A Patient Navigation Trial for Housing and Health (PATHH): A randomized controlled trial

About This Grant

Nearly one in three women have experienced physical or sexual violence. Women who have survived violence (WSV) demonstrate high rates of housing instability and health problems, including increased morbidity and mortality related to substance use, depression, and HIV. Housing influences long-term well-being and contributes to differences in health outcomes that can persist over time. Healthcare engagement for WSV is often limited by factors such as fragmented services, complex eligibility requirements, and inconsistent follow-up systems. Despite the established link between housing and health, there is a lack of evidence-based interventions designed to directly improve housing instability while simultaneously supporting improved connection to healthcare services. There is an urgent need for approaches that promote housing stability and improve engagement in care for WSV to reduce preventable negative health outcomes. Patient Navigation (PN) is an evidence-based intervention shown to support engagement in social and healthcare services among populations facing complex needs. Building on our prior research and adapting the core components of the Navigation Services to Avoid Re-hospitalization (NavSTAR) intervention, we propose to develop and test PATHH (Patient Navigation Trial for Housing and Health), a PN model focused on improving housing stability and health self-efficacy for WSV. Guided by a Community Advisory Board, we will adapt PN to support PATHH’s implementation across individual, organizational, and community levels (Aim 1). PATHH will then be evaluated as an augmentation to existing services in partnership with community organizations (Aims 2 and 3). To assess effectiveness, we will conduct a parallel, two-arm randomized controlled trial (N=300), randomly assigning WSV 1:1 to PATHH (N=150) or treatment-as-usual (N=150). Primary outcomes will include housing stability and health self-efficacy; secondary outcomes include substance use, mental health, and physical health. We will also evaluate implementation outcomes at the trial’s conclusion. This study is significant in testing a scalable PN approach designed to improve housing stability and health for WSV, and innovative in extending PN beyond traditional healthcare settings into community-based partnerships, while also generating evidence to guide future implementation of PN models.