We present interim findings of a cross-site case study of an initiative to expand Housing First (HF) in Canada through training and technical assistance (TTA). HF is an evidence-based practice designed to end chronic homelessness for consumers of mental health services. We draw upon concepts from implementation science and systems change theory to examine how early implementation occurs within a system. Case studies examining HF early implementation were conducted in six Canadian communities receiving HF TTA. The primary data are field notes gathered over 1.5 years and evaluations from site-specific training events (k = 5, n = 302) and regional network training events (k = 4, n = 276). We report findings related to: (a) the facilitators of and barriers to early implementation, (b) the influence of TTA on early implementation, and (c) the "levers" used to facilitate broader systems change. Systems change theory enabled us to understand how various "levers" created opportunities for change within the communities, including establishing system boundaries, understanding how systems components can function as causes of or solutions to a problem, and assessing and changing systems interactions. We conclude by arguing that systems theory adds value to existing implementation science frameworks and can be helpful in future research on the implementation of evidence-based practices such as HF which is a complex community intervention. Implications for community psychology are discussed.
Community psychology has long been concerned with social justice. However, deployments of this term are often vague and undertheorized. To address this weakness in the field's knowledge body we explored John Rawls's theory of social justice and Amartya Sen's economic theory of the capabilities approach and evaluated each for its applicability to community psychology theory, research, and action. Our unpacking of the philosophical and political underpinnings of Rawlsian theory of social justice resulted in identifying characteristics that limit the theory's utility in community psychology, particularly in its implications for action. Our analysis of the capability approach proposed by Amartya Sen revealed a framework that operationalizes social justice in both research and action, and we elaborate on this point. Going beyond benefits to community psychology in adopting the capabilities approach, we posit a bi-directional relationship and discuss how community psychology might also contribute to the capabilities approach. We conclude by suggesting that community psychology could benefit from a manifesto or proclamation that provides a historical background of social justice and critiques the focus on the economic, sociological, and philosophical theories that inform present-day conceptualizations (and lack thereof) of social justice for community psychology.
In this study, we examine changes in the homeless‐serving system in the context of a training and technical assistance initiative to scale up Housing First (HF) in 6 Canadian communities. Based on qualitative data from focus groups and individual interviews with key stakeholders (k = 7, n = 35) and field notes gathered over a 3‐year period (n = 146), we found 2 main system changes: (a) changes in the capacity of the service delivery system at multiple levels of analysis (from individual to policy) to implement HF, and (b) changes in the coordination of parts of the service delivery system and collaboration among local stakeholders to enhance HF implementation. These changes were facilitated or constrained by the larger context of evidence, climate, policy, and funding. The findings were discussed in terms of systems change theory and implications for transformative systems change in the mental health and homelessness sectors.
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