A pilot program to address tenants’ complex social, psychological, and medical needs in social housing: lessons learned

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Enabling Participation	The Hub services support the literature that proximity to services can enhance participation (Skodra 2020); however, the complexity of tenant needs requires finding diverse solutions and programs. Many tenants wanted to be proactive in changing their lives for the better, rather than be stagnant. There was a desire for programs and training in financial security, support groups/classes/events on self-care, and possibly addressing the continuum of care/coordinated care for tenants across physical and mental health. Gender-focused programing were identified as a gap, however plans to include it were stalled due to COVID-19. Communication was a challenge. Consistent advertising, providing explanations of what the services entail or its benefits to tenants, and consistent follow-up were identified as important factors.
Demonstrating Effectiveness	We had challenges with demonstrating the effectiveness of the Hub, as reported in the literature (Freeman et al. 2020). In our case, the programs changed, the tenant population was somewhat transient, and several important outcomes were ambiguous and challenging to track change. There was also considerable change to the Hub as a result of the COVID-19 pandemic that required a flexible strategy. Our approach was tenant-centered, which prioritized tenant lived experiences and needs. We engaged with tenants through the interview study, and by examined objective measures, such as the number of emergency calls to the buildings.
Community Engagement & Collaboration	Providing programs directly within social housing benefits from collaboration across community support services, healthcare agencies, and housing services (Skodra 2020, Marshall et al. 2021). Localized approaches, such as those occurring within social housing authorities, enabled the success of interventions as local partners were knowledgeable about the needs of the community (Warwick-Booth et al. 2020). Further, providing opportunities for community building amongst tenants was important. Casual, relaxed social events encouraged participation and may have helped address social isolation, however addressing complicated social dynamics remains a challenge.

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Freeman, A.L., et al., 2020. Community health worker intervention in subsidized housing: New York City, 2016–2017. American journal of public health, 110 (5), 689–692. 10.2105/AJPH.2019.305544.

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Marshall, C.A., et al., 2021. “Nobody cares about you as a group of people”: A mixed methods study of women living in congregate social housing in Ontario, Canada. Housing and society, 48 (1), 21–42. 10.1080/08882746.2020.1793285.

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Warwick-Booth, L., Coan, S., and Bagnall, A.M., 2020. Personalised housing support to improve health and well-being: findings from a local pilot programme in Yorkshire, England. Cities & health, 4 (1), 82–93. 10.1080/23748834.2019.1644078.

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Data availability statement

The data used in this paper cannot be made publicly available as the qualitative interviews that informed the paper contain identifying information.