Permanent Supportive Housing Overdose Prevention+ Study

Preventing Overdose in Supportive Housing: Stepped Wedge Randomized Controlled Trial of a Multi-Sector, Upstream Intervention

This community-partnered study examines a technical assistance intervention designed to help permanent supportive housing agencies implement evidence-based practices to prevent tenant overdose and improve tenant health.

Homelessness and housing instability are strongly linked with overdose risk. Permanent supportive housing (PSH) -subsidized housing paired with supportive services-is a key strategy to end homelessness yet supportive housing tenants face high overdose risk due to a confluence of factors. This multi-sector, community-partnered, stepped wedge randomized controlled trial evaluates the impact of a technical assistance intervention designed to support supportive housing agencies in sustainably implementing evidence-based practices to reduce tenant overdose and improve tenant health more broadly. The technical assistance intervention will be delivered to supportive housing agencies in New Jersey and New York who are enrolled in the trial. Outcomes include PSH agency implementation of overdose prevention practices and downstream tenant overdose, substance use, and other health-related outcomes. Outcomes will be assessed using surveys, administrative data, and agency records. This trial is a part of the HEAL Initiative (https://heal.nih.gov/).

We will be enrolling supportive housing agencies from NY and NJ to participate in this study. Trial enrollment and intervention delivery will occur at the level of the agency. There are anticipated to be 24 supportive housing agencies total that will be enrolled in the study; approximately 6 agencies will be randomly assigned to each of the four intervention waves in the stepped wedge randomized controlled trial.

Inclusion Criteria:

Supportive Housing Agencies/Individuals who Work at Supportive Housing Agencies:

• Serve at least 40 tenants in New York and/or New Jersey
• Have a significant concern for overdose (as demonstrated by past year tenant overdose)
• Be willing to complete all activities required for participation in the trial

Tenants who Live in Supportive Housing Agencies:

• Must live in an enrolled Supportive Housing Agency
• Must be 18 years and older

Exclusion Criteria:

• See inclusion criteria.