Avenue 360 Health and Wellness, a Federally Qualified Health Center, and AIDS Foundation Houston (AFH), a community-based AIDS Service Organization, implemented Project CORE. This intervention aimed to improve health outcomes for people with HIV through the coordination of supportive employment and housing services. Through Project CORE, 39% of participants were placed in housing and 39% gained employment.
Houston, TX
The rising costs of housing, coupled with discrimination due to HIV status, gender, and/or sexual orientation, have placed an increased burden on people with HIV who are living on a low income or in poverty. People with HIV may also face significant barriers to employment, such as health-related challenges or discrimination. Avenue 360 Health and Wellness and AFH also identified the need for improved partnerships and coordination in their approach to delivering housing and employment services to people with HIV in the Houston area.
“The overall goal of Project CORE was to enhance the coordination of employment and housing services to ultimately improve wellbeing, housing stability, and employment experiences of people with HIV.”
With its foundation in the Prevention Institute’s Community-Centered Health Home model, Project CORE brought together multiple community partners, including clinics, AIDS Service Organizations, and employment agencies, to discuss employment and housing opportunities. The partners then coordinated all available resources to address the identified gaps in care.
Collaboration was a cornerstone of Project CORE. It relied on the skills and expertise of multiple partners to meet the needs of its clients. AFH was the home site for the Project CORE team, consisting of an outreach specialist, data specialist, and network navigator. It also hosted the employment workshops and was the hub of Project CORE activities. Avenue 360 Health and Wellness was the lead clinical partner for the project, using its electronic health record to document clinical outcomes and coordinate medical services. Employment workshops and other job trainings were provided by a group of community-based organizations.
Using a strengths-based approach, a network navigator and outreach specialist helped connect eligible clients to entitlement benefits, employment services, job skills workshops, and other supportive services, including the U.S. Department of Housing and Urban Development’s Housing Opportunities for Persons with AIDS (HOPWA) program, food and nutrition services, and case management. The goal was to create a “one-stop-shop” approach to service delivery.
Structured employment workshops were held at AFH and facilitated by Workforce Solutions, a community-based organization. The 1.5-hour weekly sessions ran for four weeks and featured resume and cover letter writing, interview skills, job searching 101, re-entering the workforce, and other employment topics. Seven cohorts of up to 25 participants were held during the three-year project period.
In total, 111 clients participated in Project CORE. Of these clients, 39% received housing placement, 39% gained employment, and 14% were newly connected to HIV primary care.
| Category | Information |
|---|---|
| Evaluation data | Avenue 360 Health & Wellness used electronic health record data to evaluate outcomes for Project CORE. |
| Measures |
Project CORE evaluated outcomes associated with the percentage of participants:
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| Results |
During the project period:
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“We thought that branding was very important from the beginning of Project CORE. Establishing a strong, community-centered, accessible, and descriptive brand has been key in previous projects.”
Agency partnerships. Project CORE was born out of a partnership between Avenue 360 Health and Wellness, offering clinical services, and AFH, offering community-based support services. The two agencies first identified what services they already offered that helped ensure stable housing and meaningful employment for their clients. They quickly realized that the goals of Project CORE could also help other community-based agencies serving people with HIV to meet their organizational goals. The project expanded to include 10 partner agencies.
Client input. The community advisory board at Avenue 360 provided an opportunity for client input, including the development of marketing materials and recruitment strategies.
Staffing. Three key staff members were hired to conduct Project CORE activities: a network navigator responsible for connecting clients to services and benefits; an outreach specialist responsible for conducting, coordinating, and facilitating the provision of employment services to clients; and a data specialist responsible for data management, program intake, and assessments of the clients for Project CORE. Candidates were recruited from postings to United Way, Job Bank online, as well as on the websites of partnering agencies.
Project promotion. Project CORE developed a marketing and branding strategy to promote the project. Great care was taken to develop branding that used a contemporary style, appealing to a broad audience and being inclusive without being stigmatizing.
Staff training. Key staff were trained on the Getting to Work Curriculum, designed specifically to help staff understand the experiences of people with HIV while seeking employment.
Project CORE was integrated with AFH services and is sustained as part of standard operations.
“Project CORE, while new, enhances service provision, creates coordination between AFH and Avenue 360. It is integrated within the AFH, which is one step to promoting sustainability.”
Client engagement and recruitment proved difficult at first. Clients were often experiencing homelessness and were difficult to reach and engage in services. For many, obtaining housing took priority over securing employment or engaging in job training.
The partnership found several strategies to be effective. These included:
- Incentives such as meals and bus tickets encouraged attendance at information sessions.
- A social network strategy encouraged existing participants to recruit others for Project CORE, and they received a $15 gift card for each new participant recruited.
- To help boost participation in the initiative, recruitment was expanded from one clinic site (Avenue 360 Health and Wellness) to multiple HIV primary care sites across the area.
- The provision of coordinated clinical and supportive services depended on the close partnership between multiple service providers.
