Reducing friction, enabling response: a realist evaluation of a mobile outreach model for marginalized populations

The study examined the Supportive Outreach Services (S.O.S.) mobile program in Grey County, Ontario, which provides coordinated care to people experiencing homelessness, substance use problems, and mental illness. The research included 31 semi-structured interviews with service providers, partners, system leaders, and clients. Analysis revealed five interconnected mechanisms of success: trust built through repeated, non-judgmental encounters supports engagement; physical proximity reduces barriers to participation; accessible support enables timely help-seeking; cross-sector relationships enable adaptive coordination; and visible results build legitimacy that sustains participation and resources. The effectiveness of mobile outreach depends less on the services delivered and more on its capacity to reduce barriers, sustain relationships, and adapt care across organizational boundaries.