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Knowledge and attitudes of Implementation Support Practitioners-Findings from a systematic integrative review. PLoS One 2022; 17:e0267533. [PMID: 35544529 PMCID: PMC9094539 DOI: 10.1371/journal.pone.0267533] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/10/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND It requires thoughtful planning and work to successfully apply and sustain research-supported interventions like healthcare treatments, social support, or preventive programs in practice. Implementation support practitioners (ISPs) such as facilitators, technical assistance providers, knowledge brokers, coaches or consultants may be involved to actively support the implementation process. This article presents knowledge and attitudes ISPs bring to their work. METHODS Building on a previously developed program logic, a systematic integrative review was conducted. Literature was sourced by searching nine electronic data bases, organizational websites, and by launching a call for publications among selected experts and social media. Article screening was performed independently by two researchers, and data from included studies were extracted by members of the research team and quality-assured by the lead researcher. The quality of included RCTs was assessed based on a framework by Hodder and colleagues. Thematic Analysis was used to capture information on knowledge and attitudes of ISPs across the included studies. Euler diagrams and heatmaps were used to present the results. RESULTS Results are based on 79 included studies. ISPs reportedly displayed knowledge about the clinical practice they work with, implementation / improvement practice, the local context, supporting change processes, and facilitating evidence-based practice in general. In particular, knowledge about the intervention to be implemented and its target population, specific improvement / implementation methods and approaches, organizational structures and sensitivities, training, and characteristics of (good) research was described in the literature. Seven themes describing ISPs' attitudes were identified: 1) professional, 2) motivated / motivating / encouraging / empowering, 3) empathetic / respectful / sensitive, 4) collaborative / inclusive, 5) authentic, 6) creative / flexible / innovative / adaptive, and 7) frank / direct / honest. Pertaining to a professional attitude, being responsive and focused were the most prevalent indicators across included publications. CONCLUSION The wide range and complexity of knowledge and attitudes found in the literature calls for a comprehensive and systematic approach to collaboratively develop a professional role for ISPs across disciplines. Embedding the ISP role in different health and social welfare settings will enhance implementation capacities considerably.
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Killaspy H, Harvey C, Brasier C, Brophy L, Ennals P, Fletcher J, Hamilton B. Community-based social interventions for people with severe mental illness: a systematic review and narrative synthesis of recent evidence. World Psychiatry 2022; 21:96-123. [PMID: 35015358 PMCID: PMC8751572 DOI: 10.1002/wps.20940] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
People living with severe mental illness (SMI) are one of the most marginalized groups in society. Interventions which aim to improve their social and economic participation are of crucial importance to clinicians, policy-makers and people with SMI themselves. We conducted a systematic review of the literature on social interventions for people with SMI published since 2016 and collated our findings through narrative synthesis. We found an encouragingly large amount of research in this field, and 72 papers met our inclusion criteria. Over half reported on the effectiveness of interventions delivered at the service level (supported accommodation, education or employment), while the remainder targeted individuals directly (community participation, family interventions, peer-led/supported interventions, social skills training). We identified good evidence for the Housing First model of supported accommodation, for the Individual Placement and Support model of supported employment, and for family psychoeducation, with the caveat that a range of models are nonetheless required to meet the varied housing, employment and family-related needs of individuals. Our findings also highlighted the importance of contextual factors and the need to make local adaptations when "importing" interventions from elsewhere. We found that augmentation strategies to enhance the effectiveness of social interventions (particularly supported employment and social skills training) by addressing cognitive impairments did not lead to transferable "real life" skills despite improvements in cognitive function. We also identified an emerging evidence base for peer-led/supported interventions, recovery colleges and other interventions to support community participation. We concluded that social interventions have considerable benefits but are arguably the most complex in the mental health field, and require multi-level stakeholder commitment and investment for successful implementation.
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Affiliation(s)
- Helen Killaspy
- Department of Epidemiology and Applied Clinical Research, Division of PsychiatryUniversity College LondonLondonUK,Camden & Islington NHS Foundation TrustLondonUK
| | - Carol Harvey
- Psychosocial Research Centre, Department of PsychiatryUniversity of MelbourneMelbourneVICAustralia,North Western Mental HealthParkvilleVICAustralia
| | - Catherine Brasier
- Department of Occupational TherapySocial Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe UniversityMelbourneVICAustralia
| | - Lisa Brophy
- Department of Occupational TherapySocial Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe UniversityMelbourneVICAustralia
| | | | - Justine Fletcher
- Centre for Mental Health, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVICAustralia
| | - Bridget Hamilton
- Centre for Psychiatric NursingSchool of Health Sciences, University of MelbourneMelbourneVICAustralia
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Carvalho AP, Furtado JP. Fatores contextuais e implantação da intervenção Housing First: uma revisão da literatura. CIENCIA & SAUDE COLETIVA 2022; 27:133-150. [DOI: 10.1590/1413-81232022271.19642021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo O Housing First (HF) tem se difundido no cenário internacional como uma intervenção baseada em evidência para superar a situação de rua entre pessoas com agravos de saúde mental. No Brasil, o HF tem sido adotado como referência no desenvolvimento de iniciativas voltadas para pessoas em situação de rua que fazem uso prejudicial de drogas. Estudos apontam a necessidade de maior compreensão da dinâmica implantação do modelo HF em diferentes cenários. De tal modo, utilizando o método de revisão de literatura, analisamos os fatores que facilitam e dificultam a implantação do HF. Foram selecionados 68 artigos, publicados entre 2003 e 2020, nas bases PubMed, Scopus, PsychoINFO, Embase, Lilacs e Scielo. Identificamos fatores em quatro dimensões: características da intervenção, contexto de implantação, aspectos institucionais e processo de implantação. A indisponibilidade de habitações, a falta de coordenação dos serviços necessários aos moradores e a resistência dos agentes implantadores aos princípios do HF são fatores que dificultam a implantação. Por sua vez, agentes com valores, atitudes e competências convergentes ao modelo e educação permanente aparecem como facilitadores. Apontamos a necessidade de se compreender e favorecer o processo de integração do HF aos sistemas de proteção social existentes.
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Song MJ, Yu L, Enright RD. Trauma and healing in the underserved populations of homelessness and corrections: Forgiveness Therapy as an added component to intervention. Clin Psychol Psychother 2020; 28:694-714. [PMID: 33179387 DOI: 10.1002/cpp.2531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 11/06/2022]
Abstract
The purpose of this article is to begin applying the principles of the psychology of forgiveness to people who are without homes and people who are in prisons. A review of the literature shows trauma for both groups. When the trauma is caused by unjust treatment by others, then excessive anger can result, compromising one's psychological and physical health. We review the interventions that have been offered for those without homes and the imprisoned to examine which existing programmes address such anger. Forgiveness Therapy, although untried in these two settings, may be one beneficial approach for substantially reducing unhealthy anger. Forgiveness interventions have shown a cause-and-effect relationship between learning to forgive and overcoming psychological compromise such as strong resentment and clinical levels of anxiety and depression. The literature review here suggests that forgiveness therapy for those without homes and the imprisoned may be a new and important consideration for ameliorating anger and aiding in a changed life pattern.
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Affiliation(s)
| | - Lifan Yu
- Department of Psychology, University of North Florida, Jacksonville, Florida, USA
| | - Robert D Enright
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Brown M, Tran AD, Cummings C, Fay L, Malone D, Fyall R, Tsemberis S. Attempting Randomized Housing First Research in a Community Context: Reflections on Failure. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:201-213. [PMID: 32153031 DOI: 10.1002/ajcp.12421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Housing First (HF) model of permanent supportive housing for individuals experiencing chronic homelessness has a strong evidence base that has largely been driven by researchers in the field of community psychology in partnership with community-based organizations. However, important gaps in the HF literature remain. Implementing rigorous research designs to further the evidence for HF requires immense resources to fund both the housing intervention and the research activities. In the absence of such resources, university-community partnerships may be established to integrate research within business-as-usual services and utilize existing housing units. This first person account presents a "post-mortem" exploration of an attempt to conduct a randomized trial of scattered-site and single-site approaches to HF within a community context from the perspectives of multiple stakeholders involved in the endeavor. Despite strengths of the research collaborative, the project did not come to completion due to a series of both insurmountable and avoidable barriers. Yet, the experience illuminated several potential challenges researchers and housing providers conducting work in this area may encounter, such as ever-changing homeless service system policies that may impact research and organizational procedures. Lessons learned and recommendations for preventing or overcoming systems-level barriers and potential challenges within the university-community partnership are described.
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Affiliation(s)
| | | | | | - Lauren Fay
- Downtown Emergency Service Center, Seattle, WA, USA
| | | | | | - Sam Tsemberis
- Pathways Housing First Institute, Los Angeles, CA, USA
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Greenwood RM, Manning RM, O'Shaughnessy BR, Vargas-Moniz MJ, Loubière S, Spinnewijn F, Lenzi M, Wolf JR, Bokszczanin A, Bernad R, Källmén H, Ornelas J. Homeless Adults' Recovery Experiences in Housing First and Traditional Services Programs in Seven European Countries. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:353-368. [PMID: 31793001 DOI: 10.1002/ajcp.12404] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Across Europe, as governments turn to housing-led strategies in attempts to reverse rising rates of homelessness, increasing numbers of Housing First (HF) programs are being implemented. As HF programs become more widespread, it is important to understand how service users experience them compared to the more prevalent traditional treatment-first approach to addressing long-term homelessness. Although there is a large body of research on service users' experiences of Housing First compared to treatment-first in North American contexts, comparatively less is known about how these two categories of homeless services are experienced in the European context. In a correlational and cross-sectional study, part of a larger examination of homelessness in Europe, participants (n = 520) engaged with either HF (n = 245) or traditional services (TS; n = 275) programs in seven countries completed measures of their experiences of services (consumer choice, housing quality, and service satisfaction) and recovery (time in independent housing, psychiatric symptoms, and community integration). Across the seven countries, participants engaged with HF programs reported experiencing more consumer choice, better perceived housing quality, and more satisfaction with services than participants engaged in TS programs. Participants in HF programs also reported a greater proportion of time in independent accommodation, fewer psychiatric symptoms, and more community integration. Varying patterns of association between experiences of services and recovery outcomes were observed. Findings indicate HF consistently predicts greater recovery than TS across diverse sociopolitical and economic contexts. Implications of findings for configurations of homeless services and homeless services policy are discussed.
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Affiliation(s)
| | - Rachel M Manning
- Department of Psychology, University of Limerick, Limerick, Ireland
| | | | - Maria J Vargas-Moniz
- APPsyCI - Applied Psychology Research Center Capabilities and Inclusion, ISPA-Instituto Universitário, Lisboa, Portugal
| | - Sandrine Loubière
- Department of Research and Innovation, Support Unit for Clinical Research and Economic Evaluation, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Freek Spinnewijn
- FEANTSA, European Federation of National Organisations Working with the Homeless, Bruxelles, Belgique
| | - Michela Lenzi
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Judith R Wolf
- Impuls - Netherlands Center for Social Care Research, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | | | - Håkan Källmén
- STAD, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - José Ornelas
- APPsyCI - Applied Psychology Research Center Capabilities and Inclusion, ISPA-Instituto Universitário, Lisboa, Portugal
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7
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Worton SK. Examining peer networking as a capacity-building strategy for Housing First implementation. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:1147-1162. [PMID: 31531999 DOI: 10.1002/jcop.22240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/28/2019] [Accepted: 08/21/2019] [Indexed: 06/10/2023]
Abstract
AIMS This study examines peer networking as a capacity-building strategy for the implementation of Housing First (HF), a complex community intervention targeting chronic homelessness. METHODS A qualitative, multiple case study was conducted to examine the capacity-building activities of two, multicommunity peer networks established by community leaders in the Canadian Homelessness sector. Data collection activities included document analysis, key informant interviews (n = 10), and a follow-up focus group with interview participants in each network. Thematic analyses were conducted for each network, followed by a cross-case analysis. RESULTS Engaging in a multicommunity peer network enhances leaders' capacity to advance HF by creating opportunities to foster trust and communication, inform continuous improvement, and navigate ambiguity. A number of contextual factors influence connections between peer networking and capacity building. CONCLUSION Peer networks are a valuable source of support and timely, contextually relevant knowledge for community leaders advancing local adaptation and implementation of HF.
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Choy-Brown M, Tiderington E, Tran Smith B, Padgett DK, Stefancic A. Strategies for Sustaining Fidelity: A Multi-state Qualitative Analysis in Housing First Programs. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 48:36-45. [PMID: 32323216 DOI: 10.1007/s10488-020-01041-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Little is known about long-term fidelity of evidence-based interventions (EBIs) under changing conditions. This study examines how staff at 'mature' (eight or more years in operation) Housing First (HF) programs strategize to sustain EBI fit in different geographic areas in the Mid-Atlantic/Northeastern United States. Six focus groups (FGs) at three purposively selected HF programs were conducted with separate FGs for case managers and supervisors at each site. FG discussions elicited participants' service approaches and strategies in addressing fidelity amidst ongoing changes affecting each program. Thematic content analysis of FG transcripts was conducted using the five HF fidelity domains (housing choice/structure, separation of housing and services, service philosophy, service array, and program structure) as a priori themes with inductive content analyses conducted on data in each theme. Strategies for rigor were employed. Case managers (N = 17) and supervisors (N = 16) were predominantly white (76%) and female (60%). Across the themes, challenges included lack of affordable housing and choice, funders' restrictions and practice 'drift.' Strategies included community engagement and hiring, strong leadership and 'bending the rules.' There were no differences across sites. Later-stage implementation challenges show the need for continued vigilance in fidelity to EBIs. Among the strategies used to address fidelity in this study, the pursuit of pro-active community engagement to attract knowledgeable staff as well as increase local buy-in was considered pivotal at all three sites. These findings underscore the need to attend to the external setting as well as to internal program operations.
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Affiliation(s)
- Mimi Choy-Brown
- University of Minnesota, 1404 Gortner Avenue, St. Paul, MN, 55108, USA.
| | - Emmy Tiderington
- Rutgers University, 360 Martin Luther King Jr. Boulevard, Newark, NJ, 07102, USA
| | - Bikki Tran Smith
- University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA
| | - Deborah K Padgett
- New York University, 1 Washington Square North, New York, NY, 10011, USA
| | - Ana Stefancic
- Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
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9
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Wendt DC, Hartmann WE, Allen J, Burack JA, Charles B, D'Amico EJ, Dell CA, Dickerson DL, Donovan DM, Gone JP, O'Connor RM, Radin SM, Rasmus SM, Venner KL, Walls ML. Substance Use Research with Indigenous Communities: Exploring and Extending Foundational Principles of Community Psychology. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:146-158. [PMID: 31365138 PMCID: PMC6777961 DOI: 10.1002/ajcp.12363] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Many Indigenous communities are concerned with substance use (SU) problems and eager to advance effective solutions for their prevention and treatment. Yet these communities also are concerned about the perpetuation of colonizing, disorder-focused, stigmatizing approaches to mental health, and social narratives related to SU problems. Foundational principles of community psychology-ecological perspectives, empowerment, sociocultural competence, community inclusion and partnership, and reflective practice-provide useful frameworks for informing ethical community-based research pertaining to SU problems conducted with and by Indigenous communities. These principles are explored and extended for Indigenous community contexts through themes generated from seven collaborative studies focused on understanding, preventing, and treating SU problems. These studies are generated from research teams working with Indigenous communities across the United States and Canada-inclusive of urban, rural, and reservation/reserve populations as well as adult and youth participants. Shared themes indicate that Indigenous SU research reflects community psychology principles, as an outgrowth of research agendas and processes that are increasingly guided by Indigenous communities. At the same time, this research challenges these principles in important ways pertaining to Indigenous-settler relations and Indigenous-specific considerations. We discuss these challenges and recommend greater synergy between community psychology and Indigenous research.
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Affiliation(s)
- Dennis C Wendt
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - William E Hartmann
- School of Interdisciplinary Arts and Sciences, University of Washington-Bothell, Bothell, WA, USA
| | - James Allen
- Memory Keepers Medical Discovery Team - American and Rural Health Equity, Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA
| | - Jacob A Burack
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Billy Charles
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | | | - Colleen A Dell
- Department of Sociology, School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Daniel L Dickerson
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dennis M Donovan
- Department of Psychiatry and Behavioral Sciences, Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
| | - Joseph P Gone
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anthropology, Harvard University, Cambridge, MA, USA
| | - Roisin M O'Connor
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Sandra M Radin
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
| | - Stacy M Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Kamilla L Venner
- Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, NM, USA
| | - Melissa L Walls
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA
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Abstract
Research indicates that homeless women are reported to experience more mental health issues than women who are not homeless and are an increasing proportion of the overall homeless population. In addition, homeless women are more likely to have alcohol and/or other drug use disorders. We provide a comprehensive review of the contemporary literature that revealed homeless women experience a range of mental health problems including depression, anxiety, post-traumatic stress disorder and alcohol and other drug use disorders. Studies in this literature review indicate that some women have pre-existing mental health issues which precipitate homelessness while others develop mental illness because of their homelessness; domestic violence was also recognised as an antecedent to homelessness, although further research is needed in this area. The results of this study indicate that the homeless cohort is a complex one with distinct needs. We provide information that can help refine assessment processes and plan appropriate services to address the mental health needs of homeless women. Finally, recommendations for mental health nursing practice in regard to caring for homeless women are made.
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Affiliation(s)
- Alison Duke
- a Bolton Clarke Homeless Persons Program, McAuley Community Services for Women , Melbourne , Australia
| | - Adam Searby
- b School of Health and Biomedical Sciences - Nursing , RMIT University , Melbourne , Australia
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11
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Pierse N, Ombler J, White M, Aspinall C, McMinn C, Atatoa-Carr P, Nelson J, Hawkes K, Fraser B, Cook H, Howden-Chapman P. Service usage by a New Zealand Housing First cohort prior to being housed. SSM Popul Health 2019; 8:100432. [PMID: 31289743 PMCID: PMC6593313 DOI: 10.1016/j.ssmph.2019.100432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background The Ending Homelessness in New Zealand: Housing First research programme is evaluating outcomes for people housed in a Housing First programme run by The People's Project in Hamilton, New Zealand. This baseline results paper uses administrative data to look at the scope and duration of their interactions with government services. Methods We linked our de-identified cohort to the Integrated Data Infrastructure (IDI). This database contains administrative data on most services provided by the New Zealand Government to citizens. Linkage rates in all datasets were above 90%. This paper reports on the use of government services by the cohort before being housed. We focus on the domains of health, justice and income support. Results The cohort of 390 people had over 200,000 recorded interactions across a range of services in their lifetime. The most common services were health, justice and welfare. The homeless cohort had used the services at rates far in excess of the general population. Unfortunately these did not prevent them from becoming homeless. Conclusion These preliminary findings show the homeless population have important service delivery needs and a very high level of interaction with government services. This highlights the importance of analysing the contributing factors towards homelessness; for evaluation of interventions such as Housing First, and for understanding the need for integrated systems of government policy and practice to prevent homelessness. This paper also provides the baseline for post-Housing First evaluations. A homeless cohort in New Zealand had a high rate of service usage leading up to engagement with Housing First services. The cohort appeared in government linked data at higher rates than the general population. The cohort had over 200,000 interactions with government services within the five years prior to being housed by Housing First services. This paper shows the need for a systems-wide strategy to prevent homelessness.
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Affiliation(s)
- Nevil Pierse
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
| | - Jenny Ombler
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
| | - Maddie White
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
| | - Clare Aspinall
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
| | | | - Polly Atatoa-Carr
- National Institute for Demographic and Economic Analysis, University of Waikato, New Zealand
| | | | | | - Brodie Fraser
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
| | - Hera Cook
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
| | - Philippa Howden-Chapman
- He Kainga Oranga/Housing and Health Research Group, University of Otago Wellington, New Zealand
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12
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Nelson G, Worton SK, Macnaughton E, Tsemberis S, MacLeod T, Hasford J, Goering P, Stergiopoulos V, Aubry T, Distasio J. Systems change in the context of an initiative to scale up Housing First in Canada. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:7-20. [PMID: 30506925 DOI: 10.1002/jcop.22095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/26/2018] [Accepted: 05/04/2018] [Indexed: 06/09/2023]
Abstract
In this study, we examine changes in the homeless-serving system in the context of a training and technical assistance initiative to scale up Housing First (HF) in 6 Canadian communities. Based on qualitative data from focus groups and individual interviews with key stakeholders (k = 7, n = 35) and field notes gathered over a 3-year period (n = 146), we found 2 main system changes: (a) changes in the capacity of the service delivery system at multiple levels of analysis (from individual to policy) to implement HF, and (b) changes in the coordination of parts of the service delivery system and collaboration among local stakeholders to enhance HF implementation. These changes were facilitated or constrained by the larger context of evidence, climate, policy, and funding. The findings were discussed in terms of systems change theory and implications for transformative systems change in the mental health and homelessness sectors.
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Affiliation(s)
| | | | | | | | | | | | - Paula Goering
- Centre for Addiction and Mental Health
- University of Toronto
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13
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Macnaughton E, Nelson G, Worton SK, Tsemberis S, Stergiopoulos V, Aubry T, Hasford J, Distasio J, Goering P. Navigating Complex Implementation Contexts: Overcoming Barriers and Achieving Outcomes in a National Initiative to Scale Out Housing First in Canada. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 62:135-149. [PMID: 30106486 DOI: 10.1002/ajcp.12268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Eric Macnaughton
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Geoffrey Nelson
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - S Kathleen Worton
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sam Tsemberis
- Pathways Housing First Training Institute, Montclair, NJ, USA
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tim Aubry
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Julian Hasford
- School of Child and Youth Care, Ryerson University, Toronto, ON, Canada
| | - Jino Distasio
- Institute of Urban Studies, University of Winnipeg, Winnipeg, MB, Canada
| | - Paula Goering
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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Townley G, Brown M, Sylvestre J. Community Psychology and Community Mental Health: A Call for Reengagement. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 61:3-9. [PMID: 29315707 DOI: 10.1002/ajcp.12225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well-being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross-cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under-examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health.
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Affiliation(s)
- Greg Townley
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Molly Brown
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - John Sylvestre
- Center for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada
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