Prioritizing Prevention: Examining Shelter Diversion as an Early Intervention Approach to Respond to Youth Homelessness

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Only after I realized that this was a research proposal (or study protocol) and not a research article, could I make any sense of it. In checking back through the review request I received, and its unique format is indicated, but not highlighted. 

I have never seen study protocols in a peer review journals before, so this format caught me off guard -- since funded research has already been peer-reviewed (which is how funding decisions are made).  Furthermore, many of the review prompts are inappropriate for this type of submission, making it somewhat challenging to evaluate using the journal rubric. I flag this because I am not sure of the ethical dimensions of using peer-reviewed content developed for grant-seeking in a peer-reviewed journal submission. On the other hand, it's an excellent way for students to learn how to create a strong research design, which this is. 

The strengths of this submission include: 1. the alignment between the stated research approach and ethical commitments and the methods of data collection and sources of data indicated; 2. the succinct description of the JEDI framework;  3. the ambitiousness of the study; and 4. the potential utility of the findings -- which are likely to be extremely helpful for communities across Canada seeking to support family mediation and effective, supportive, and equitable diversion strategies during a national housing affordability crisis. 

Author Response

Comments: Only after I realized that this was a research proposal (or study protocol) and not a research article, could I make any sense of it. In checking back through the review request I received, and its unique format is indicated, but not highlighted. 

I have never seen study protocols in a peer review journals before, so this format caught me off guard -- since funded research has already been peer-reviewed (which is how funding decisions are made).  Furthermore, many of the review prompts are inappropriate for this type of submission, making it somewhat challenging to evaluate using the journal rubric. I flag this because I am not sure of the ethical dimensions of using peer-reviewed content developed for grant-seeking in a peer-reviewed journal submission. On the other hand, it's an excellent way for students to learn how to create a strong research design, which this is. 

The strengths of this submission include: 1. the alignment between the stated research approach and ethical commitments and the methods of data collection and sources of data indicated; 2. the succinct description of the JEDI framework;  3. the ambitiousness of the study; and 4. the potential utility of the findings -- which are likely to be extremely helpful for communities across Canada seeking to support family mediation and effective, supportive, and equitable diversion strategies during a national housing affordability crisis.

Response: We recognize that a protocol paper may be hard to review based on typical Journal criteria - thank you for reviewing in this context and thank you for your positive comments noted below. 

Reviewer 2 Report

Comments and Suggestions for Authors

This study has the potential to add significantly to homeless prevention literature and have real-world impact. The CBPR approach is a valuable piece that is often missing in research and I am excited to see it incorporated here. I have questions regarding recruitment, consent, and data analysis. For example, will sampling be representative, purposive or something else? What will the consent process look like? Will youth be able to participate without parental involvement? Also, What types of data will you be collecting (specific variables)? If demographics will be included, how will race and gender be treated? Will small numbers be removed from the analysis or included as part of the findings? Will minority groups be counted together (e.g. White vs. All Other), and if so, why? What will be the study duration and why?

 

The section on JEDI was well defined, however, I am not clear on how JEDI will be operationalized in the study. How will JEDI principles be concretely applied and what is the end goal of this? It is an important and needed approach, but does not seem to be incorporated in the actual study.

The plans for dissemination and impact are important and timely.

 

 

Author Response

Comment 1: This study has the potential to add significantly to homeless prevention literature and have real-world impact. The CBPR approach is a valuable piece that is often missing in research and I am excited to see it incorporated here. I have questions regarding recruitment, consent, and data analysis. For example, will sampling be representative, purposive or something else? What will the consent process look like? Will youth be able to participate without parental involvement? Also, What types of data will you be collecting (specific variables)? If demographics will be included, how will race and gender be treated? Will small numbers be removed from the analysis or included as part of the findings? Will minority groups be counted together (e.g. White vs. All Other), and if so, why? What will be the study duration and why?

Response: Thank you very much for these comments. We have added additional detail about the recruitment, data collection, consent processes and variables for analysis

Comment 2: The section on JEDI was well defined, however, I am not clear on how JEDI will be operationalized in the study. How will JEDI principles be concretely applied and what is the end goal of this? It is an important and needed approach, but does not seem to be incorporated in the actual study.

Response: Thank you for pointing this out - we have added content about the intentional composition of our research team and the value add of the CBR approach which creates equitable and safe spaces for diverse experience and contribution. 

Comment 3: The plans for dissemination and impact are important and timely.

Response - Thank you!

Reviewer 3 Report

Comments and Suggestions for Authors

 

This study has many important contributions to prevention policy, literature, and discussions. The study includes important community based and justice principles that are commendable. Below I outline some comments the authors may find helpful in organizing the Protocol and further emphasizing the contributions of this important project.

 

Introduction

         “While cities across Canada are responding in varying degrees, efforts to prevent homelessness are sporadic and less developed than crisis responses and Housing First programs [5]. This means most of our homelessness responses support people after they have already become homeless.”

                  This sentence needs clarification given the previous sentences outlining the three primary responses and examples of legislation, etc. The authors may consider adding a few sentences on Canada’s known crisis response to homelessness and its failures.

         The introduction is a bit hard to follow. The authors begin by talking about responses to homelessness and then jump into the impacts and predictors, as well as youth homelessness. It might be more helpful for the authors to start by discussing homelessness and its impacts, then youth homelessness, and then Canadian responses. This would provide a nice lead into the study protocol.

 

Background

         This introduction to prevention could use further specificity; the argument seems to be that prevention needs to be targeted – if so, what does this look like and how does the existing prevention literature help us understand this? The discussion of prevention strategies and the continuum are helpful – how do these concepts and approaches tie into or influence the specific groups discussed and how might they lead to changes in approach? The Canadian approaches (or lack thereof) to prevention could also be better introduced here to show the inefficiency in existing policies (and provide the support for change/a prevention focus).

         The section on youth homelessness prevention is a strong one and with an introduction to fragmentation of homelessness policies (supported by literature) there would be a nice lad into the discussion on lack of integration that appears here.

         The section on shelter diversion is great, but I was left wanting to know more about its use and prevalence in Canada. Prior to jumping into the successes of existing programs, the authors could set up how prevalent (or not) the approach is and consider its use across Canada – is this an approach that is growing and only found within certain communities? Is it the focus of local level collaborations or are upper levels of government also involved?  This would also be helpful for readers to know prior to jumping into the methods – to set up the case selection/sample to be utilized.

 

Materials and methods  

         The introduction of JEDI (3.1) is helpful, but should also include how the strategy is used/how it applies as an outcome to the project. As the description stands now it is separate from the project and not embedded within the practices and methods introduced later (the section on CBPR does this well by introducing CBPR and then showing how it is applied in the context of the project itself).

         “Our project was initiated and conceptualized between the community agencies noted 241

above and researchers from the University of Calgary and the University of Toronto.”

                   It is unclear which community agencies the authors refer to here.

         More on the sample of diversion programs – the scope and location (as well as actors involved) – would help readers fully grasp the scope of the project. The comparative approach is mentioned (and then cities later identified in research questions) without discussion of how cases were chosen or why. In RQ #3 6 cities are mentioned (as “e.g.”): are these the only sites? Why are these the sites chosen? As a “national study” more information on sites chosen will also help boost claims made in the Discussion later.

Author Response

Comment 1: 

While cities across Canada are responding in varying degrees, efforts to prevent homelessness are sporadic and less developed than crisis responses and Housing First programs [5]. This means most of our homelessness responses support people after they have already become homeless.”

                  This sentence needs clarification given the previous sentences outlining the three primary responses and examples of legislation, etc. The authors may consider adding a few sentences on Canada’s known crisis response to homelessness and its failures.

         The introduction is a bit hard to follow. The authors begin by talking about responses to homelessness and then jump into the impacts and predictors, as well as youth homelessness. It might be more helpful for the authors to start by discussing homelessness and its impacts, then youth homelessness, and then Canadian responses. This would provide a nice lead into the study protocol.

Response: Thank you for your suggestions - we agree that the introduction needed some reframing for clarification purposes. We have moved several sections around to improve the flow of arguments and added some text about the limitations of housing first (national housing shortage) as the primary response to ending homelessness. 

Comment 2: 

Background

         This introduction to prevention could use further specificity; the argument seems to be that prevention needs to be targeted – if so, what does this look like and how does the existing prevention literature help us understand this? The discussion of prevention strategies and the continuum are helpful – how do these concepts and approaches tie into or influence the specific groups discussed and how might they lead to changes in approach? The Canadian approaches (or lack thereof) to prevention could also be better introduced here to show the inefficiency in existing policies (and provide the support for change/a prevention focus).

         The section on youth homelessness prevention is a strong one and with an introduction to fragmentation of homelessness policies (supported by literature) there would be a nice lad into the discussion on lack of integration that appears here.

         The section on shelter diversion is great, but I was left wanting to know more about its use and prevalence in Canada. Prior to jumping into the successes of existing programs, the authors could set up how prevalent (or not) the approach is and consider its use across Canada – is this an approach that is growing and only found within certain communities? Is it the focus of local level collaborations or are upper levels of government also involved?  This would also be helpful for readers to know prior to jumping into the methods – to set up the case selection/sample to be utilized.

Response: Thank you again for pointing out some gaps and lack of clarity in this section. We have added a paragraph at the beginning of this section about fractured/siloed policies and how pathways into homelessness are diverse based on people's experiences and so prevention strategies need to be multi level and layered and cut across government mandates and ministries.

In terms of the scale and scope of shelter diversion across Canada - we were not able to articulate how many organizations and where they are located. We stated this, and added that as one of the expected outcomes of this project  - an expanded community of practice - we also added that two national organizations - CAEH and COH are also looking at diversion research for other populations, adults and families. 

Materials and methods  

         The introduction of JEDI (3.1) is helpful, but should also include how the strategy is used/how it applies as an outcome to the project. As the description stands now it is separate from the project and not embedded within the practices and methods introduced later (the section on CBPR does this well by introducing CBPR and then showing how it is applied in the context of the project itself).

         “Our project was initiated and conceptualized between the community agencies noted 241

above and researchers from the University of Calgary and the University of Toronto.”

                   It is unclear which community agencies the authors refer to here.

         More on the sample of diversion programs – the scope and location (as well as actors involved) – would help readers fully grasp the scope of the project. The comparative approach is mentioned (and then cities later identified in research questions) without discussion of how cases were chosen or why. In RQ #3 6 cities are mentioned (as “e.g.”): are these the only sites? Why are these the sites chosen? As a “national study” more information on sites chosen will also help boost claims made in the Discussion later.

Response: we added a paragraph about how we have embedded EDI approaches throughout our project. 

We clarified the partners and actually removed the words 'national study' and replaced with 'multi-site' study where relevant.