Housing first in Ireland: an evaluation of programme  implementation

Scientific evidence has become part of the day to day operations in our public services through the use of evidence-based programmes (EBPs). However, their success has varied greatly and inconsistently, with high failure rates in new contexts. To address this research-practice gap, implementation science has developed to focus on the methods and factors that influence how successfully specific interventions are incorporated into service settings. The question is: What is it about the implementation of an EBP that will make it a success or a failure?

The purpose of this dissertation was to evaluate the implementation of an EBP that was developed for one context (New York City) and implemented in another (Dublin, Ireland) to determine the factors that positively and negatively affected programme implementation, and to offer a framework for understanding its outcomes. The programme I examine is the Dublin Housing First Demonstration Project (DHFP; December 2009-September 2014). The DHFP was a pilot implementation and adaptation of Pathways Housing First (PHF), an established EBP and Complex Community Intervention (CCI) that reduces and ends long-term homelessness.

Data for this dissertation were collected between January 2012 and September 2014. The data corpus consists of individual and focus group interviews with DHFP team members, key stakeholders and providers. In addition, I analysed key programme documents, annual reports from organisations involved in the DHFP, as well as EU, national and local policy statements. I used Thematic Analysis (TA) as my method for data analysis and conducted my data coding using a hybrid approach (Fereday & Muir-Cochrane, 2006). A codebook was used to code my data-set based on prior research, Durlak and DuPre’s (2008) conceptual framework, and the concepts reflected in the PHF fidelity scale (Stefancic, et al., 2013). Inductive codes were assigned to segments of data that described a new themes observed in the text, but not accounted for within the existing framework (Fereday & Muir-Cochrane, 2006). 

Durlak and DuPre’s (2008) framework provided a useful conceptual framework of factors that can affect programme implementation. However, some elements were shown to be more relevant to the DHFP implementation than others, and based on my findings I conclude there are three key factors essential to a successful programme implementation, all of which are part of the initial implementation stage: 1) the manager’s relationship with the team, 2) relationship with stakeholder organisation, 3) fidelity to operational practices. Within fidelity to operational practices, I have identified an additional three factors that were essential to success: 1) training combined with supervision, 2) oversight from provider agency, 3) programme evaluation. Finally, there are also four factors that operate as barriers to effective implementation. These factors are across the installation, exploration and initial implementation stages of programme implementation: 1) work climate, 2) resource allocation, 3) community support, 4) political support. Overall, my findings, combined with Durlak and DuPre’s (2008) implementation framework will assist researchers, funders, and programme evaluators to implement Housing First programmes and other CCI’s with greater effect.