Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model
IntroductionHomelessness in the United States increased every year since 2016, with a 38% increase from 2023 to 2024. Much of the increase is attributable to rising home and rent costs, economic hardship caused by the recent pandemic, and the ending of protective legislation. Notably, people who exp...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1623385/full |
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| author | Danielle M. Kline Pranav Padmanabhan Pranav Padmanabhan Sarah E. Brewer Sarah E. Brewer Magdalena Cerdá Elysia Versen Katherine M. Keyes Margot Kushel Margot Kushel Margot Kushel Erin C. Wilson Paul Wesson Paul Wesson Ayaz Hyder Alaina Boyer Alia Al-Tayyib Joshua A. Barocas Joshua A. Barocas |
| author_facet | Danielle M. Kline Pranav Padmanabhan Pranav Padmanabhan Sarah E. Brewer Sarah E. Brewer Magdalena Cerdá Elysia Versen Katherine M. Keyes Margot Kushel Margot Kushel Margot Kushel Erin C. Wilson Paul Wesson Paul Wesson Ayaz Hyder Alaina Boyer Alia Al-Tayyib Joshua A. Barocas Joshua A. Barocas |
| author_sort | Danielle M. Kline |
| collection | DOAJ |
| description | IntroductionHomelessness in the United States increased every year since 2016, with a 38% increase from 2023 to 2024. Much of the increase is attributable to rising home and rent costs, economic hardship caused by the recent pandemic, and the ending of protective legislation. Notably, people who experience homelessness have an increased risk of substance use disorders, HIV infection and poorer HIV outcomes than people who are stably housed. The iHouse model aims to develop feasible, effective, and cost-effective tailored approaches to improve health outcomes in this population including life expectancy, overdose, and HIV.Methods and analysisThe study will employ Group Model Building methods and use insights from that process to develop an agent-based model simulating the dynamic processes contributing to HIV incidence and treatment, overdose, and life expectancy among people along the housing and homelessness continuum in Denver, CO and San Francisco, CA. The model will evaluate multiple outcomes from 4 conceptual dimensions: (1) movement along the housing continuum, (2) population health (overdose and HIV incidence and life expectancy), (3) budgetary impact, (4) economic value.Ethics and disseminationThis study has been approved by the Colorado Institutional Review Board at the University of Colorado under protocol 24–0878. The data generated by this protocol, the methodologies used, and the findings will be made available in a timely manner to other researchers. iHOUSE code and parameter values will be published in Git Hub, such that all model analyses can be reproduced by independent investigators. Documentation of all parameter estimates and model results will be published for independent review and confirmation. In addition, supplemental materials and appendices for the model will be shared on a publicly available website. |
| format | Article |
| id | doaj-art-02e4c4d1e8914ca48a8fdac685e19f8e |
| institution | DOAJ |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-02e4c4d1e8914ca48a8fdac685e19f8e2025-08-20T02:52:00ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-08-011310.3389/fpubh.2025.16233851623385Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based modelDanielle M. Kline0Pranav Padmanabhan1Pranav Padmanabhan2Sarah E. Brewer3Sarah E. Brewer4Magdalena Cerdá5Elysia Versen6Katherine M. Keyes7Margot Kushel8Margot Kushel9Margot Kushel10Erin C. Wilson11Paul Wesson12Paul Wesson13Ayaz Hyder14Alaina Boyer15Alia Al-Tayyib16Joshua A. Barocas17Joshua A. Barocas18Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Colorado, Aurora, CO, United StatesDivision of General Internal Medicine, Department of Medicine, School of Medicine, University of Colorado, Aurora, CO, United StatesDepartment of Epidemiology, Colorado School of Public Health, Aurora, CO, United StatesAdult and Child Center for Outcomes Research and Delivery Science, University of Colorado, Aurora, CO, United StatesDepartment of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United StatesDepartment of Population Health, New York University Grossman School of Medicine, New York, NY, United StatesColorado Evaluation and Action Lab, University of Denver, Denver, CO, United StatesSchool of Public Health, Columbia University Medical Center, New York, NY, United StatesDivision of Health Equity and Society, University of California, San Francisco, San Francisco, CA, United StatesCenter for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, United States0Benioff Homeless and Housing Initiative, University of California, San Francisco, San Francisco, CA, United States1Public Health Foundation Enterprises, Inc., City of Industry, CA, United States0Benioff Homeless and Housing Initiative, University of California, San Francisco, San Francisco, CA, United States2Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States3Independent Consultant, DataToEngage, Futuwwa LLC, Columbus, OH, United States4National Health Care for the Homeless Council, Nashville, TN, United States5Public Health Institute at Denver Health, Denver, CO, United StatesDivision of General Internal Medicine, Department of Medicine, School of Medicine, University of Colorado, Aurora, CO, United States6Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Aurora, CO, United StatesIntroductionHomelessness in the United States increased every year since 2016, with a 38% increase from 2023 to 2024. Much of the increase is attributable to rising home and rent costs, economic hardship caused by the recent pandemic, and the ending of protective legislation. Notably, people who experience homelessness have an increased risk of substance use disorders, HIV infection and poorer HIV outcomes than people who are stably housed. The iHouse model aims to develop feasible, effective, and cost-effective tailored approaches to improve health outcomes in this population including life expectancy, overdose, and HIV.Methods and analysisThe study will employ Group Model Building methods and use insights from that process to develop an agent-based model simulating the dynamic processes contributing to HIV incidence and treatment, overdose, and life expectancy among people along the housing and homelessness continuum in Denver, CO and San Francisco, CA. The model will evaluate multiple outcomes from 4 conceptual dimensions: (1) movement along the housing continuum, (2) population health (overdose and HIV incidence and life expectancy), (3) budgetary impact, (4) economic value.Ethics and disseminationThis study has been approved by the Colorado Institutional Review Board at the University of Colorado under protocol 24–0878. The data generated by this protocol, the methodologies used, and the findings will be made available in a timely manner to other researchers. iHOUSE code and parameter values will be published in Git Hub, such that all model analyses can be reproduced by independent investigators. Documentation of all parameter estimates and model results will be published for independent review and confirmation. In addition, supplemental materials and appendices for the model will be shared on a publicly available website.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1623385/fullhousinghomelessgroup model buildingagent-based modelHIVsubstance use |
| spellingShingle | Danielle M. Kline Pranav Padmanabhan Pranav Padmanabhan Sarah E. Brewer Sarah E. Brewer Magdalena Cerdá Elysia Versen Katherine M. Keyes Margot Kushel Margot Kushel Margot Kushel Erin C. Wilson Paul Wesson Paul Wesson Ayaz Hyder Alaina Boyer Alia Al-Tayyib Joshua A. Barocas Joshua A. Barocas Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model Frontiers in Public Health housing homeless group model building agent-based model HIV substance use |
| title | Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model |
| title_full | Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model |
| title_fullStr | Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model |
| title_full_unstemmed | Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model |
| title_short | Improving health and housing outcomes through a simulation and economic model: an evidence-based protocol of a group model building approach to develop an agent-based model |
| title_sort | improving health and housing outcomes through a simulation and economic model an evidence based protocol of a group model building approach to develop an agent based model |
| topic | housing homeless group model building agent-based model HIV substance use |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1623385/full |
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