Research on Transitional Housing for People with HIV

Overview

The Leonard Davis Institute of Health Economics (Penn LDI), the Penn Center for AIDS Research (CFAR), and the Philadelphia Department of Public Health (PDPH) Division of HIV Health (DHH) are soliciting research proposals focused on transitional housing for people with HIV (PWH).

The City of Philadelphia PDPH/DHH is funding a new HIV transitional housing and supportive services program. The program will be consistent with client-centered best practice including Housing First principles and program policies of harm reduction, low-barrier methods, client choice and self-determination.

We seek proposals that connect Penn researchers with PDPH/DHH to answer questions that are of mutual interest and will impact policy and/or program implementation. Projects may focus on Philadelphia’s new transitional housing program or other transitional housing programs in the US that can help inform policies and practice around transitional housing for PWH. More details on this transitional housing program are included below, along with areas of interest to PDPH/DHH.

Key Dates

This RFA is now closed.

Proposal Details

We invite LDI Senior Fellows and CFAR faculty to propose ideas for one-year collaborative pilot projects aimed at advancing policy and practice around and successful adoption of transitional housing programs. Selected projects will be eligible for up to $25,000.

Proposals should focus on research questions around the implementation or effectiveness of transitional housing programs, be feasible for completion in a one-year timeline and have the potential for impact by advancing our understanding of the effectiveness of transitional housing programs or informing current or future efforts aimed at addressing homelessness.

Available Resources

PDPH/DHH staff will be available to help facilitate the project, including access to its infrastructure and/or data within its purview, including (but not limited to) data on application for and enrollment in the transitional housing program, short-term outcomes of enrolled an unenrolled individuals (e.g., being housed, satisfaction, quality of life, needs assessment) and longer-term health-related outcomes (e.g., viral load, CD4 count, and Ryan White health care utilization).

CFAR resources include the Biostatistics and Data Science Core, which has a biostatistician on-site at PDPH to assist with the use of city data by CFAR/Penn investigators (including on-site analysis of data that cannot leave PDPH until it is aggregated), the Prevention Science & Community Outreach Core, and the Developmental Core that can link new-to-HIV/AIDS investigators with established CFAR investigators.

Penn LDI resources include assistance in translation and dissemination of completed research.

Eligibility, Application Process, Timeline, and Budget

LDI Senior Fellows and CFAR faculty are eligible to apply. Selected projects will be eligible for up to $25,000 in funding. Faculty and trainee salary support are not allowable.

An informational meeting with PDPH/DHH leadership will be held on Wednesday, September 20 at 8 a.m. to provide more information about the transitional housing program, and answer questions from interested investigators. Please register using the link provided above. For those unable to attend, the session will be recorded and available upon request.

Proposal review will occur in two stages:

Investigators should submit a one-page concept sheet (due October 2, 2023) describing the planned research question and possible approach to answer it. Penn LDI/CFAR/PDPH DHH will review these proposals and, by mid-October, only select concepts to move forward to full proposals.

Teams submitting selected concepts will work with PDPH/DHH to further develop their projects, and four-page research proposals will be due by mid-November (tentatively November 20, 2023). Successful proposals will be notified in late November, with a planned start date of January 1, 2024.

How to Apply

We urge all interested faculty to attend the informational discussion with PDPH/DHH on September 20. Please email Nadiyah Browning (nadiyahb@wharton.upenn.edu) if you’d like a copy of the recording.

To submit a research concept please complete the online application form, which includes:

A one-page concept sheet describing an idea for a project in one or more priority areas and how your current area of work aligns, the data sources that may be needed, and the potential impact.
The proposed project budget (up to $25,000) and timeline. Projects should have a one-year timeline with a planned start date of January 1, 2024.
Investigator(s)’ NIH biosketch(es).

More Details About the Philadelphia Transitional Housing Program for People with HIV

National strategies and state and local HIV plans aim to decrease homelessness and housing instability by 50% for PWH by 2025. The City of Philadelphia’s Ending the HIV Epidemic Community Plan includes goals and objectives for housing people with HIV. The City of Philadelphia PDPH/DHH is funding a new HIV transitional housing and supportive services program. The program will be consistent with client-centered best practice including Housing First principles and program policies of harm reduction, low-barrier methods, client choice and self-determination.

The services that will be provided through this program include: (1) housing counseling to secure permanent housing, (2) housing medical case management to assure retention in HIV care and viral suppression, and (3) processing of rent payments directly to the owner(s) or their designated agent. Participants will be eligible for up to 48 months of housing assistance; if permanent housing has not been obtained by then, participation in the program may be continued until permanent housing is obtained. PWH currently experiencing homelessness will receive the highest priority for participation, followed by those who are unstably housed. PWH who are cost-burdened, defined as households that spend more than 50% of their incomes on rent will also be eligible for housing as space permits. Based on local data from the CDC funded Medical Monitoring Project, there are an estimated 4,000 PWH who meet the eligibility requirements for this program. Eligible individuals will be screened and put on a waiting list for housing beginning in 2024. PDPH/DHH anticipates housing 40 individuals over the first six months of the program.

Research Areas of Specific Interest

Examples of projects that might be of interest are listed below. A project’s methodological approach should be chosen to best answer the research question and could include observational studies using existing sources of data and rigorous methodological approaches, policy evaluation, or the application of qualitative and/or implementation science methods. Projects could focus on PDPH DHH’s model or on other models in the US. Projects in which participants are prospectively assigned a study intervention designed to test health outcomes (NIH-defined “clinical trial”) are not allowable under this funding mechanism; projects that evaluate outcomes from intervention assignment intrinsic to the PDPH/DHH program (e.g; lottery) are allowable.

Identification of strategies best suited to implement and enroll participants into a transitional housing program Identification of barriers and facilitators of effective implementation of a transitional housing program, particularly across multiple partners
Identification of strategies best suited to implement and enroll participants into a transitional housing program Identification of barriers and facilitators of effective implementation of a transitional housing program, particularly across multiple partners
Identification of factors that influence the successful implementation of the transitional housing program, including individual health-related and non-health-related characteristics as well as programmatic components
Evaluation of the effect of the transitional housing model on short and longer-term outcomes and on costs. This could be accomplished through using causal inference methods and observational data or using modeling. This could be done in collaboration with PDPH DHH and built into program implementation. Using a lottery to assign housing to eligible individuals would be allowable.
Evaluation of the effect of the transitional housing model on costs, such as program costs for the PHPG DHH program at scale or net costs per person based on expected outcomes.