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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

  • Original Article
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American Journal of Community Psychology

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.

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Authors and Affiliations

  1. Wilfrid Laurier University, Waterloo, ON, Canada

    Eric Macnaughton, Geoffrey Nelson & Rachel Caplan

  2. Columbia University, New York, NY, USA

    Ana Stefancic

  3. Portland State University, Portland, OR, USA

    Greg Townley

  4. University of Ottawa, Ottawa, ON, Canada

    Tim Aubry

  5. University of Winnipeg, Winnipeg, MB, Canada

    Scott McCullough

  6. Simon Fraser University, Burnaby, BC, Canada

    Michelle Patterson

  7. Centre for Inner City Health, University of Toronto, Toronto, ON, Canada

    Vicky Stergiopoulos

  8. Université Laval, CSSS Vieille-Capitale, Quebec, QC, Canada

    Catherine Vallée

  9. Pathways to Housing, New York, NY, USA

    Sam Tsemberis

  10. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

    Sam Tsemberis

  11. McGill University, Montreal, QC, Canada

    Marie-Josée Fleury & Myra Piat

  12. Douglas Hospital, Verdun, QC, Canada

    Marie-Josée Fleury & Myra Piat

  13. Centre for Addiction and Mental Health, Toronto, ON, Canada

    Paula Goering

  14. University of Toronto, Toronto, ON, Canada

    Paula Goering

  15. 5475 Sophia St., Vancouver, BC, V5W2W2, Canada

    Eric Macnaughton

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  1. Eric Macnaughton
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  2. Ana Stefancic
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  3. Geoffrey Nelson
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  6. Tim Aubry
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  9. Vicky Stergiopoulos
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  10. Catherine Vallée
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Correspondence to Eric Macnaughton.

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Macnaughton, E., Stefancic, A., Nelson, G. et al. 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. Am J Community Psychol 55, 279–291 (2015). https://doi.org/10.1007/s10464-015-9709-z

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  • DOI: https://doi.org/10.1007/s10464-015-9709-z

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