Development and validation of a Housing First fidelity survey

Psychiatr Serv. 2013 Sep 1;64(9):911-4. doi: 10.1176/


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.

Publication types

  • Research Support, American Recovery and Reinvestment Act
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • California
  • Factor Analysis, Statistical
  • Humans
  • Mental Health Services / standards*
  • Public Housing / standards*
  • Surveys and Questionnaires / standards*