Effectiveness of Interventions for Meaningful Activity Participation in Homelessness: A Systematic Review

Background. Meaningful activity participation has been identified as a key outcome of services designed to support individuals during and following homelessness. Little is known about the effectiveness of interventions for promoting this outcome. Purpose. To identify the range and effectiveness of interventions on promoting meaningful activity participation among persons with experiences of homelessness. Method. We conducted a systematic review using the Joanna Briggs Institute methodology following PRISMA guidelines including a critical appraisal and narrative synthesis. Findings. Of 12,343 titles and abstracts screened, we included 12 studies. The authors of the included studies primarily used standardized measures of meaningful activity engagement. Critical appraisal scores ranged from 50.0 to 77.8. The most common interventions evaluated in the included studies were psychosocial interventions (n = 6; 50.0%), followed by case management and housing support interventions (n = 4; 33.3%) and Housing First (n = 2; 16.7%). While several interventions demonstrated effectiveness in promoting meaningful activity participation including psychosocial and case management interventions, Housing First, Critical Time Intervention, and a peer support intervention were found to be ineffective for promoting engagement in meaningful activity. Conclusion. Few intervention studies have been conducted that demonstrate effectiveness for promoting participation in meaningful activity for individuals during and following homelessness. Occupational therapy researchers and practitioners can build on existing evidence by developing and evaluating novel approaches by co-designing interventions in collaboration with persons with experiences of homelessness and service providers. Description. La participation a des activites signifiantes a ete identifiee comme un resultat cle des services concus pour soutenir les individus pendant et apres l'itinerance. On sait peu de choses sur l'efficacite des interventions en ce sens. Objectif. Identifier la teneur et l'efficacite des interventions visant a promouvoir la participation a des activites signifiantes aupres des personnes ayant une experience de l'itinerance. Methodologie. Nous avons realise une revue systematique recourant a la methodologie de l'Institut Joanna Briggs selon les lignes directrices PRISMA et comprenant une evaluation critique ainsi qu'une synthese narrative. Resultats. Sur les 12 343 titres et resumes passes en revue, 12 etudes ont ete retenues. Les auteurs des etudes incluses ont principalement eu recours a des mesures standardisees de l'engagement dans des activites signifiantes. Les scores attribues lors de l'evaluation critique vont de 50,0 a 77,8. Les interventions les plus courantes evaluees dans les etudes incluses etaient les interventions psychosociales (n = 6; 50,0%), suivies par les interventions de gestion de cas et de soutien au logement (n = 4; 33,3%) et Logement d'abord (n = 2; 16,7%). Si plusieurs interventions se sont revelees efficaces pour promouvoir la participation a des activites signifiantes, notamment les interventions psychosociales et de gestion de cas, Logement d'abord, Critical Time Intervention et une intervention de soutien par les pairs se sont revelees inefficaces pour promouvoir l'engagement dans des activites signifiantes. Conclusion. Peu d'etudes d'intervention demontrent l'efficacite de la promotion de la participation a des activites signifiantes pendant et apres l'itinerance. Les chercheurs et les praticiens en ergotherapie peuvent s'appuyer sur les donnees probantes existantes en developpant et en evaluant de nouvelles approches par la coconception d'interventions en collaboration avec des personnes ayant une experience de l'itinerance et des prestataires de services.