Abstract
BackgroundThere is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes.Methods/designDrawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes.DiscussionThis project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general.
Highlights
There is currently a lack of scientifically designed and tested implementation strategies
We propose to accomplish our goal by modifying a promising but limited Housing First model (HFM) implementation strategy known as the Housing First Technical Assistance and Training Program (HFTAT) and testing its effectiveness among a small sample of Housing First programs
Specific questions guiding the research arm include the following: Is the adapted HFTAT a feasible implementation strategy for the HFM?; Does the adapted HFTAT lead to changes in implementation outcomes?; and How does the context of the intervention affect the implementation process? Before presenting our study protocol, we provide background related to the HFM and the original version of the HFTAT, describe the HFTAT’s limitations and how we plan to address them, and present the theoretical framework guiding our study design
Summary
Based on previous performance of the HFTAT in its face-to-face format, we expect the adapted version will be evaluated positively by administrators and staff. It is our intent that this project and the subsequent one will result in an evidence-based implementation strategy that will increase the scalability and ultimate impact of the HFM. The development of such a strategy is in the best interest of policy makers, funders, providers, clients, and researchers, given how ubiquitous the model has become and the demonstrated problems related to its implementation. Authors’ information DPW is Assistant Professor of Health Policy and Management and Interim Director of the Center for Health Policy in the Fairbanks School of Public Health (FSPH) at Indiana University-Purdue University Indianapolis (IUPUI). RT is Director of the Illinois Co-Occurring Center for Excellence at Heartland Health Outreach, Inc
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