Adapting an evidence-based intervention for homeless women: engaging the community in shared decision-making

Abstract

As interest grows in the diffusion of evidence-based interventions (EBIs), there is increasing concern about how to mitigate implementation challenges; this paper concerns adapting an EBI for homeless women. Complementing earlier focus groups with homeless women, homeless service providers (n = 32) were engaged in focus groups to assess capacity, needs, and barriers with implementation of EBIs. Deductive analyses of data led to the selection of four EBIs. Six consensus groups were then undertaken; three each with homeless women (n = 24) and homeless service providers (n = 21). The selected EBI was adapted and pretested with homeless women (n = 9) and service providers (n = 6). The structured consensus group process provided great utility and affirmed the expertise of homeless women and service providers as experts in their domain. Engaging providers in the selection process reduced the structural barriers within agencies as obstacles to diffusion.

Figures

Fig. 1

Selection procedures. aFocus groups were completed as part of a previously funded project and are published elsewhere. bPrior to meetings, an updated HIV/AIDS prevention EBI review (9 EBIs identified) was conducted based on preliminary feedback from provider focus groups and expert interviews.