{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T08:10:47Z","timestamp":1782202247739,"version":"3.54.5"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Abstract<\/jats:title>\n                  <jats:p>A 2012 Massachusetts shelter eligibility regulation required many families to spend a night in a location \u201cnot meant for human habitation\u201d before qualifying for the state-run shelter system, and many families experiencing homelessness stayed in pediatric emergency departments (EDs) overnight to meet this requirement. ED clinicians initially recognized an increase in ED visits for homelessness after this regulation and began compiling and sharing stories with key institutional and community partners and stakeholders. To bolster advocacy efforts, the authors collected data on the magnitude of the problem and its associated health care costs. Guided by the policy knowledge of community partners, the authors leveraged the expertise and advocacy power of clinicians to share these data and stories with legislators via written and oral testimony, community events, and the media. Academic publication lent additional credibility and exposure to their research. In 2019, the Massachusetts Legislature passed budget language to overturn the 2012 shelter eligibility regulation. However, despite this policy victory, some families continue to present to EDs for homelessness. Therefore, current advocacy efforts have shifted focus toward implementation and enforcement of the new policy, monitoring issues, and developing new programmatic responses. In this advocacy case study, we illustrate how clinicians have unique abilities to serve as effective advocates for social policy change using a framework of strategies including storytelling, coalition building, tailored communication, and data sharing. Partnering with existing advocacy networks within their institution and community enhances the advocacy efforts of all stakeholders to influence social and health outcomes for children and families.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-057935","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T08:13:20Z","timestamp":1674116000000},"source":"Crossref","is-referenced-by-count":8,"title":["Community-Academic Advocacy to Improve Shelter Access for Families Experiencing Homelessness"],"prefix":"10.1542","volume":"151","author":[{"given":"Mia","family":"Kanak","sequence":"first","affiliation":[{"name":"aDivision of Emergency Medicine and Transport Medicine, Children\u2019s Hospital Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Turley","sequence":"additional","affiliation":[{"name":"bMassachusetts Coalition for the Homeless, Lynn, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois K.","family":"Lee","sequence":"additional","affiliation":[{"name":"cDivision of Emergency Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"dHarvard Medical School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Sandel","sequence":"additional","affiliation":[{"name":"eDepartment of Pediatrics, Boston Medical Center, Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"cDivision of Emergency Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"dHarvard Medical School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"2023111013561945500_B1","unstructured":"US Interagency Council on Homelessness\n          . Homelessness in America: focus on families with children. Available at: https:\/\/www.usich.gov\/resources\/uploads\/asset_library\/Homeslessness_in_ America_Families_with_Children.pdf. Accessed January 17, 2022"},{"issue":"2","key":"2023111013561945500_B2","doi-asserted-by":"crossref","first-page":"e20201408","DOI":"10.1542\/peds.2020-1408","article-title":"Homelessness, children, and COVID-19: a looming crisis","volume":"146","author":"Coughlin","year":"2020","journal-title":"Pediatrics"},{"key":"2023111013561945500_B3","unstructured":"Wulfhorst\n              E\n            \n          . Coronavirus could put 1.5 million US families on cusp of homelessness. Available at: https:\/\/www.reuters.com\/article\/us-health-coronavirus-housing- trfn\/coronavirus-could-put-1-5-million-u- s-families- on-cusp-of-homelessness- idUSKBN21Q27M. Accessed March 6, 2020"},{"issue":"7","key":"2023111013561945500_B4","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1542\/pir.25.7.235","article-title":"Homeless children: what every clinician should know","volume":"25","author":"Karr","year":"2004","journal-title":"Pediatr Rev"},{"issue":"2","key":"2023111013561945500_B5","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.pcl.2019.12.007","article-title":"Homelessness in pediatric populations: strategies for prevention, assistance, and advocacy","volume":"67","author":"Beharry","year":"2020","journal-title":"Pediatr Clin North Am"},{"issue":"2","key":"2023111013561945500_B6","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jaac.2014.11.008","article-title":"The prevalence of mental illness in homeless children: a systematic review and meta-analysis","volume":"54","author":"Bassuk","year":"2015","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2023111013561945500_B7","volume-title":"Emergency Assistance Advocacy Guide: A Guide to Emergency Shelter and Rehousing Services for Homeless Families with Children in Massachusetts","author":"Bourquin","year":"2015"},{"key":"2023111013561945500_B8","unstructured":"Galvin\n              WF\n            \n          . Secretary of the Commonwealth. Massachusetts Register. Section 760 CMR: Department of Housing and Community Development, Subsection 67.06: Temporary Emergency Shelter. Available at: https:\/\/www.mass.gov\/files\/documents\/2017\/10\/25\/760cmr67.pdf. Accessed November 5, 2021"},{"key":"2023111013561945500_B9","unstructured":"Massachusetts Coalition for the Homeless\n          . Stand up with families experiencing homelessness advocacy event. Available at: www.mahomeless.org\/advocacy\/item\/10-18-16-emergency-assistance-advocacy- event. Accessed January 18, 2022"},{"key":"2023111013561945500_B10","unstructured":"Massachusetts Coalition for the Homeless\n          . Legislative Action Day. Available at: https:\/\/mahomeless.org\/wp-content\/uploads\/2019\/01\/images_agenda_for_ lad_2020_as_of_2-26-20_for_website.pdf. Accessed January 18, 2022"},{"key":"2023111013561945500_B11","unstructured":"Massachusetts Coalition for the Homeless\n          . MA House Bill 659 testimony from Dr. Amanda Stewart [video]. Available at: https:\/\/www.youtube.com\/watch?v=XuDwQRL7zRY. Accessed January 19, 2022"},{"key":"2023111013561945500_B12","unstructured":"Massachusetts Coalition for the Homeless\n          . MA House Bill 659 testimony from Dr. Mia Kanak [video]. Available at: https:\/\/www.youtube.com\/watch?v=mduAb5GIPMo. Accessed January 19, 2022"},{"key":"2023111013561945500_B13","unstructured":"Kanak\n              M\n            \n          . Testimony supporting H.659, an act to protect families experiencing homelessness from having to sleep in unsafe places. Massachusetts Coalition for the Homeless. Available at: https:\/\/mahomeless.org\/wp-content\/uploads\/2017\/08\/images_H659_Testimony_-_ Mia_Kanak.pdf. Accessed January 18, 2022"},{"issue":"8","key":"2023111013561945500_B14","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.2105\/AJPH.2018.304493","article-title":"Trends in homeless children and young adults seeking shelter in a Boston pediatric emergency department following state housing policy changes, 2011-2016","volume":"108","author":"Kanak","year":"2018","journal-title":"Am J Public Health"},{"issue":"5","key":"2023111013561945500_B15","doi-asserted-by":"crossref","first-page":"e20181224","DOI":"10.1542\/peds.2018-1224","article-title":"Pediatric emergency department visits for homelessness after shelter eligibility policy change","volume":"142","author":"Stewart","year":"2018","journal-title":"Pediatrics"},{"key":"2023111013561945500_B16","article-title":"Trends in homeless children and young adults seeking shelter in a Boston pediatric emergency department following state housing policy changes","author":"American Journal of Public Health Facebook page"},{"key":"2023111013561945500_B17","unstructured":"Nandyala\n              S\n            \n          . Housing and emergency department shelter. Public Health Post. Boston University School of Public Health. Available at: https:\/\/www.publichealthpost.org\/databyte\/housing-and-emergency-department- shelter\/. Accessed November 17, 2021"},{"key":"2023111013561945500_B18","unstructured":"Shoenberg\n              S\n            \n          . Report: homeless children go to emergency rooms to prove shelter eligibility. MassLive. Available at: https:\/\/www.masslive.com\/politics\/2018\/10\/report_homeless_children_go_to.html. Accessed January 18, 2022"},{"key":"2023111013561945500_B19","unstructured":"Trends in homeless children and young adults seeking shelter in a Boston pediatric emergency department following state housing policy changes, 2011\u20132016: overview of attention for article published in American Journal of Public Health, August 2018. Altmetric. Available at: https:\/\/apha.altmetric.com\/details\/44030089. Accessed January 18, 2022"},{"key":"2023111013561945500_B20","unstructured":"Pediatric emergency department visits for homelessness after shelter eligibility policy change. Overview of attention for article published in Pediatrics, Altmetric. Available at: https:\/\/www.altmetric.com\/details\/49689831. Accessed January 18, 2022"},{"key":"2023111013561945500_B21","unstructured":"Massachusetts Law Reform Institute\n          . Emergency assistance (EA) is the Massachusetts program providing emergency shelter and re-housing services for homeless families with children. Available at: https:\/\/www.masslegalhelp.org\/homelessness\/emergency-assistance\/advocacy-guide\/introduction. Accessed December 20, 2021"},{"key":"2023111013561945500_B22","unstructured":"Mass.gov\n          . 70040101 - Emergency Assistance Family Shelters and Services. FY2021 Enacted Budget Summary. Available at: https:\/\/budget.digital.mass.gov\/summary\/fy21\/enacted\/housing-and-economic-development\/housing-and-community-development\/70040101. Accessed December 20, 2021"},{"issue":"2","key":"2023111013561945500_B23","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1136\/emermed-2020-210124","article-title":"Paediatric ED utilisation in the early phase of the COVID-19 pandemic","volume":"38","author":"Lee","year":"2021","journal-title":"Emerg Med J"},{"issue":"4","key":"2023111013561945500_B24","doi-asserted-by":"crossref","first-page":"487","DOI":"10.5811\/westjem.2016.5.30240","article-title":"Addressing social determinants of health from the emergency department through social emergency medicine","volume":"17","author":"Anderson","year":"2016","journal-title":"West J Emerg Med"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2022-057935\/1564794\/peds_2022057935.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2022-057935\/1564794\/peds_2022057935.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T13:57:33Z","timestamp":1699624653000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/151\/2\/e2022057935\/190492\/Community-Academic-Advocacy-to-Improve-Shelter"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,19]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1,19]]},"published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2022-057935","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,19]]},"article-number":"e2022057935"}}