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Table 1 Characteristics of included studies

From: Interventions for preventing or treating malnutrition in homeless problem-drinkers: a systematic review

Study Location Study design Participants Intervention Comparison Primary outcomes reporteda
N Inclusion criteria Recruitment Homeless type (shelter/ rough sleeper) Heavy drinkers    
Educational information or support interventions
 Rusness 1993 USA UBA 7 Homeless women at a shelter Shelter Shelter NR Biweekly classes focused on nutrition information, shopping and cooking skills No control group Nutritional status
 Hinton 2001 UK UBA 18 Residents at the homeless shelter A homeless shelter Shelter dwellers NR a session on food hygiene and nutrition, a cooking competition No control group Nob
 Derrickson 2003 USA RCT 210 Households at risk of homelessness who requested assistance between January to August 2001 NR, likely from the database of the Salvation Army Family Services Office At risk households NR 3-h nutrition workshop 1-h food safety workshop. Nutritional status
 Heslin 2003 USA Comparative survey 974 Homeless women of reproductive age in Los Angeles County shelters and meal programs. Shelters and meal programs NR, likely all types NR case manager assigned to optimise uptake of WIC Homeless women in WIC without case manager No
 Helfrich 2006 USA UBA 32 Self-identify a life skill need, be willing to engage in sessions each week, able to give informed consent and understand English Shelters/ emergency shelters, transitional/ emergency housing program Shelter NR Life-skills workshops & individual sessions No control group No
 Johnson 2009 USA UBA 50 Long-term residents in the shelter (2 to 6 months), have at least one child residing with her in the shelter, and is enrolled in the shelter’s life skills program Two homeless shelters Shelter NR Nutrition education classes No control group Nutritional status
 Bonevski 2012 Australia UBA 6 >  18 years, English speaking, receiving accommodation support from the participating homeless centre A non-government homelessness outreach centre NR, likely shelter 58% Telephone personal counselling on health No control group Nutritional status
 Rustad 2013 USA UBA 118 English-speaking, low-income women living in the Minneapolis/ St Paul area Soup kitchens, grocery stores, Laundromats, food shelves, and homeless shelters NR, likely shelter or in transition NR 3 nutrition and health education sessions No control group Nutritional status
 Barbour 2016 Australia UBA 5 Young person engaged with case management services in the community agency, with an interest in eating healthier and improving their cooking skills Agencies helping homeless youth Crisis accommodation, sleeping rough and couch-surfing NR Food literacy programme, participants engaged in a 3-h group interactive session over 8 weeks Daily recommended values DRVs for males of age 19–50 years Nutritional status
Fortification / Supplement Interventions
 Darnton-Hill 1986 Australia Comparative Survey 106 Quasi random selection: the first three attendees of the homeless shelter/clinic; first person sitting left of the entrance plus two more at the day centre Homeless shelter, day centre, and a clinic NR, Likely shelter and rough sleepers 70% Men taking oral multivitamin Not taking vitamins Nutritional status
 Drijver 1993 Netherlands UBA 9 Almost daily alcohol consumption for past 5 years; average use of 8 E (80 g) alcohol per day; age 20–65 years; no vitamin supplements in the past month; thiamine level < 110 nmol Homeless houses and outpatient facilities for alcoholics NR, likely all types 100% (all drinking > 5 years, 80 g or more /day) Single or weekly Intramuscular injection of combined 200 mg thiamine, 100 mg pyridoxine, 1000 ng cyanocobalamin No control group Nutritional status
 Darmon 2009 France Repeat Survey 130 Men attending any of the 8 emergency shelters in Paris (3 night shelters and 5 food aid day centres) Emergency shelters NR, Likely shelter and rough sleepers NR, likely majority Fortified chocolate spread distribution No control group No
Food provision interventions
 Garden 2013 Russia Case (historical) control 142 All homeless patients with tuberculosis referred to a St. Petersburg’s Tuberculosis dispensary Tuberculosis dispensary NR, likely all types 45% (registered alcoholics) Daily food packs including canned meat, bread, butter, egg and soup with cream, juice, tea and yoghurt (2000 kcal) Homeless treated at the tuberculosis dispensary in previous years No
 Murakami 2013 Brazil UBA 315 Low income people (elderly, unemployed, homeless and itinerant) who have been to the restaurant ≥3 time per week NR NR, likely all types NR Low cost meals available at restaurants No control group Nutritional status
 Villena 2013 Spain Survey 50 Clients coming to the meal provision centre Community kitchen NR, likely all types NR Evaluating five community kitchen menus No control group No
 Pelham-Burn 2014 UK Survey 16 Clients coming to a meal provision centre The lounge area / front desk of the meal provision centre NR, likely all types NR Taste testing 12 lunch dishes. No control group No
 Allen 2014 Australia UBA 78 Rooming house residents, homeless persons and others deemed eligible for entry to the project Café Meals project database North Yarra Community Health All types 19% alcohol dependent Providing clients a subsidy that entitles them to one meal per day at one of four local cafés No control group Nutritional status
Multicomponent interventions
 Wiecha 1993 USA Comparative Survey 77 Homeless families without overt substance abuse or emotional problems with a child under 6 placed by the public welfare in temporary accommodation Shelters and meal programs Transitional homeless NR Kitchen facilities without food support (shelter) versus facilities & food support (shelter) No kitchen facilities or food support (hotels) Nutritional status
 Tarasuk 1994 Canada UBA 49 Homeless adult attenders of an inner city drop in centre Drop in centre for homeless adults All types NR Three sequential interventions: 1) weekly cooking classes; 2)making the centres’ kitchen available for use to street-living; 3)communal cooking and dining No control group No
 Hamm 1999 USA UBA 31 families in transition- who are temporarily living in shelters, transitional housing or with friends/family Homeless shelters, soup kitchens, transitional housing, nurseries and day-care centres and family support centres Transitional homeless NR Group nutrition education classes, health checks and food pack vouchers useable at specified stores Non-homeless WIC participants No
 Stewart 2009 Canada UBA 56 Homeless or in transition homeless youth An employment programme and drop-in centres All types 34% sought counselling for alcohol/ drugs Weekly support groups (help with homework, course or job finding, recreational activity, meal, transport) No control group No
 Richards 2011 USA Comparative Survey 11,181 Homeless pregnant women with complete data in the PRAMS database PRAMS database All types NR WIC homeless women Non WIC homeless women No
 Kadoura 2014 USA UBA 25 Homeless families with at least one child at the shelter school. Speak English or Spanish. Homeless shelter Shelter 60% parents reported drug and alcohol use substance abuse 10 two-hour sessions, including physical activity, education/training, and a ‘healthy dinner’ Non concurrent national data Nutritional status
 Grazioli 2015 USA UBA 6 Homeless drinkers, with a disability; homeless for at least 1 year or on 4 or more separate occasions in the past 3 years; aged 21–65 years 2 community-based agencies NR, likely all types 100% Safer-drinking strategies: treatment with extended-release naltrexone and harm-reduction counselling No control group Liver function
 Kendzor 2016 USA RCT 32 ≥18 years of age; willing+ able to attend all visits; > 6th grade literacy level; able to walk; resident of the transitional shelter for ≤2 months. One shelter Shelter dweller NR Newsletters, fruit/veg provision & pedometers/ walking goals. No Intervention: Paid assessment-only Nutritional status
  1. Kcal kilo calories, N number of participants analysed, NR not reported, PRAMS Pregnancy Risk Assessment Monitoring System project for CDC, USA, RCT randomised controlled trial, UBA uncontrolled before after study, WIC The Special Supplemental Nutrition Program for Women, Infants, and Children in the USA. a Primary outcomes of the review that were reported in the study. b This means that the study did not measure or report any of the primary outcomes of this review