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Brief Reports   |    
Development and Validation of a Housing First Fidelity Survey
Todd P. Gilmer, Ph.D.; Ana Stefancic, M.A.; Marisa Sklar, M.S.; Sam Tsemberis, Ph.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200500
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Dr. Gilmer is affiliated with the Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093 (e-mail: tgilmer@ucsd.edu). Ms. Stefancic and Dr. Tsemberis are with Pathways to Housing, Inc., and Ms. Stefancic is also with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, both in New York City. Ms. Sklar is with the San Diego State University–University of California, San Diego, Joint Doctoral Program in Clinical Psychology. The preliminary results of this study were presented at the Housing First Partners’ research conference, March 21–23, 2012, in New Orleans; the Academy Health annual research meeting, June 24–26, 2012, in Orlando, Florida; and the Agency for Healthcare Research and Quality annual conference, September 9–12, 2012, in Bethesda, Maryland.

Copyright © 2013 by the American Psychiatric Association


Objectives  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.

Methods  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.

Results  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.

Conclusions  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.

Abstract Teaser
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housing ; philosophy
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Anchor for Jump
Table 1Factor analysis of survey items associated with fidelity to Housing First, by program domain
Table Footer Note

a Cronbach’s α=.72

Table Footer Note

b Cronbach’s α=.78

Table Footer Note

c Squared multiple correlation

Table Footer Note

d Kaiser-Meyer-Olkin statistic



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