Dataset Information

Recognizing and responding to women experiencing homelessness with gendered and trauma-informed care.

ABSTRACT: BACKGROUND:The purpose of this study is to highlight the experiences of women who are often hidden in what we know and understand about homelessness, and to make policy and practice recommendations for women-centred services including adaptations to current housing interventions. METHODS:Three hundred survey interviews were conducted with people experiencing homelessness in Calgary, Alberta, Canada. The survey instrument measured socio-demographics, adverse childhood experiences, mental and physical health, and perceived accessibility to resources. Eighty-one women participants were identified as a subsample to be examined in greater depth. Descriptive statistics and logistic regressions were calculated to provide insight into women respondents' characteristics and experiences of homelessness and how they differed from men's experiences. RESULTS:Women's experiences of homelessness are different from their male counterparts. Women have greater mental health concerns, higher rates of diagnosed mental health issues, suicidal thoughts and attempts, and adverse childhood trauma. The results should not be considered in isolation, as the literature suggests, because they are highly interconnected. CONCLUSION:In order to ensure that women who are less visible in their experiences of homelessness are able to access appropriate services, it is important that service provision is both gender specific and trauma-informed. Current Housing First interventions should be adapted to ensure women's safety is protected and their unique needs are addressed.

SUBMITTER: Milaney K

PROVIDER: S-EPMC7099814 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Recognizing and responding to women experiencing homelessness with gendered and trauma-informed care.

Milaney Katrina K Williams Nicole N Lockerbie Stacy Lee SL Dutton Daniel J DJ Hyshka Elaine E

BMC public health 20200326 1

<h4>Background</h4>The purpose of this study is to highlight the experiences of women who are often hidden in what we know and understand about homelessness, and to make policy and practice recommendations for women-centred services including adaptations to current housing interventions.<h4>Methods</h4>Three hundred survey interviews were conducted with people experiencing homelessness in Calgary, Alberta, Canada. The survey instrument measured socio-demographics, adverse childhood experiences, ...[more]

PMID: 32216770

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Project description:ImportanceWomen and families constitute the fastest-growing segments of the homeless population. However, there is limited evidence on whether women experiencing homelessness have poorer childbirth delivery outcomes and higher costs of care compared with women not experiencing homelessness.ObjectiveTo compare childbirth delivery outcomes and costs of care between pregnant women experiencing homelessness vs those not experiencing homelessness.Design, setting, and participantsThis cross-sectional study included 15 029 pregnant women experiencing homelessness and 308 242 pregnant women not experiencing homelessness who had a delivery hospitalization in 2014. The study used statewide databases that included all hospital admissions in 3 states (ie, Florida, Massachusetts, and New York). Delivery outcomes and delivery-associated costs were compared between pregnant women experiencing homelessness and those not experiencing homelessness cared for at the same hospital (analyzed using the overlap propensity-score weighting method and multivariable regression models with hospital fixed effects). The Benjamini-Hochberg false discovery rate procedure was used to account for multiple comparisons. Data were analyzed from January 2020 through May 2020.ExposureHousing status at delivery hospitalization.Main outcomes and measuresOutcome variables included obstetric complications (ie, antepartum hemorrhage, placental abnormalities, premature rupture of the membranes, preterm labor, and postpartum hemorrhage), neonatal complications (ie, fetal distress, fetal growth restriction, and stillbirth), delivery method (ie, cesarean delivery), and delivery-associated costs.ResultsAmong 15 029 pregnant women experiencing homelessness (mean [SD] age, 28.5 [5.9] years) compared with 308 242 pregnant women not experiencing homelessness (mean [SD] age, 29.4 [5.8] years) within the same hospital, those experiencing homelessness were more likely to experience preterm labor (adjusted probability, 10.5% vs 6.7%; adjusted risk difference [aRD], 3.8%; 95% CI, 1.2%-6.5%; adjusted P = .03) and had higher delivery-associated costs (adjusted costs, $6306 vs $5888; aRD, $417; 95% CI, $156-$680; adjusted P = .02) compared with women not experiencing homelessness. Those experiencing homelessness also had a higher probability of placental abnormalities (adjusted probability, 4.0% vs 2.0%; aRD, 1.9%; 95% CI, 0.4%-3.5%; adjusted P = .053), although this difference was not statistically significant.Conclusions and relevanceThis study found that women experiencing homelessness, compared with those not experiencing homelessness, who had a delivery and were admitted to the same hospital were more likely to experience preterm labor and incurred higher delivery-associated costs. These findings suggest wide disparities in delivery-associated outcomes between women experiencing homelessness and those not experiencing homelessness in the US. The findings highlight the importance for health care professionals to actively screen pregnant women for homelessness during prenatal care visits and coordinate their care with community health programs and social housing programs to make sure their health care needs are met.

Project description:OBJECTIVES:To explore the views and experiences of people who are homeless and those supporting them regarding conversations and approaches to palliative care SETTING: Data were collected between October 2015 and October 2016 in homeless hostels and day centres and with staff from primary and secondary healthcare providers and social care services from three London boroughs. PARTICIPANTS:People experiencing homelessness (n=28), formerly homeless people (n=10), health and social care providers (n=48), hostel staff (n=30) and outreach staff (n=10). METHODS: In this qualitative descriptive study, participants were recruited to interviews and focus groups across three London boroughs. Views and experiences of end-of-life care were explored with people with personal experience of homelessness, health and social care professionals and hostel and outreach staff. Saturation was reached when no new themes emerged from discussions. RESULTS:28 focus groups and 10 individual interviews were conducted. Participants highlighted that conversations exploring future care preferences and palliative care with people experiencing homelessness are rare. Themes identified as challenges to such conversations included attitudes to death; the recovery focused nature of services for people experiencing homelessness; uncertainty regarding prognosis and place of care; and fear of negative impact. CONCLUSIONS:This research highlights the need for a different approach to supporting people who are homeless and are experiencing advanced ill health, one that incorporates uncertainty and promotes well-being, dignity and choice. We propose parallel planning and mapping as a way of working with uncertainty. We acknowledge that these approaches will not always be straightforward, nor will they be suitable for everyone, yet moving the focus of conversations about the future away from death and dying, towards the present and the future may facilitate conversations and enable the wishes of people who are homeless to be known and explored.

Project description:BackgroundStudies suggest female Veterans are under-identified as homeless in the VA healthcare system, which may impact their ability to access necessary services. In addition, the increasing number of female Veterans experiencing homelessness requires a better understanding of their access to necessary healthcare and social care.ObjectivesThe purpose of this systematic review was to examine the barriers and facilitators for access to healthcare and social care among women Veterans experiencing homelessness.DesignA mixed methods systematic review was conducted and includes quantitative and qualitative primary research studies.Data sources and methodsSeven databases were searched for quantitative or qualitative research studies. Studies which addressed access or use of healthcare or social services, which were focused on female Veterans or allowed for comparison between male and female Veterans were included. Data were synthesized using a convergent integrated approach.ResultsThirty-five studies met inclusion criteria; 27 quantitative, 6 qualitative and 2 mixed methods studies. Three main themes resulted: (1) the comparison of access and use of healthcare and social services between women and men; (2) female specific barriers to access or use of social and health services; (3) female specific facilitators to access or use of social and health services.ConclusionsResults showed although women Veterans had similar or better outcomes with permanent housing programming compared to men, gaps remain in the provision of emergency and short-term housing accommodations. In addition, many studies found that homeless women Veterans were unaware of the healthcare and social services available through the VA. Programs and policies need to ensure they are maximizing their reach to women Veterans experiencing homelessness by providing outreach and education, so they understand the benefits available when they discharge from the military and to understand the unique healthcare and social needs of women Veterans.

Dataset Information

Recognizing and responding to women experiencing homelessness with gendered and trauma-informed care.

Publications

Recognizing and responding to women experiencing homelessness with gendered and trauma-informed care.

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