Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada.
Pathways Housing First Training Institute, Montclair, NJ, USA.
Am J Community Psychol. 2018 Sep;62(1-2):135-149. doi: 10.1002/ajcp.12268. Epub 2018 Aug 14.
The scaling out of Housing First (HF) programs was examined in six Canadian communities, in which a multi-component HF training and technical assistance (TTA) was provided. Three research questions were addressed: (a) What were the outcomes of the TTA in terms of the development of new, sustained, or enhanced programs, and fidelity to the HF model? (b) How did the TTA contribute to implementation and fidelity? and (c) What contextual factors facilitated or challenged implementation and fidelity? A total of 14 new HF programs were created, and nine HF programs were sustained or enhanced. Fidelity assessments for 10 HF programs revealed an average score of 3.3/4, which compares favorably with other HF programs during early implementation. The TTA influenced fidelity by addressing misconceptions about the model, encouraging team-based practice, and facilitating case-based dialogue on site specific implementation challenges. The findings were discussed in terms of the importance of TTA for enhancing the capacities of the HF service delivery system-practitioners, teams, and communities-while respecting complex community contexts, including differences in policy climate across sites. Policy climate surrounding accessibility of housing subsidies, and use of Assertive Community Treatment teams (vs. Intensive Case Management) were two key implementation issues.
本研究考察了加拿大六个社区扩大住房优先（HF）项目的情况，在这些社区中提供了多组分 HF 培训和技术援助（TTA）。研究提出了三个问题：（a）TTA 在开发新的、持续的或增强的项目以及保持 HF 模型的忠实性方面的结果如何？（b）TTA 如何促进实施和保持忠实性？（c）哪些环境因素促进或挑战了实施和保持忠实性？共创建了 14 个新的 HF 项目，9 个 HF 项目得到维持或加强。对 10 个 HF 项目的保真度评估显示，平均得分为 3.3/4，与早期实施的其他 HF 项目相比表现良好。TTA 通过解决对该模型的误解、鼓励基于团队的实践以及促进针对特定于地点的实施挑战的基于案例的对话来影响保真度。研究结果从增强 HF 服务提供系统（从业者、团队和社区）能力的角度讨论了 TTA 的重要性，同时尊重复杂的社区背景，包括各地点政策环境的差异。住房补贴的可及性以及使用果断社区治疗团队（与强化案例管理相比）是两个关键的实施问题。
