All tenants in three TCHC buildings will be invited to participate in a survey on their building conditions at baseline, 6 months and 12 months. Once baseline data collection is complete, there will be a community organizing campaign involving tenants to advocate for improved building conditions.

The intervention will be community organizing and will consist of engaging tenants, health providers, legal service staff, social service agencies and advocacy organizations (e.g. ACORN). Each building team will identify initial priorities and then invite all building members to discuss and to finalize, as well as a plan for change. Building teams will engage in advocacy to TCHC and its representatives, and other city departments as appropriate. Engaging in advocacy will consist of a wide range of activities but essentially means presenting evidence (e.g. personal experiences, data) to policymakers and decision makers to affect change.

Acceptability and feasibility of the intervention, assessed through qualitative focus groups with participants in each intervention building. The HEARTH Survey was built by the research team (example question: How satisfied are you with the condition of your building?). All qualitative data will be managed and analyzed with the data management software, NVivo.

Change in the state of housing evaluated by a questionnaire completed by tenants and official reports from the Toronto Community Housing Corporation. The HEARTH survey consisted of various questions relating to this, leading to different answers due to different scales. For example, for safety of the building, the options were: very safe, fairly safe, neither safe nor unsafe, fairly unsafe, and very unsafe. All scales had 5 options/outcomes but different wordings. No quantitative score was used for this.

Change in self-rated physical and mental health, sense of security, social integration, evaluated by surveys of residents using PROMIS scale. This scale is validated. For pain, the minimum score is 0 and the maximum score is 10, with 10 representing the worst pain imaginable. The higher the number on the scale, the worse the outcome/issue is.