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Promising Practices

The Promising Practices database informs professionals and community members about documented approaches to improving community health and quality of life.

The ultimate goal is to support the systematic adoption, implementation, and evaluation of successful programs, practices, and policy changes. The database provides carefully reviewed, documented, and ranked practices that range from good ideas to evidence-based practices.
Learn more about the ranking methodology.

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Chicago Housing Health Partnership (Cook)

Filed under Evidence-Based Practice, Economy / Housing & Homes, Adults, Urban

Goal: The goal of the Chicago Housing Health Partnership is to use tailored case management to place chronically medically ill homeless individuals in stable, long-term housing and facilitate access to medical services.

Community Aging in Place - Advancing Better Living for Elders (CAPABLE) (Baltimore, MD)

Filed under Evidence-Based Practice, Health / Older Adults, Adults, Older Adults, Urban

Goal: CAPABLE is a 5-month structured home visit program delivered by an occupational therapist (OT), a registered nurse (RN), and a handyman to improve daily function in older adults and to lower the monthly average Medicaid expenditure and likelihood of costly healthcare services.

Impact: This study demonstrates that home visit programs can improve the daily quality of life in aging adults. Additionally, they can lead to a reduction in Medicaid expenditures via lower inpatient costs and lower long-term care costs.

Critical Time Intervention

Filed under Evidence-Based Practice, Health / Mental Health & Mental Disorders

Goal: The goal of the Critical Time Intervention is to prevent homelessness among people with severe mental illness.

Impact: Evaluations of this program have found sizable reductions (24-67%) in average number of nights spent homeless over the 18-month follow-up period and more than a 60% reduction in likelihood of being homeless in the final weeks of the 18-month follow-up. Cost offsets and savings have been shown.

Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol Problems

Filed under Evidence-Based Practice, Economy / Housing & Homes, Adults, Racial/Ethnic Minorities

Goal: To evaluate the association of a “Housing First” intervention for chronically homeless individuals with severe alcohol problems with health care use and costs.

Impact: Total cost offsets for Housing First participants relative to controls averaged $2449 per person per month after accounting for housing program costs.

Health Equity: Tenant-Based Housing Voucher Programs

CDC

Filed under Evidence-Based Practice, Economy / Housing & Homes

Impact: The Community Preventive Services Task Force (CPSTF) recommends tenant-based housing voucher programs to improve health and health-related outcomes for adults based on sufficient evidence of effectiveness. Health-related outcomes include housing quality and security, healthcare use, and neighborhood opportunities (e.g., lower poverty level, better schools).

Children ages 12 years and younger whose households use vouchers show improvements in education, employment, and income later in life. Outcomes for adolescents vary by gender. Females 10-20 years of age whose families use tenant-based vouchers to live in lower poverty neighborhoods experience better health outcomes while males of the same age experience worse physical and mental health outcomes. Additional research is needed to better understand and address challenges faced by adolescent males.

CPSTF finds societal benefits exceed the cost of tenant-based housing voucher programs that serve families with young children who are living in public housing, provide pre-move counseling, and move families to neighborhoods with greater opportunities.

Tenant-based housing voucher programs give many people access to better housing and neighborhood opportunities, both of which are considered social determinants of health. Because these programs are designed for households with low incomes, they are expected to advance health equity.

Housing for Health Permanent Supportive Housing Program (Los Angeles County)

Filed under Evidence-Based Practice, Economy / Housing & Homes, Adults, Urban

Goal: Housing for Health program goals are to improve patients’ health, reduce costs to the public health system, and demonstrate DHS’s commitment to addressing homelessness within Los Angeles County.

Impact: The average public service utilization cost per participant for the year prior to housing totaled $38,146; in the year after receiving housing, it totaled $15,358. When taking into account PSH costs, RAND observed a 20-percent net cost savings, suggesting a potential cost benefit of the program.

Pathways to Housing, Inc. (NYC, DC, Philadelphia)

Filed under Evidence-Based Practice, Economy / Housing & Homes, Adults, Urban

Goal: The goal of Pathways to Housing, Inc. is to provide independent housing, treatment services for physical and mental health, and employment to mentally ill individuals who are chronically homeless.

Impact: Pathways to Housing has received numerous awards for its projects in New York City, Philadelphia, and D.C. In addition to achieving large effects in terms of housing outcomes, compared with standard care in the community, Housing First also improves community functioning and quality of life.

Social Determinants of Health: Permanent Supportive Housing with Housing First (Housing First Programs)

CDC

Filed under Evidence-Based Practice, Economy / Housing & Homes

Impact: The Community Preventive Services Task Force (CPSTF) recommends permanent supportive housing with Housing First (Housing First programs) to promote health equity for people who are experiencing homelessness and have a disabling condition.

Evidence shows Housing First programs decrease homelessness, increase housing stability, and improve quality of life for homeless persons living with disabling conditions, including those with HIV infection. For clients living with HIV infection, these programs also improve clinical indicators and mental health and reduce mortality. Housing First programs also lead to reduced hospitalization and use of emergency departments for homeless persons with disabling conditions, including HIV infection.

The CPSTF finds the economic benefits exceed the intervention cost for Housing First Programs in the United States. Because homelessness is associated with lower income and is more common among racial and ethnic minority populations, Housing First Programs are likely to advance health equity.

Affordable Housing in Arlington, Virginia (Arlington, VA)

Filed under Good Idea, Economy / Housing & Homes

Goal: The mission of AHC is twofold: to preserve the supply of affordable housing in the mid-Atlantic region, especially Northern Virginia and Baltimore, Maryland; and to ensure that properties developed or owned by AHC enhance the quality of life in the neighborhoods where they are located.

An Effective Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success and/or promise in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures of improvement in outcome of interest (i.e. increase in voter registration, not just delivery of voter registration drive) and/ or the outcome measure is increased or improved compared to the baseline measurement or the control group but the difference is not statistically significant.

A Good Idea meets the following HCI criteria:

  1. The program description includes: the sponsoring organization, program goals, program funding source, program implementation steps and outcomes.
  2. The program evaluation is limited to descriptive measure(s) of success/accomplishment (i.e., program participation rates, number of services/education sessions/radio messages provided). Note: oftentimes, the program has been newly implemented and a program evaluation has not yet been conducted. Programs that have not yet been evaluated, but which show promise in improving health or quality of life, are classified as Good Ideas until an evaluation is conducted.

An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.