Fidelity of a strengths-based intervention used by dutch shelters for homeless young adults

Abstract

OBJECTIVE: In a cluster randomized controlled trial, this study aimed to investigate the effectiveness of and fidelity to Houvast (Dutch for "grip"), a strengths-based intervention to improve the quality of life for homeless young adults. METHODS: Fidelity was measured six months after professionals and team leaders at five Dutch shelters for homeless young adults finished their training in Houvast. Fidelity was measured with the Dutch version of the strengths model fidelity scale, which consists of ten indicators distributed across three subscales: structure, supervision, and clinical practice. A total fidelity score was composed by averaging the ten indicator scores for each facility. During one-day audits by two trained assessors visiting each facility, a file analysis (N=46), a focus group with homeless young adults (N=19), and interviews with the team leader and supervisor (N=9) were conducted. Professionals, supervisors, and team leaders completed questionnaires two weeks before the audit (N=43). In addition, an evaluation of the audit was conducted six months later. RESULTS: Although none of the five shelters achieved a sufficient total model fidelity score, median scores on caseload, group supervision, and strengths assessment were satisfactory. Each facility received a report with a set of recommendations to improve model fidelity. The evaluation showed improvements in use of the strengths assessment and personal recovery plans and in supervision. CONCLUSIONS: Facilities face several challenges when implementing a new intervention, and implementing Houvast was no exception. Learning experiences and possible explanations for the insufficient total fidelity scores are reported.