for people experiencing homelessness.
That many homeless people are currently waiting to be housed means they can be randomly allocated to different housing solutions at scale quickly.
Who can participate?
Single person households temporarily accommodated by the local authority.
What does the study involve?
Participants will be randomly allocated to different types of settled housing: Private Rented Sector, Social Housing, and Housing First, or to business as usual accommodation provided by local authorities (e.g. hostels).
Potential participants will be identified via their Local Authority, who will gain verbal consent to share their contact details with the trial team. The trial team will contact potential participants providing full trial information, conduct informed consent and a baseline survey, after which they will be randomised. The survey will be conducted again at 3 months, 6 months, 9 months and 12 months follow up time-points. We hope to use this research to make recommendations to the government to support decisions on social housing across the UK and to understand more about homelessness and the effect it has on health and wellbeing and social economics.
What are the possible benefits and risks of participating?
While some people find it helpful to talk about their experiences, participants may find discussing these subjects upsetting or distressing. Participants will be fully informed that they do not have to continue with the survey if they don’t want to, do not have to talk about anything they find uncomfortable or upsetting and can withdraw at any time. We will send participants a list of organisations after each time-point, so they have access to help and support, should they feel they need it.
Where is the study run from?
Cardiff University, Centre for Trials Research (UK)
When is the study starting and how long is it expected to run for?
August 2020 to February 2022
Who is funding the study?
UK Research and Innovation
Who is the main contact?
Liz Randell, movingon@cardiff.ac.uk
(updated 04/01/2021, previously:
Bethan Pell, pellb@cardiff.ac.uk)
Contact information
Public
Neuadd Meirionnydd
Heath Park
Cardiff
CF14 4YS
United Kingdom
| Phone | +44 (0)292 0687608 |
|---|---|
| randelle@cardiff.ac.uk |
Study information
| Study design | Interventional pilot randomized controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Community |
| Study type | Other |
| Participant information sheet | ISRCTN69564614_PIS_v1.0_10Aug2020.pdf |
| Scientific title | COVID-19 and rough sleepers: a unique opportunity for a randomised controlled trial testing models of housing and support that reduce risks of infection and transmission, and reduce homelessness |
| Study acronym | Moving On Trial |
| Study hypothesis | Participants in the intervention group have: 1. Lower levels of COVID-19 infection 2. Better stability of housing tenure 3. The intervention is more cost-effective than business as usual (BAU) accommodation |
| Ethics approval(s) | Approved 12/08/2020, The School of Geography and Planning Research Ethics Committee (Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WT, UK; +44 (0)2920874022; lumbe@cardiff.ac.uk), ref: 2020_24 |
| Condition | COVID-19 and homelessness |
| Intervention | Current interventions as of 03/08/2021: This research will pursue a unique time limited opportunity to conduct a randomised controlled trial to evaluate the effectiveness and cost-effectiveness of permanent housing on the risk of COVID-19 infection and housing stability for people experiencing homelessness. Up to 150 single homeless people who have been temporarily accommodated by approximately three local authorities in England will be recruited. The study population will be representative of all single person households who have approached local authorities for homelessness assistance. This population group is typically dominated by males, aged 25-49. Participants will be randomised to either the intervention, which includes several different types of settled housing: Private Rented Sector (PRS) (low and medium support), Social Housing (low and medium support), and Housing First (High support), or the comparator, which is Business as usual (BAU) accommodation provided by local authorities (LA) (e.g. hostels). Randomisation willl occur after informed consent and completion of the baseline questionnaire on Qualtrics. Randomisation will be completed daily and results communicated to the participating LAs, ensuring a timely allocation of housing to applicants and a reduction in the likelihood of cross over. Randomisation will be on a 1:1 ratio and will employ a stratified (by LA) block design. These participants will be interviewed up to 3 times across a 9 month period. They will be interviewed over the telephone using an existing survey used to explore the lives of rough sleepers by the Ministry of Housing, Communities and Local Government in England, which has been adapted appropriately, specifically for the trial. The trial will use an offline Qualtrics application system built by Cardiff University’s Centre for Trials Research and this will be used to collect consent and survey response data by researchers/trial staff via the telephone interviews. The study will explore past and current experiences of homeless individuals in relation to a range of life domains, including; housing, health, adverse life experiences such as imprisonment, and substance misuse. The research team has sought to markedly reduce the number of questions posed and to explore the appropriateness of these questions with someone with lived experience of homelessness. However, personal questions about life experiences are a key part of the survey. _____ Previous interventions: This research will pursue a unique time limited opportunity to conduct a randomised controlled trial to evaluate the effectiveness and cost-effectiveness of permanent housing on the risk of COVID-19 infection and housing stability for people experiencing homelessness. Up to 1,200 single homeless people who have been temporarily accommodated by six local authorities in England will be recruited. The study population will be representative of all single person households who have approached local authorities for homelessness assistance. This population group is typically dominated by males, aged 25-49. Participants will be randomised to either the intervention, which includes several different types of settled housing: Private Rented Sector (PRS) (low and medium support), Social Housing (low and medium support), and Housing First (High support), or the comparator, which is Business as usual (BAU) accommodation provided by local authorities (LA) (e.g. hostels). Randomisation willl occur after informed consent and completion of the baseline questionnaire on Qualtrics. Randomisation will be completed daily and results communicated to the participating LAs, ensuring a timely allocation of housing to applicants and a reduction in the likelihood of cross over. Randomisation will be on a 1:1 ratio and will employ a stratified (by LA) block design. These participants will be interviewed up to 4 times across a 12 month period. They will be interviewed over the telephone using an existing survey used to explore the lives of rough sleepers by the Ministry of Housing, Communities and Local Government in England, which has been adapted appropriately, specifically for the trial. The trial will use an offline Qualtrics application system built by Cardiff University’s Centre for Trials Research and this will be used to collect consent and survey response data by researchers/trial staff via the telephone interviews. The study will explore past and current experiences of homeless individuals in relation to a range of life domains, including; housing, health, adverse life experiences such as imprisonment, and substance misuse. The research team has sought to markedly reduce the number of questions posed and to explore the appropriateness of these questions with someone with lived experience of homelessness. However, personal questions about life experiences are a key part of the survey. |
| Intervention type | Other |
| Primary outcome measure | Current primary outcome measure as of 03/08/2021: 1. Participant recruitment: Percentage of participants approached by LAs, and who are eligible, consent to the study (and thus are willing to be randomised) 2. LA recruitment: Number of LAs who entered study as a proportion of those approached and who showed some interest in the study. 3. Participant retention: Percentage of participants retained at final follow-up timepoint as a proportion of those recruited. 4. Adherence: LAs adhere to assignment of participant to randomised allocation. _____ Previous primary outcome measure: 1. Prevalence of COVID-19 infection at 12 months using self-report 2. Housing stability (number of days in settled accommodation and housing retention) at 12 months using self-report |
| Secondary outcome measures | Current secondary outcome measures as of 03/08/2021: 1. Completeness of data collection at 3 and 6 months in relation to: 1.1. COVID-19 Infection 1.2. General health (EQ-5D) 1.3. Mental health (GAD-7, ONS-4) 1.4. Employment status 1.5. Income 1.6. Drug and alcohol (AUDIT C) use 1.7. Service access use for mental health 1.8. Drug and alcohol rehabilitation/ service use 1.9. Healthcare service use 1.10. Cost-effectiveness (including healthcare and mental health service use, and offending) 2. Data linkage: Percentage of participants consenting to data linkage _____ Previous secondary outcome measures: Assessed at baseline, 3, 6 and 12 -month follow-up: 1. General health measured using EQ-5D 2. Mental health measured using GAD-7, WEMWBS 3. Employment status measured using data linkage from DWP 5. Income measured using data linkage from DWP 6. Drug and alcohol (AUDIT C) use measured using NHS Digital 7. Service access use for mental health measured using NHS Digital 8. Drug and alcohol rehabilitation/ service use measured using NHS Digital 9. Healthcare service use measured using NHS Digital 10. Cost-effectiveness (including healthcare and mental health service use, and offending) measured using outline by Green Book (HM Treasury, 2018) |
| Overall study start date | 01/08/2020 |
| Overall study end date | 31/01/2022 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | Up to 150 |
| Total final enrolment | 50 |
| Participant inclusion criteria | 1. Single person households temporarily accommodated by the local authority 2. Recourse to public funds |
| Participant exclusion criteria | Does not meet inclusion criteria |
| Recruitment start date | 06/01/2021 |
| Recruitment end date | 30/06/2021 |
Locations
Countries of recruitment
- United Kingdom
- Wales
Study participating centre
4th Floor
Neuadd Meirionnydd
Heath Park
Cardiff
CF14 4YS
United Kingdom
Sponsor information
University/education
Centre for Trials Research
College of Biomedical & Life Sciences, 7th Floor
Neuadd Meirionnydd
Heath Park
Cardiff
CF14 4YS
Wales
United Kingdom
| Phone | +44 (0)29 2068 7620 |
|---|---|
| CTR@cardiff.ac.uk | |
| Website | http://www.cardiff.ac.uk/ |
"ROR" |
https://ror.org/03kk7td41 |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- UKRI
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 01/08/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Stored in publicly available repository |
| Publication and dissemination plan | Findings disseminated through a new MHCLG/CHI Research Network. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are stored in a publicly available repository: UK Data Service. Data is currently available: https://beta.ukdataservice.ac.uk/datacatalogue/studies/study?id=855729, https://doi.org/10.5255/UKDA-SN-855729. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | version v1.0 | 10/08/2020 | 16/12/2020 | No | Yes |
| Protocol article | 01/02/2022 | 01/02/2022 | Yes | No | |
| Dataset | 31/08/2022 | 28/02/2024 | No | No |
Additional files
- ISRCTN69564614_PIS_v1.0_10Aug2020.pdf
- uploaded 16/12/2020
Editorial Notes
24/09/2024: The intention to publish date was changed from 01/08/2024 to 01/08/2025.
28/02/2024: IPD sharing plan and dataset added.
27/02/2024: The intention to publish date was changed from 01/08/2023 to 01/08/2024.
21/02/2023: The intention to publish date was changed from 01/02/2023 to 01/08/2023.
01/02/2022: The following changes have been made:
1. Publication reference added.
2. The overall trial end date has been changed from 06/01/2022 to 31/01/2022.
3. The trial website has been added.
03/08/2021: The following changes were made to the trial record:
1. The study design was changed from "Interventional randomized controlled trial" to "Interventional pilot randomized controlled trial".
2. The interventions were changed.
3. The primary outcome measure was changed.
4. The secondary outcome measures were changed.
5. The target number of participants was changed from "1,200" to "Up to 150".
6. The total final enrolment was added.
7. The recruitment end date was changed from 31/03/2021 to 30/06/2021.
17/02/2021: The recruitment end date has been changed from 14/02/2021 to 31/03/2021.
04/01/2021: The following changes were made to the trial record:
1. The public contact was changed.
2. The plain English summary was updated to reflect these changes.
16/12/2020: The participant information sheet was uploaded as an additional file.
12/08/2020: Trial’s existence confirmed by Cardiff University
