The housing first technical assistance and training (HFTAT) implementation strategy: outcomes from a mixed methods...

Area of Science:

• Implementation Science
• Public Health Interventions
• Mental Health Services Research

Background:

• The Housing First (HF) model is a complex supportive housing intervention for individuals with serious mental illness and substance use disorders.
• Implementing HF requires significant individual and structural changes within organizations.
• The Housing First Training and Technical Assistance (HFTAT) Program was developed as a distance-based strategy to facilitate HF implementation.

Purpose of the Study:

• To evaluate the initial effectiveness of the HFTAT Program.
• To assess both individual-level (e.g., knowledge, attitudes, satisfaction) and structural-level (e.g., fidelity) outcomes.
• To understand the utility of a combined training and consultation approach for organizational change.

Main Methods:

• A mixed-method design was employed, collecting quantitative data at various time points and qualitative data at the end of the program.
• Participants included 113 staff and administrators from three HF programs across three states.
• Outcomes measured included satisfaction, HF knowledge acquisition and retention, attitudes toward evidence-based interventions, and program fidelity.

Main Results:

• Satisfaction with both training and consultation was high, with participants finding both components necessary.
• HF knowledge increased post-training and was retained at 3-month follow-up; attitudes toward evidence-based interventions improved over 6 months.
• Program fidelity scores improved across all participating programs over 9 months, though some elements of the strategy were less compatible with the work context.

Conclusions:

• The HFTAT Program is a well-liked and effective implementation strategy for the Housing First model.
• Multifaceted strategies and combined training/consultation approaches are valuable for complex intervention implementation.
• Narrative storytelling shows promise for overcoming attitudinal barriers, highlighting the importance of strategy-environment compatibility.