Evolving an evidence-based model for homelessness prevention.

While some progress has been made in addressing chronic homelessness through supportive models, a comprehensive solution for housing loss must include prevention. The purpose of this article is twofold: to conduct a review of the literature on the domains of the Framework for Homelessness Prevention; and to use literature on the concept of quaternary prevention, preventing the harms of service provision, to theorise an additional domain. The Framework for Homelessness Prevention draws upon theory from public health exploring primary, secondary and tertiary prevention, and also integrates primordial prevention. This leads to a typology of homelessness prevention that incorporates the following five domains: (a) Structural prevention; (b) Systems prevention; (c) Early intervention; (d) Eviction prevention; and (e) Housing stability. By systematically reviewing the literature we build out the evidence-base supporting these domains. The team used research databases, internet searches and retrospective reference list reviews to identify high-quality journal articles on prevention, which were then sorted by level of prevention. Through this process, we evolved our thinking on the Framework in considering that quaternary prevention was not initially included. Therefore, we explored the literature related to quaternary prevention in the context of homelessness and offer a sixth domain for the Framework: Empowerment. Ultimately, a comprehensive Framework for Homelessness Prevention will support communities and governments to more effectively prevent homelessness through upstream approaches.

Perspectives of Canadian fitness professionals on exercise and possible anorexia nervosa.

BACKGROUND: Many individuals with eating disorders, including anorexia nervosa (AN), engage in overexercise. Little is known about fitness professionals' perceptions of their responsibilities when interacting with clients with possible AN. The purpose of the current study was to examine Alberta fitness professionals' experiences with clients suspected of having AN, and their views on related ethical issues. Specifically, we aimed to examine (1) their experiences with fitness clients suspected of having AN; (2) their opinions about related ethical responsibilities of fitness professionals; and (3) their views on related training and ethical issues. METHODS: We administered a 21-item online survey to 143 Canadian fitness professionals about their experiences and perspectives on encountering individuals with possible AN in exercise classes and at their exercise facilities. RESULTS: Sixty-two percent of respondents had encountered a client they believed had AN. Three-quarters had never received any training on managing clients with AN and felt inadequately prepared for such situations. Although most felt ethically obliged to intervene with such a client, more than two-thirds reported no relevant guidelines in their professional training. CONCLUSIONS: Many fitness professionals are faced with clients with possible AN, have the desire to help, feel ethically obligated to take action, but do not know what course of action to take, if any. Work is needed to clarify ethical issues and related training needs for certification programs for fitness professionals regarding AN.