Development and Validation of a Housing First Fidelity Survey

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.