Barriers and facilitators of implementing a shallow rental subsidy program at an area agency on aging

As the number of older adults experiencing homelessness and housing insecurity grows, there is an increasing need for responses aimed at preventing housing loss in later life. Because Area Agencies on Aging (AAAs) serve older adults across the socioeconomic spectrum and all older adults in the United States have access to AAA programs that support maintaining community-based living, they are well-positioned to address housing challenges. However, little is known about the implementation of these programs, limiting the adoption of practices across the AAA network. Using the Consolidated Framework for Implementation Research (CFIR), this study aims to identify facilitators and barriers to implementing a shallow rental subsidy program at an AAA.

We used a sequential mixed-methods implementation science design. Quantitative data were collected from AAA staff through a survey, and qualitative data were collected through focus groups.

Barriers and facilitators were identified across the 11 constructs within the CFIR inner-setting domain. Facilitators to implementation included the AAA's client-centered culture and structural characteristics (e.g., having an established Housing Assistance Program). Barriers to implementation included incompatibility with case manager workloads and a short timeframe that created confusion about the program.

Findings highlight opportunities for AAAs to implement shallow rental subsidy programs. Having an existing housing team structure is a facilitator for implementing new housing-related programs (e.g., shallow subsidies). Additionally, clear, targeted communication about the rationale for program elements and adequate time for referral, screening, and enrollment are essential for successful implementation.