# A Pragmatic Randomized Trial Integrating Homelessness Diversion Services into an Emergency Department Discharge System

> **NIH NIH R01** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2022 · $592,812

## Abstract

Project Summary/Abstract
The COVID-19 pandemic has shined a spotlight on the long-standing problem of homelessness 
in the U.S., a major public health concern since homelessness is both a cause and contributor 
to poor mental and physical health. Rising income inequality and disparate access to 
services/resources among vulnerable populations has been exacerbated by the pandemic 
which has resulted in a large population of people who are at-risk of becoming homeless. 
Primary prevention efforts are required to eliminate homelessness but the science of 
homelessness prevention is limited with no known scientifically rigorous trials testing the impact 
of homelessness diversion as an intervention for health and housing. Emergency departments 
(ED) provide an opportune space to target homeless diversion efforts to maximize the reach to 
individuals with elevated health and housing needs. Our long-term goal is to inform the 
knowledge base about homelessness diversion, including understanding whether embedding a 
homeless diversion program within a hospital ED discharge system has health and wellness 
benefits for the recipients (individuals) and the organizations who serve them (community).
Guided by preliminary work and data, this goal will be accomplished through three specific aims 
to: 1) Determine whether a homelessness diversion program integrated into a hospital ED 
discharge system will lower ED use via increased housing retention and wellbeing. Our 
hypothesis is that relative to individuals receiving standard care, individuals who receive 
homelessness diversion services will have lower emergency department use via increased 
housing retention and health-related quality of life. Our approach to testing the working 
hypothesis will be to perform a pragmatic single-blind randomized trial with 1,000 individuals 
exiting the ED and analyze outcomes over six months. 2) Determine characteristics of 
individuals most likely to benefit from homelessness diversion. Our approach will be to conduct 
secondary analyses of data from our randomized trial to identify sociodemographic and clinical 
factors related to outcomes from homeless diversion services. 3. Discover opportunities to tailor 
homeless diversion services to better meet the needs of diverse communities. We will conduct 
surveys and focus groups with 40 diverse homeless diversion clients followed by consideration 
of key stakeholders. The findings from this project will provide critical information on the most 
effective strategies for diverting individuals at imminent risk for homelessness, providing an 
upstream intervention to addressing health inequities among this vulnerable population.

## Key facts

- **NIH application ID:** 10597810
- **Project number:** 1R01MD018213-01
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Vanessa Rose Schick
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $592,812
- **Award type:** 1
- **Project period:** 2022-09-26 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10597810

## Citation

> US National Institutes of Health, RePORTER application 10597810, A Pragmatic Randomized Trial Integrating Homelessness Diversion Services into an Emergency Department Discharge System (1R01MD018213-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10597810. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*