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.

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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.

Better Beginnings, Better Futures is a large‐scale, multi‐year, longitudinal research‐demonstration project designed to reduce children's problems, promote healthy child development, and enhance family and community environments in three economically disadvantaged communities in the province of Ontario, Canada. The initial intervention was implemented from 1993 to 1997 and focused on families with children from 4 to 8 years of age in their first 4 years of schooling (from Junior Kindergarten to Grade 2). This study examined the long‐term parent, family and community programme outcomes, 15 years after the start of the intervention, when the young people who had participated in the intervention as young children were 18 to 19 years of age. Comparison of intervention communities with matched non‐intervention communities showed a mix of outcomes. Although few significant differences between intervention and comparison communities were found with regard to parents' health and family outcomes, there was evidence that parents in the intervention communities were engaging in fewer risk behaviours, had lower levels of depression and had more community involvement than parents in the comparison communities. These results suggest that the intervention did have some positive long‐term effects on youths' parents and on their community environments. Results are discussed with respect to the importance of considering family and neighbourhood contexts in the development and evaluation of prevention programmes. Copyright © 2012 John Wiley & Sons, Ltd.

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.

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

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The scaling out of Housing First (HF) programs was examined in six Canadian communities, in which a multi-component HF training and technical assistance (TTA) was provided. Three research questions were addressed: (a) What were the outcomes of the TTA in terms of the development of new, sustained, or enhanced programs, and fidelity to the HF model? (b) How did the TTA contribute to implementation and fidelity? and (c) What contextual factors facilitated or challenged implementation and fidelity? A total of 14 new HF programs were created, and nine HF programs were sustained or enhanced. Fidelity assessments for 10 HF programs revealed an average score of 3.3/4, which compares favorably with other HF programs during early implementation. The TTA influenced fidelity by addressing misconceptions about the model, encouraging team-based practice, and facilitating case-based dialogue on site specific implementation challenges. The findings were discussed in terms of the importance of TTA for enhancing the capacities of the HF service delivery system-practitioners, teams, and communities-while respecting complex community contexts, including differences in policy climate across sites. Policy climate surrounding accessibility of housing subsidies, and use of Assertive Community Treatment teams (vs. Intensive Case Management) were two key implementation issues.