Integrating Mixed Methods in Health Services and Delivery System Research
Variation in the Implementation of California's Full Service Partnerships for Persons with Serious Mental Illness
Article first published online: 21 OCT 2013
© Health Research and Educational Trust
Health Services Research
Volume 48, Issue 6pt2, pages 2245–2267, December 2013
How to Cite
Gilmer, T. P., Katz, M. L., Stefancic, A. and Palinkas, L. A. (2013), Variation in the Implementation of California's Full Service Partnerships for Persons with Serious Mental Illness. Health Services Research, 48: 2245–2267. doi: 10.1111/1475-6773.12119
- Issue published online: 26 NOV 2013
- Article first published online: 21 OCT 2013
- Manuscript Accepted: 22 JUL 2013
- American Recovery and Reinvestment
- Agency for Health Care Research and Quality for Healthcare Delivery Systems Research. Grant Number: 1R01HS019986
- Mental health;
- homeless populations;
- health care organizations and systems
This study examined variation in the implementation of California's Full Service Partnerships (FSPs), which are supported housing programs that do “whatever it takes” to improve outcomes among persons with serious mental illness who are homeless or at risk of homelessness.
Ninety-three FSPs in California.
A mixed methods approach was selected to develop a better understanding of the complexity of the FSP programs. The design structure was a combined explanatory and exploratory sequential design (qualQUANqual) where a qualitative focus group was used to develop a quantitative survey that was followed by qualitative site visits. The survey was used to describe the breadth of variation based on fidelity to the Housing First model, while the site visits were used to provide a depth of information on high- versus low-fidelity programs.
We found substantial variation in implementation among FSPs. Fidelity was particularly low along domains related with housing and service philosophy, indicating that many FSPs implemented a rich array of services but applied housing readiness requirements and did not adhere to consumer choice in housing.
There remains room for improvement in the recovery-orientation of FSPs. Fortunately, we have identified several processes by which program managers and counties can increase the fidelity of their programs.