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Fidelity to the Housing First Model and Variation in Health Service Use Within Permanent Supportive Housing
Author(s): Todd P. Gilmer, Ana Stefancic, Benjamin F. Henwood, Susan L. Ettner
Publication Date: 2015
Objective: Permanent supportive housing (PSH) programs are being implemented throughout the United States. This study examined the relationship between fidelity to the Housing First model and health service use among clients in PSH programs in California. Methods: Data from a survey of PSH program practices were merged with administrative data on service utilization to examine the association between fidelity to a benchmark program, the Ho...
Further Validation of the Pathways Housing First Fidelity Scale
Author(s): Paula Goering, Scott Veldhuizen, Geoffrey B. Nelson, Ana Stefancic, Sam Tsemberis, Carol E. Adair, Jino Distasio, Tim Aubry, Vicky Stergiopoulos, David L. Streiner
Publication Date: 2016
Objective This study examined whether Housing First fidelity ratings correspond to program operation descriptions from administrative data and predict client outcomes. Methods A multisite, randomized controlled trial (At Home/Chez Soi) in five Canadian cities included two assessments of 12 programs over two years. Outcomes for 1,158 clients were measured every six months. Associations between fidelity ratings and administrative data (Spearm...
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
Author(s): 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, Ph.D., Paula Goering
Publication Date: 2015
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...
Quality of life after housing first for adults with serious mental illness who have experienced chronic homelessness
Author(s): Benjamin F. Henwood, Jason Matejkowski, Ana Stefancic, Jonathan M. Lukens
Publication Date: 2014
Abstract This 1-year longitudinal study of adults who have recently transitioned from homelessness to Permanent Supportive Housing (PSH) focuses on quality of life as a primary outcome of interest. Eighty of 103 new tenants participated in structured interviews at the time of entry into their new home and at 12-months post-housing. t-tests assessed differences in community participation and quality of life measures at the 2 time points. Mixed eff...
Pathways Housing First for Homeless Persons with Psychiatric Disabilities: Program Innovation, Research, and Advocacy
Author(s): Ronni Michelle Greenwood, Ana Stefancic, Sam Tsemberis
Publication Date: 2013
This article describes how the Pathways Housing First (PHF) model of homelessness intervention evolved from a radical idea to the gold standard of service delivery for homelessness intervention programs that serve adults with psychiatric and/or substance abuse diagnoses, not only in the United States, but worldwide. Through the example of PHF we explain how the integration of rigorous research with consumer-driven service delivery yielded an evid...
Implementations of Housing First in Europe: Successes and Challenges in Maintaining Model Fidelity
Author(s): Ronni Michelle Greenwood, Ana Stefancic, Sam Tsemberis, Volker Busch-Geertsema
Publication Date: 2013
To describe and evaluate the fidelity of Housing First (HF) initiatives in six European countries to the Pathways HF (PHF) model and examine the larger social, historical, and political factors that may foster or impede model fidelity. Key stakeholders representing six European HF initiatives completed semi-structured phone interviews. Interviews were thematically analyzed according to five key fidelity domains and updated with interim results of...
Early Implementation Evaluation of a Multi-site Housing First Intervention for Homeless People with Mental Illness: A Mixed Methods Approach
Author(s): Geoffrey Nelson, Ana Stefancic, Jennifer Rae, Greg Townley, Sam Tsemberis, Eric Macnaughton, Tim Aubry, Jino Distasio, Roch Hurtubise, Michelle Patterson, Vicky Stergiopoulos, Myra Piat, Ph.D., Paula Goering
Publication Date: 2013
This research sought to determine whether the implementation of Housing First in a large-scale, multi-site Canadian project for homeless participants with mental illness shows high fidelity to the Pathways Housing First model, and what factors help or hinder implementation. Fidelity ratings for 10 Housing First programs in five cities were made by an external quality assurance team along five key dimensions of Housing First based on 84 key inform...
Follow-Up Implementation and Fidelity Evaluation of the Mental Health Commission of Canada's At Home/Chez Soi Project: Cross-site Report
Author(s): Geoffrey Nelson, Eric Macnaughton, Rachel Caplan, Tim Macleod, Greg Townley, Myra Piat, Ph.D., Ana Stefancic, Sam Tsemberis, Paula Goering
Organization: Mental Health Commission of Canada
Publication Date: 2013
This report presents the overall findings from an implementation and fidelity evaluation of the At Home/Chez Soi initiative, a pan-Canadian Housing First demonstration project presently being implemented in Moncton, Montréal, Toronto, Winnipeg, and Vancouver. The present study examined the second phase of implementation, using a mixed methods strategy. The quantitative data were gathered by an external Quality Assurance team, which produced 10 fi...
Implementation and Fidelity Evaluation of the Mental Health Commission of Canada's At Home/Chez Soi Project: Cross-Site Report
Author(s): Geoffrey Nelson, Jennifer Rae, Greg Townley, Paula Goering, Eric Macnaughton, Myra Piat, Ph.D., Nathalie Egalité, Ana Stefancic, Sam Tsemberis
Organization: Mental Health Commission of Canada
Publication Date: 2012
This report presents the overall findings from an implementation and fidelity evaluation of the At Home/Chez Soi initiative, a pan-Canadian Housing First demonstration project presently being implemented in Moncton, Montréal, Toronto, Winnipeg, and Vancouver. The present study examined the first phase of implementation, using a mixed methods strategy. In particular, the study sought to understand the extent to which the interventions met fidelity...
Measuring Homelessness and Residential Stability: the Residential Time-line Follow-back Inventory
Author(s): Sam Tsemberis, Gregory J. McHugo, Valerie Williams, Patricia Hanrahan, Ana Stefancic
Publication Date: 2007
Reliable and valid longitudinal residential histories are needed to assess interventions to reduce homelessness and increase community tenure. This study examined the test-retest reliability, sensitivity to change, and concurrent validity of the Residential Time-Line Follow-Back (TLFB) Inventory, a method used to record residential histories in the Collaborative Program to Prevent Homelessness (n = 1,381). The Residential TLFB Inventory yielded t...