{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:26:46Z","timestamp":1793658406673,"version":"4.5.1"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"St. Michael's Hospital Research Training Centre","award":["Scholarship, #2019"],"award-info":[{"award-number":["Scholarship, #2019"]}]},{"DOI":"10.13039\/100022897","name":"Mental Health Commission of Canada","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100022897","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","award":["HSRF #259"],"award-info":[{"award-number":["HSRF #259"]}],"id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"canadian institutes of health research","doi-asserted-by":"publisher","award":["CIHR MOP-130405"],"award-info":[{"award-number":["CIHR MOP-130405"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Housing First (HF)-based interventions have been implemented in North America and beyond to help people exit homelessness. The effect of these interventions on access to primary and specialist care services is not well-defined. This study assesses the long-term effects of an HF intervention for homeless adults with mental illness on primary care physician (PCP) and non-primary care physician (non-PCP) visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a secondary analysis of the At Home\/Chez Soi study, a randomized trial of HF for homeless adults with mental illness in Toronto, Canada. High-need (HN) participants were randomized to HF with assertive community treatment (HF-ACT) or treatment as usual (TAU). Moderate needs (MN) participants were randomized to HF with intensive case management (HF-ICM) or TAU. The primary outcomes were the incidence and the number of visits to a PCP and non-PCP over 7-years post-randomization, compared to the 1-year pre-randomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 575 enrolled participants, 527 (80 HN and 347 MN) participants were included in the analyses. HN participants who received HF-ACT had a significant reduction in the number of visits to a PCP compared to TAU participants (ratio of rate ratios (RRR): 0.66, 95% CI: 0.48-0.93) and a significant reduction in the number of non-PCP visits compared with TAU participants (RRR: 0.64, 95% CI: 0.42-0.97) in the 7-years post-randomization compared to the 1-year pre-randomization. MN participants who received HF-ICM had a significant increase in incident visits to a PCP compared to TAU participants (RRR: 1.66, 95% CI: 1.10-2.50). No effect of HF-ICM was observed on the incidence or number of non-PCP visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HF has differing effects on visits to PCPs and non-PCPs among homeless people with high and moderate needs for mental health supports. HF does not result in a consistent increase in PCP and non-PCP visits over a 7-year follow-up period. The At Home\/Chez Soi study is registered with ISRCTN (ISRCTN, ISRCTN42520374).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501327211027102","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T01:51:35Z","timestamp":1625795495000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Long-Term Effects of a Housing First Intervention on Primary Care and Non-Primary Care Physician Visits Among Homeless Adults with Mental Illness: A 7-Year RCT Follow-Up"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1131-8439","authenticated-orcid":false,"given":"Cilia","family":"Mejia-Lancheros","sequence":"first","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, ON, Canada"},{"name":"Research Group in Nursing Care and Practice, Family Nursing and Health Measurement. Faculty of Nursing, Universidad Nacional de Colombia, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lachaud","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"To","sequence":"additional","affiliation":[{"name":"St Joseph\u2019s Health Centre, Department of Family and Community Medicine, Unity Health Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patsy","family":"Lee","sequence":"additional","affiliation":[{"name":"McMaster University, Michael G. DeGroote School of Medicine, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosane","family":"Nisenbaum","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, ON, Canada"},{"name":"Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"O\u2019Campo","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Stergiopoulos","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health, Toronto, ON, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Hwang","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Unity Health Toronto, Toronto, ON, Canada"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"bibr1-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00409.x"},{"key":"bibr2-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1"},{"key":"bibr3-21501327211027102","doi-asserted-by":"publisher","DOI":"10.6064\/2012\/432892"},{"key":"bibr4-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-019-1002-6"},{"key":"bibr5-21501327211027102","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp19X704633"},{"key":"bibr6-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61132-6"},{"key":"bibr7-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70177-9"},{"key":"bibr8-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30188-4"},{"key":"bibr9-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.21.2045"},{"key":"bibr10-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1002\/hec"},{"key":"bibr11-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2011.00628.x"},{"key":"bibr12-21501327211027102","volume-title":"Housing First: Ending Homelessness, Transforming Systems, and Changing Lives","author":"Padgett DK","year":"2016"},{"key":"bibr13-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1037\/cap0000206"},{"key":"bibr14-21501327211027102","unstructured":"Busch-Geertsema V. Housing First Europe. Final Report. European Union Programme for Employment and Social Security \u2013 PROGRESS; 2013."},{"key":"bibr15-21501327211027102","volume-title":"The Pathways Model to End Homelessness for People with Mental Illness and Addiction","author":"Tsemberis S","year":"2015"},{"key":"bibr16-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000112"},{"key":"bibr17-21501327211027102","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2013.03.120239"},{"key":"bibr18-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30371-2"},{"key":"bibr19-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-787"},{"key":"bibr20-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2011-000323"},{"key":"bibr21-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-9338(99)80239-9"},{"key":"bibr22-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.202303"},{"key":"bibr23-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1163"},{"key":"bibr24-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.561"},{"key":"bibr25-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2372-3"},{"key":"bibr26-21501327211027102","volume-title":"Mental Health and Primary Care Policy Framework","author":"Centre for Addiction and Mental Health","year":"2016"},{"key":"bibr27-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1177\/0840470416679413"},{"key":"bibr28-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013610"},{"issue":"8","key":"bibr29-21501327211027102","first-page":"563","volume":"66","author":"Andermann A","year":"2020","journal-title":"Can Fam Physician"},{"key":"bibr30-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1014-x"},{"key":"bibr31-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2005.06.003"},{"issue":"525","key":"bibr32-21501327211027102","first-page":"286","volume":"56","author":"Wright NMJ","year":"2006","journal-title":"Br J Gen Pract"},{"key":"bibr33-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1256-2"},{"key":"bibr34-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-020-01106-z"},{"key":"bibr35-21501327211027102","doi-asserted-by":"publisher","DOI":"10.25071\/2291-5796.34"},{"key":"bibr36-21501327211027102","doi-asserted-by":"publisher","DOI":"10.1177\/2150132720910289"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501327211027102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501327211027102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501327211027102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:22:51Z","timestamp":1777508571000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501327211027102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":36,"alternative-id":["10.1177\/21501327211027102"],"URL":"https:\/\/doi.org\/10.1177\/21501327211027102","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"21501327211027102"}}