The Housing First Model (HFM) Fidelity Index: Designing and Testing a Tool for Measuring Integrity of Housing Programs That Serve Active Substance Users

Overview

Journal Subst Abuse Treat Prev Policy

Publisher Biomed Central

Specialty Psychiatry

Date 2013 May 7

PMID 23641860

Citations 15

Authors

Dennis P Watson

John Orwat

Dana E Wagner

Valery Shuman

Randi Tolliver

Affiliations

Soon will be listed here.

Abstract

Background: The Housing First Model (HFM) is an approach to serving formerly homeless individuals with dually diagnosed mental health and substance use disorders regardless of their choice to use substances or engage in other risky behaviors. The model has been widely diffused across the United States since 2000 as a result of positive findings related to consumer outcomes. However, a lack of clear fidelity guidelines has resulted in inconsistent implementation. The research team and their community partner collaborated to develop a HFM Fidelity Index. We describe the instrument development process and present results from its initial testing.

Methods: The HFM Fidelity Index was developed in two stages: (1) a qualitative case study of four HFM organizations and (2) interviews with 14 HFM "users". Reliability and validity of the index were then tested through phone interviews with staff members of permanent housing programs. The final sample consisted of 51 programs (39 Housing First and 12 abstinence-based) across 35 states.

Results: The results provided evidence for the overall reliability and validity of the index.

Conclusions: The results demonstrate the index's ability to discriminate between housing programs that employ different service approaches. Regarding practice, the index offers a guide for organizations seeking to implement the HFM.

Citing Articles

Stakeholder perspectives on sustainment of Housing First in a VA permanent supportive housing program.

Fletcher E, Gabrielian S, Flynn A, Greenberg J, Hovsepian S, Oberman R Health Serv Res. 2022; 57(2):374-384.

PMID: 35238030 PMC: 8928030. DOI: 10.1111/1475-6773.13904.

The comparative effectiveness of different models of permanent supportive housing on problematic substance use, depression, and anxiety symptoms over time.

Dickson-Gomez J, McAuliffe T, Quinn K, Spector A, Toepfer P, Bendixen A Am J Orthopsychiatry. 2021; 91(4):514-523.

PMID: 33939448 PMC: 8370390. DOI: 10.1037/ort0000550.

A Longitudinal Mixed Method Approach for Assessing Implementation Context and Process Factors: Comparison of Three Sites from a Housing First Implementation Strategy Pilot.

Watson D, Snow-Hill N, Saldana L, Walden A, Staton M, Kong A Implement Res Pract. 2021; 1.

PMID: 33392509 PMC: 7774649. DOI: 10.1177/2633489520974974.

Characterizing components of and attendance at resident-driven Housing First programming in the context of community-based participatory research.

Collins S, Goldstein S, King V, Orfaly V, Gu J, Clark A J Community Psychol. 2020; 49(5):1376-1392.

PMID: 33301627 PMC: 8190162. DOI: 10.1002/jcop.22491.

Provider perspectives of housing programs for young adults experiencing homelessness.

Semborski S, Redline B, Rhoades H, Henwood B Child Youth Serv Rev. 2020; 112.

PMID: 33041411 PMC: 7543879. DOI: 10.1016/j.childyouth.2020.104898.

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