Development and Validation of a Housing First Fidelity Survey

Abstract

Programs that use the Housing First model are being implemented throughout the United States and internationally. The authors describe the development and validation of a Housing First fidelity survey. A 46-item survey was developed to measure fidelity across five domains: housing process and structure, separation of housing and services, service philosophy, service array, and team structure. The survey was administered to staff and clients of 93 supported-housing programs in California. Exploratory and confirmatory factor analyses were used to identify the items and model structure that best fit the data. Sixteen items were retained in a two-factor model, one related to approach to housing, separation of housing and services, and service philosophy and one related to service array and team structure. Our survey mapped program practices by using a common metric that captured variation in fidelity to Housing First across a large-scale implementation of supported-housing programs.