Peer advocacy and access to healthcare for people who are homeless in London, UK: A mixed method impact, economic and process evaluation protocol

Sujit D. Rathod*, Andrew Guise, P. J. Annand, Paniz Hosseini, Elizabeth Williamson, Alec Miners, Kate Bowgett, Martin Burrows, Robert W. Aldridge, Serena Luchenski, Dee Menezes, Alistair Story, Andrew Hayward, Lucy Platt

*Corresponding author for this work

Research output: Contribution to journalComment/debate


People who are homeless experience higher morbidity and mortality than the general population. These outcomes are exacerbated by inequitable access to healthcare. Emerging evidence suggests a role for peer advocates—that is, trained volunteers with lived experience—to support people who are homeless to access healthcare. We plan to conduct a mixed methods evaluation to assess the effects (qualitative, cohort and economic studies); processes and contexts (qualitative study); fidelity; and acceptability and reach (process study) of Peer Advocacy on people who are homeless and on peers themselves in London, UK. People with lived experience of homelessness are partners in the design, execution, analysis and dissemination of the evaluation. Ethics approval for all study designs has been granted by the National Health Service London—Dulwich Research Ethics Committee (UK) and the London School of Hygiene and Tropical Medicine’s Ethics Committee (UK). We plan to disseminate study progress and outputs via a website, conference presentations, community meetings and peer-reviewed journal articles.

Original languageEnglish
Article numbere050717
JournalBMJ Open
Issue number6
Publication statusPublished - 17 Jun 2021
Externally publishedYes

Bibliographical note

Funding Information:
Funding This work was supported by the UK National Institute for Health Research (PHR Project 17/44/40). Disclaimer The National Institute for Health Research had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data or decision to submit results. Competing interests None declared. Patient consent for publication Not required.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


  • epidemiology
  • primary care
  • public health
  • qualitative research
  • statistics & research methods


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