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Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan-Canadian Multi-site Housing First Program for Homeless People with Mental Illness |
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| Authors: | Eric Macnaughton Ana Stefancic Geoffrey Nelson Rachel Caplan Greg Townley Tim Aubry Scott McCullough Michelle Patterson Vicky Stergiopoulos Catherine Vallée Sam Tsemberis Marie-Josée Fleury Myra Piat Paula Goering |
| Affiliation: | 1. Wilfrid Laurier University, Waterloo, ON, Canada 15. 5475 Sophia St., Vancouver, BC, V5W2W2, Canada 2. Columbia University, New York, NY, USA 3. Portland State University, Portland, OR, USA 4. University of Ottawa, Ottawa, ON, Canada 5. University of Winnipeg, Winnipeg, MB, Canada 6. Simon Fraser University, Burnaby, BC, Canada 7. Centre for Inner City Health, University of Toronto, Toronto, ON, Canada 8. Université Laval, CSSS Vieille-Capitale, Quebec, QC, Canada 10. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA 9. Pathways to Housing, New York, NY, USA 11. McGill University, Montreal, QC, Canada 12. Douglas Hospital, Verdun, QC, Canada 13. Centre for Addiction and Mental Health, Toronto, ON, Canada 14. University of Toronto, Toronto, ON, Canada |
| Abstract: | This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and leadership facilitated implementation, while staff turnover, rehousing participants, participant isolation, and limited vocational/educational supports impeded implementation. The findings shed light on important implementation “drivers” at the staff, program, and community levels. |
| Keywords: | Housing first Implementation Mixed methods Evaluation Fidelity |
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