title: Enhanced Methodologies to Enumerate Persons Experiencing Homelessness in a Large Urban Area.
abstract: BACKGROUND
  Homelessness is a public health problem, and persons experiencing homelessness are a vulnerable population. Estimates of the number of persons experiencing homelessness inform funding allocations and services planning and directly determine the ability of a community to intervene effectively in homelessness. The point-in-time (PIT) count presents a logistical problem in large urban areas, particularly those covering a vast geographical area.
  
  
  METHODS
  Working together, academia, local government, and community organizations improved the methodology for the count. Specific enhancements include use of incident command system (ICS), increased number of staging areas/teams, specialized outreach and Special Weapons and Tactics teams, and day-after surveying to collect demographic information.
  
  
  RESULTS
  This collaboration and enhanced methodology resulted in a more accurate estimate of the number of persons experiencing homelessness and allowed comparison of findings for 4 years. While initial results showed an increase due to improved counting, the number of persons experiencing homelessness counted for the subsequent years showed significant decrease during the same time period as a "housing first" campaign was implemented. The collaboration also built capacity in each sector: The health department used ICS as a training opportunity; the academics enhanced their community health efforts; the service sector was taught and implemented more rigorous quantitative methods; and the community was exposed to public health as a pragmatic and effective discipline.
  
  
  CONCLUSIONS
  Improvements made to increase the reliability of the PIT count can be adapted for use in other jurisdictions, leading to improved counts and better evaluation of progress in ending homelessness.
authors.affiliation: University of Texas School of Public Health, Houston, TX, USA catherine.l.troisi@uth.tmc.edu.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Troisi
authors.affiliation: Claris Technical Services, Huntsville, AL, USA.
authors.forename: Ritalinda
authors.initials: R
authors.lastname: D'Andrea
authors.affiliation: Coalition for the Homeless of Houston/Harris County, Houston, TX, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Grier
authors.affiliation: Houston Department of Health and Human Services, Houston, TX, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Williams
mesh_terms: D057191:Capacity Building / Q000379:methods; D019352:Censuses; D003299:Cooperative Behavior; D003627:Data Interpretation, Statistical; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D007373:Interinstitutional Relations; D012107:Research Design; D013781:Texas; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data
keywords: design and evaluation of programs and policies; methodological development content area; methodology; real-world dissemination; survey methodology