Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness
Background Evidence-based practices (EBPs) improve housing and health for persons who have experienced homelessness with serious mental illness (PEH-SMI) but are challenging to implement. We tested a strategy to support pilot implementation of a 12-session housing skills training intervention for PE...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-03-01
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| Series: | Implementation Research and Practice |
| Online Access: | https://doi.org/10.1177/26334895241236679 |
| _version_ | 1797272033096105984 |
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| author | Sonya Gabrielian Alison B. Hamilton Lillian Gelberg Ella R. Koosis Lauren Hoffmann David M. Carlson Alexander S. Young |
| author_facet | Sonya Gabrielian Alison B. Hamilton Lillian Gelberg Ella R. Koosis Lauren Hoffmann David M. Carlson Alexander S. Young |
| author_sort | Sonya Gabrielian |
| collection | DOAJ |
| description | Background Evidence-based practices (EBPs) improve housing and health for persons who have experienced homelessness with serious mental illness (PEH-SMI) but are challenging to implement. We tested a strategy to support pilot implementation of a 12-session housing skills training intervention for PEH-SMI, tailored from effective social skills training interventions. We aimed to optimize the implementation strategy and intervention prior to an implementation trial. Method We provided training and technical assistance to nine providers to support pilot implementation of this intervention to six groups of PEH-SMI ( n = 35) engaged in VA Greater Los Angeles’ homeless services. We used scales and semi-structured interviews with 14 PEH-SMI and all interventionists to inform implementation strategy adaptations, identify factors that impacted implementation, and assess perceptions of the intervention. Attendance was tracked and we observed a random sample of each interventionist's groups to assess treatment fidelity. Results Interventionists perceived the implementation strategy and the intervention favorably. However, interventionists often lacked physical space, staff, and resources (e.g., computers) to conduct the intervention. Interventionists found the content valuable for participants and a few suggested that group engagement should be a prerequisite for obtaining housing services. PEH-SMI were interested in the intervention's content and receptive to the group-based format. Participants attended a mean of 4 ± 3/12 groups; all groups observed had acceptable fidelity. Problems with intervention retention were described, suggesting challenges maintaining group participation when participants transitioned between VA homeless services. Conclusions To support the implementation of an EBP for PEH-SMI in homeless programs, these data suggest the value of training/technical assistance and strategies that enhance program-level buy-in to address resource concerns. Intervention adaptations, e.g., using a drop-in, open group format, in community-based settings that are easily accessible to PEH-SMI, may also increase adoption. This project was registered as “Improving Housing Outcomes for Homeless Veterans” Trial registration NCT03646149, registered 8/24/2018. |
| first_indexed | 2024-03-07T14:18:38Z |
| format | Article |
| id | doaj.art-a937dea38c014cf29da4f76ae3c7cb64 |
| institution | Directory Open Access Journal |
| issn | 2633-4895 |
| language | English |
| last_indexed | 2024-03-07T14:18:38Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Implementation Research and Practice |
| spelling | doaj.art-a937dea38c014cf29da4f76ae3c7cb642024-03-06T10:03:19ZengSAGE PublishingImplementation Research and Practice2633-48952024-03-01510.1177/26334895241236679Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illnessSonya Gabrielian0Alison B. Hamilton1Lillian Gelberg2Ella R. Koosis3Lauren Hoffmann4David M. Carlson5Alexander S. Young6 , Los Angeles, CA, USA , Los Angeles, CA, USA UCLA Fielding School of Public Health, Los Angeles, CA , Palo Alto, CA, USA , Los Angeles, CA, USA , Los Angeles, CA, USA , Los Angeles, CA, USABackground Evidence-based practices (EBPs) improve housing and health for persons who have experienced homelessness with serious mental illness (PEH-SMI) but are challenging to implement. We tested a strategy to support pilot implementation of a 12-session housing skills training intervention for PEH-SMI, tailored from effective social skills training interventions. We aimed to optimize the implementation strategy and intervention prior to an implementation trial. Method We provided training and technical assistance to nine providers to support pilot implementation of this intervention to six groups of PEH-SMI ( n = 35) engaged in VA Greater Los Angeles’ homeless services. We used scales and semi-structured interviews with 14 PEH-SMI and all interventionists to inform implementation strategy adaptations, identify factors that impacted implementation, and assess perceptions of the intervention. Attendance was tracked and we observed a random sample of each interventionist's groups to assess treatment fidelity. Results Interventionists perceived the implementation strategy and the intervention favorably. However, interventionists often lacked physical space, staff, and resources (e.g., computers) to conduct the intervention. Interventionists found the content valuable for participants and a few suggested that group engagement should be a prerequisite for obtaining housing services. PEH-SMI were interested in the intervention's content and receptive to the group-based format. Participants attended a mean of 4 ± 3/12 groups; all groups observed had acceptable fidelity. Problems with intervention retention were described, suggesting challenges maintaining group participation when participants transitioned between VA homeless services. Conclusions To support the implementation of an EBP for PEH-SMI in homeless programs, these data suggest the value of training/technical assistance and strategies that enhance program-level buy-in to address resource concerns. Intervention adaptations, e.g., using a drop-in, open group format, in community-based settings that are easily accessible to PEH-SMI, may also increase adoption. This project was registered as “Improving Housing Outcomes for Homeless Veterans” Trial registration NCT03646149, registered 8/24/2018.https://doi.org/10.1177/26334895241236679 |
| spellingShingle | Sonya Gabrielian Alison B. Hamilton Lillian Gelberg Ella R. Koosis Lauren Hoffmann David M. Carlson Alexander S. Young Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness Implementation Research and Practice |
| title | Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness |
| title_full | Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness |
| title_fullStr | Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness |
| title_full_unstemmed | Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness |
| title_short | Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness |
| title_sort | testing an implementation package in a housing skills training pilot for homeless experienced persons with serious mental illness |
| url | https://doi.org/10.1177/26334895241236679 |
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