Stakeholder Perspectives on Implementation Challenges and Strategies for Moving On Initiatives in Permanent Supportive Housing.

Moving On Initiatives (MOIs) assist individuals with the transition from permanent supportive housing to mainstream housing without the embedded supports. This emerging innovation has the potential to increase behavioral health system capacity and provide recipients with the opportunity to live in the least restrictive setting. However, few empirical studies have examined MOIs, and little is known about the implementation challenges providers face and strategies they use to realize these initiatives in practice. To identify these challenges and strategies, this study utilized over 2 years of observations at MOI "learning collaboratives," as well as eight focus groups with implementation stakeholders. Analyses informed by the Consolidated Framework for Implementation Research (CFIR) identified challenges in the outer and inner service settings, as well as at the individual and innovation level. Outer setting challenges were most prominent in the data, and one non-CFIR construct, macrosystemic characteristics arose inductively. Implications for behavioral health policy and practice are discussed.