Absence of conflict of interest.
Citation
Cunningham, M. K., Biess, J., Emam, D., & Burt., M. R. (2015). Veterans Homelessness Prevention Demonstration evaluation: Final report. Washington, DC: Urban Institute.
Highlights
- The study examined the effect of the Veterans Homelessness Prevention Demonstration (VHPD) program on the employment, earnings, public benefit receipt, and education and training outcomes of veterans at risk of homelessness.
- The study uses a nonexperimental design to examine whether there were changes in veterans’ outcomes from before the program began to six months after the program ended using self-reported data directly from the veterans.
- The study found statistically significant positive relationships between the VHPD program and veterans’ employment and earnings six months after the program ended compared with before the program. The study found mixed relationships between the VHPD program and public benefit receipt: significantly fewer veterans in the study received several types of public benefits, such as Temporary Assistance for Needy Families (TANF) or the Supplemental Nutrition Assistance Program (SNAP). Significantly more veterans in the study, however, received Veterans Pension benefits after the program compared with before it.
- The quality of causal evidence presented in this report is low because the authors did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the VHPD program; other factors are likely to have contributed.
Intervention Examined
The Veterans Homelessness Prevention Demonstration (VHPD) program
Features of the Intervention
VHPD was designed to serve veterans who were homeless or at risk for homelessness, with an emphasis on serving female veterans, veterans with children, and veterans who served in Afghanistan and Iraq under Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn.
As part of a three-year pilot program, five sites received funding from the U.S. Departments of Housing and Urban Development and Veterans Affairs (VA). The VHPD sites were required to spend 65 percent of their funding on housing assistance, which included short- or medium-term housing assistance, short-term financial assistance including moving cost, utilities, and arrears assistance. Sites had discretion to fund other services based on local need, including collaborating with U.S. Department of Labor One-Stop Career Centers to provide employment services (although only one site actually worked with a local One-Stop Career Center). Sites could also provide case management and assistance with child care, credit repair, and transportation. Finally, the program worked with local VA health care providers to improve health care access for participants.
Features of the Study
The study was a nonexperimental study that used a pre-post study design to compare outcomes of veterans before and six months after they participated in the VHPD program. The outcomes were collected directly from veterans through two surveys: one survey was conducted before the VHPD program, and the second survey was conducted six months after the VHPD program. In total, 509 veterans were enrolled in the study, and 315 of them completed both surveys and were included in the analyses.
To be eligible for the program, people had to have veteran status, be eligible for VA health care, have household income below 50 percent of the median income in the area, and be at risk of homelessness or homeless for 90 days or less.
Nearly all of the participants were veterans from the Armed Forces of the United States, and 55 percent of the sample served in Iraq and Afghanistan. About half the sample (51 percent) was White, 43 percent was African American, and 10 percent was Hispanic. About a quarter of the participants were female, and 46 percent of the sample members were ages 25 to 40.
The authors used a statistical model to compare veterans’ employment, earnings, public benefit receipt, and education and training outcomes before and after the program.
Study Sites
Five military bases and their surrounding communities participated in the study:
- Camp Pendleton in San Diego, California
- Fort Hood in Killeen, Texas
- Fort Drum in Watertown, New York
- Joint Base Lewis-McChord in Tacoma, Washington
- MacDill Air Force Base in Tampa, Florida.
Findings
Employment
- There was a statistically significant positive relationship between the VHPD program and employment. The study found that the proportion of veterans in the study who were employed full-time increased by 14 percentage points after the VHPD program compared with before it. The study also found that 43 percent of the sample members were employed at the time of follow-up compared with 25 percent before the intervention; the authors did not report the significance of this finding.
Earnings
- There was a statistically significant positive relationship between the VHPD program and earnings. The study found that the veterans in the study earned $525 more after the VHPD program than before it.
Public benefit receipt
- The study found mixed relationships between the VHPD program and public benefit receipt. Significantly fewer veterans in the study received TANF, SNAP, Medicare, Children’s Health Insurance Program, and unemployment insurance after the VHPD program compared with before it. But significantly more veterans in the study received Veterans Pension benefits after the intervention than before.
Education and training
- The study found that 29 percent of the sample members were engaged in training or education at follow-up compared with 28 percent before the intervention. The authors did not report the significance of this finding.
Considerations for Interpreting the Findings
The authors compared the outcomes of participants measured before and after they participated in the intervention. For these types of designs, the authors must observe outcomes for multiple periods before the intervention to rule out the possibility that participants had increasing or decreasing trends in the outcomes examined before enrollment in the program. That is, if participants who had increasing employment rates or earnings tended to enroll in the program, we would anticipate further increases over time, even if they did not participate in the program. Without knowing the trends before program enrollment, we cannot rule out this possibility. Therefore, the study receives a low causal evidence rating.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the VHPD program; other factors are likely to have contributed.