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What Happens After the Demonstration Phase? The Sustainability of Canada's At Home/Chez Soi Housing First Programs for Homeless Persons with Mental Illness
- Source :
- American Journal of Community Psychology. 59:144-157
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- This research examined the sustainability of Canada's At Home/Chez Soi Housing First (HF) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five-site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes and factors that influenced those outcomes. Also, a self-report HF fidelity measure was completed for nine HF programs that continued after the demonstration project. A cross-site analysis was performed, using the five sites as case studies. The findings revealed that nine of the 12 HF programs (75%) were sustained, and that seven of the nine programs reported a high level of fidelity (achieving an overall score of 3.5 or higher on a 4-point scale). The sites varied in terms of the level of systems integration and expansion of HF that were achieved. Factors that promoted or impeded sustainability were observed at multiple ecological levels: broad contextual (i.e., dissemination of research evidence, the policy context), community (i.e., partnerships, the presence of HF champions), organizational (i.e., leadership, ongoing training, and technical assistance), and individual (i.e., staff turnover, changes, and capacity). The findings are discussed in terms of the implementation science literature and their implications for how evidence-based programs like HF can be sustained.
- Subjects :
- Gerontology
Canada
Health (social science)
Housing First
media_common.quotation_subject
Fidelity
Public Policy
Context (language use)
law.invention
03 medical and health sciences
0302 clinical medicine
Nursing
Randomized controlled trial
law
medicine
Humans
Qualitative Research
Applied Psychology
Randomized Controlled Trials as Topic
media_common
030505 public health
Information Dissemination
Mental Disorders
Public Health, Environmental and Occupational Health
Mental illness
medicine.disease
Community Mental Health Services
030227 psychiatry
Turnover
Scale (social sciences)
Ill-Housed Persons
Sustainability
Housing
0305 other medical science
Psychology
Case Management
Program Evaluation
Subjects
Details
- ISSN :
- 00910562
- Volume :
- 59
- Database :
- OpenAIRE
- Journal :
- American Journal of Community Psychology
- Accession number :
- edsair.doi.dedup.....d3c21acd9a16055cba55a0553ad1b0fb