Strategies to Balance Fidelity to Housing First Principles with Local Realities: Lessons from a Large Urban Centre
Strategies to Balance Fidelity to Housing First Principles with Local Realities: Lessons from a Large Urban Centre
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DOI：
10.1353/hpu.2015.0031
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发表时间：
2015-05-01
影响因子：
1.4
通讯作者：
Stergiopoulos, Vicky
中科院分区：
文献类型：
--
作者：
O'Campo, Patricia;Zerger, Suzanne;Stergiopoulos, Vicky
方案实施在实现预期成果方面的重要性已得到充分证明，但仍需要具体指导，说明如何在动态的地方背景下实现对循证模型的忠实性。“住房第一”是为无家可归者和精神病患者提供的一个循证模式，为此类指导提供了一个重要的测试案例;它针对的是一个具有复杂需求的特殊服务不足的亚群，由具有不同知识和技能水平的从业人员提供。科学证据肯定了HF的有效性，但其快速传播的速度超过了监测能力，不仅不能监测它是否得到忠实的实施，而且也不能监测如何在多变的当地环境和挑战中实现这一目标。这一定性研究有助于满足这一需要，因为它收集了从业人员对执行挑战的见解以及为克服这些挑战而制定的具体战略。调查结果强调了制定针对HF的实施指南以及在制定的所有阶段让相关利益攸关方参与的重要性。
The importance of program implementation in achieving desired outcomes is well-documented, but there remains a need for concrete guidance on how to achieve fidelity to evidence-based models within dynamic local contexts. Housing First (HF), an evidence-based model for people experiencing homelessness and mental illness, provides an important test-case for such guidance; it targets a uniquely underserved subpopulation with complex needs, and is delivered by practitioners with varying knowledge and skill levels. Scientific evidence affirms HF's effectiveness, but its rapid dissemination has outpaced the ability to monitor not only whether it is being implemented with fidelity, but also how this can be achieved within variable local contexts and challenges. This qualitative study contributes to this need by capturing insights from practitioners on implementation challenges and specific strategies developed to overcome them. Findings reinforce the importance of developing HF-specific implementation guidelines, and of engaging relevant stakeholders throughout all phases of that development.