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Composing Harmony: The Use of Music Therapy in a Homeless Shelter

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According to the National Center on Family Homelessness (2017), Homelessness affects 2.5 million children annually (n.p). Children who are exposed to homelessness many times also suffer from adverse childhood experiences (ACEs) which can hinder a younger person's development cognitively, socially,

According to the National Center on Family Homelessness (2017), Homelessness affects 2.5 million children annually (n.p). Children who are exposed to homelessness many times also suffer from adverse childhood experiences (ACEs) which can hinder a younger person's development cognitively, socially, and can cause health problems such as heart disease later on in life. Examples of an ACE are death of a family member, witnessing or experiencing violence, economic hardship, or having a parent with a alcohol or drug addiction. About 70,000 of children in Arizona suffer from five or more ACEs. In this project music therapy interventions such as songwriting, lyric analysis, and recreative instrument play were used to address psychosocial needs for teens at a homeless shelter. The areas of psychosocial needs addressed in the music therapy group were: group cohesion, communication, and self regulation. Objectives were set each session in an eight week program to track progress of the above goals that were created based on the needs of the clients in this setting.

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2018-05

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Self-Esteem, Dietary Habits, and Perception of Body Image Among the Homeless Population

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Since underserved individuals do not have a steady supply of food, this study explored whether their standards of what they view as healthy differs from individuals who can afford a basic living that includes food and shelter. Data collection from

Since underserved individuals do not have a steady supply of food, this study explored whether their standards of what they view as healthy differs from individuals who can afford a basic living that includes food and shelter. Data collection from surveys provided information to see whether the struggles of obtaining food affects what is perceived as healthy, and whether there is a difference in dietary habits, perception of body image, and self-esteem. Homeless individuals displayed that they were more aware than non-homeless individuals that the food they were consuming was unhealthy. They were also less satisfied with their daily food diet, as most of them wished that they ate greater quantities of certain foods. Their daily food intake did confirm that they consumed more unhealthy food that lacked nutrition compared to non-homeless individuals. They also generally believed that thicker body images were healthier and more attractive compared to non-homeless people who thought that thinner body images were healthier and attractive. Homeless people also generally ranked lower on the body image scale than the image they thought was most desirable and healthy. This revealed a lack of satisfaction with their own current body. Additionally, the self-efficacy score displayed that homeless individuals generally scored lower for their self-esteem level compared to non-homeless people. This demonstrated that their daily struggles and lifestyle impacts their emotions and overall confidence.

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2018-05

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Cookies 4 Change

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This thesis discusses our path toward creating Cookies 4 Change (C4C), a student organization at Arizona State University. This organization works in tandem with the Community School's Initiative (CSI) at Children's First Leadership Academy (CFLA), a school for housing insecure

This thesis discusses our path toward creating Cookies 4 Change (C4C), a student organization at Arizona State University. This organization works in tandem with the Community School's Initiative (CSI) at Children's First Leadership Academy (CFLA), a school for housing insecure K-8 students in the valley. This mission of Cookies 4 Change is to mentor 7th and 8th grade students of the CSI program at Children's First Leadership Academy in life, in entrepreneurial endeavors, in academic pursuits, and in fundraising to illuminate future potential in both education and careers beyond. To fulfill this mission, we researched three main fields: volunteer motivation, self-esteem in the classroom, and curriculum. This research helped us to first determine the best way to structure our organization to keep ASU students engaged, second to build the self-esteem of the middle school students, and third to create sustainable curriculum on the topic of entrepreneurship. In addition, to ensure the sustainability of Cookies 4 Change, we are developing strong and committed members to take the reigns of the organization when we graduate. We have created detailed pass along documents to complement this thesis and assist them in running C4C. Lastly, we discuss the potential scalability of Cookies 4 Change as a concept to different underprivileged schools in the valley and other cities with a similar socioeconomic makeup. By delving further into our story, the research, the organization, the curriculum, our future, and the scalability, we hope to detail the work we have done to help these students and how the organization will continue helping after we are gone.

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2018-12

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Homelessness and Mental Illness: The Relationship Between These Two Factors, and Effective Service Model Solutions

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The purpose of this research study was to examine the intersection of the relationship between homelessness and mental illness, including other factors such as substance abuse. A secondary purpose of this study was to gain an awareness of service delivery

The purpose of this research study was to examine the intersection of the relationship between homelessness and mental illness, including other factors such as substance abuse. A secondary purpose of this study was to gain an awareness of service delivery models and associated funding streams for providing services to homeless persons with mental illness. A thorough literature review was conducted by the author in order to aid in answering these questions. The author also conducted interviews with 27 homeless and formerly homeless clients living in Denver who were receiving services through the Colorado Coalition for the Homeless. Finally, the author conducted 4 qualitative interviews with policy experts who worked extensively in homeless services and advocacy in the Metro-Denver area. All data was entered into an Excel workbook, and a series of graphs and tables were made to present the research results. The themes of mental illness and substance abuse were common amongst the sample population, but the most common theme was that of the lack of affordable housing available. The majority of respondents also cited involvement in the criminal justice system such as incarceration, as well as family issues as major factors in them becoming homeless. The policy experts all cited the Housing First as well as the Permanent Supportive Housing model as the most effective service delivery model for those who are both homeless and mentally-ill, and Denver is utilizing some very innovative funding streams for these service delivery models. In conclusion, the author found through both the literature review and quantitative research, that homelessness is not truly a mental illness or substance abuse issue alone, though this relationship does hold clinical importance. Homelessness is instead the result of an excessive shortage of permanent and affordable housing units across the United States.

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2018-12

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Evaluating Structural Barriers to Quality Care in the SHOW Free Clinic

Description

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.

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2017-05

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Ending Homelessness in Phoenix: How Investments in Housing First Could End Homelessness in the Valley

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Homelessness is one of the most visible and tragic problems facing Phoenix today. As Tucson cut its homelessness count nearly in half over the past six years, Phoenix only saw a reduction of 25%. The question remains: what is the

Homelessness is one of the most visible and tragic problems facing Phoenix today. As Tucson cut its homelessness count nearly in half over the past six years, Phoenix only saw a reduction of 25%. The question remains: what is the best solution for Phoenix to reduce and eventually eliminate homelessness? This paper examined costs and benefits as well as examples in other cities and states of Housing First solutions' effectiveness at reducing the number of people suffering from homelessness. It was found that Housing First solutions, namely Permanent Supportive Housing and Rapid Re-Housing, would be highly effective in combating the homelessness experienced by those in the Phoenix area.

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2017-05

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Comparative Analysis of Interprofessional Clinic Models: Recommendations for Best Practice Implementation

Description

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.

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2017-05

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Homeless Individuals' Perceptions of Welcomeness versus Unwelcomeness by Emergency Department Staff

Description

Homelessness has a history of existing as a misunderstood condition involving stereotypes, stigmas and assumptions. In fact, the combination of acute-care medical professionals with patients of chronic illness and chronic homelessness can lead to incongruity of attitudes. These mindsets have

Homelessness has a history of existing as a misunderstood condition involving stereotypes, stigmas and assumptions. In fact, the combination of acute-care medical professionals with patients of chronic illness and chronic homelessness can lead to incongruity of attitudes. These mindsets have the potential to affect the care homeless individuals receive in the emergency department (ED) and impact their intentions to seek medical help in the future (Ugarriza & Fallon, 1994, pp. 26). Furthermore, homeless individuals account for 54.5% of all ED visits in the United States (Kushel et al., 2002). The author conducted a qualitative descriptive study of 10 in-person interviews with homeless individuals in the downtown Phoenix, AZ area. The objective was to determine homeless individuals' perceptions of welcomeness and unwelcomeness by emergency department staff. Findings support significantly unwelcome experiences in the ED and negative perceptions of ED staff through repeating concepts of dehumanization, dismissal, stereotypes and discrimination. Further research is needed to create interventions for improving perceptions of ED staff, promoting health and preventing illness in the homeless population, and reducing ED visits by homeless individuals.

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2014-05

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Care Not Cash: A New Kind of Reform

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This thesis examines Care Not Cash, a welfare reform measure that replaced traditional cash General Assistance program payments for homeless persons in San Francisco with in-kind social services. Unlike most welfare reform measures, proponents framed Care Not Cash as a

This thesis examines Care Not Cash, a welfare reform measure that replaced traditional cash General Assistance program payments for homeless persons in San Francisco with in-kind social services. Unlike most welfare reform measures, proponents framed Care Not Cash as a progressive policy, aimed at expanding social services and government care for this vulnerable population. Drawing on primary and secondary documents, as well as interviews with homelessness policy experts, this thesis examines the historical and political success of Care Not Cash, and explores the potential need for implementation of a similar program in Phoenix, Arizona.

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2017-05

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Framework to Develop a Social Determinants of Health Screener for Clinics Serving Vulnerable Populations

Description

This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored

This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.

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2018-05