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- Creators: Arizona State University
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 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.
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.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This research is about urban homeless people's vulnerability to extreme temperatures and the related socio-spatial dynamics. Specifically, this research investigates heat related coping strategies homeless people use and how the urban environment setting impacts those coping strategies. Semi-structured interviews were conducted with homeless people in Phoenix, Arizona during the summer of 2010. The findings demonstrate that homeless people have a variety of coping strategies and the urban environment setting unjustly impacts those strategies. The results suggest a need for further studies that focus spatial environmental effects on homeless people and other vulnerable populations.
ContributorsSanchez, Cory (Author) / Johnson, John M. (Thesis advisor) / Harlan, Sharon L (Committee member) / Lauderdale, Pat (Committee member) / Arizona State University (Publisher)
Created2011
Description
Law enforcement officers are frequently tasked with addressing and responding to public safety and community concerns related to issues of homelessness. While interactions between law enforcement and individuals experiencing homelessness occur frequently, issues of homelessness also span public health, policy, and housing spheres. Because of this, several communities in the United States also lean on outreach workers to address issues of homelessness. Recent research has described both law enforcement officers and outreach workers as street-level bureaucrats. Both groups grapple with unique shift demands, lack of supervision, burnout, and issues such as turnover, all while leveraging their personal knowledge and connections to make decisions on a case-by- case basis.In two studies, this dissertation explores the role of the police and outreach workers in responses to issues of homelessness. This is important to address because there is evidence that these two groups have a high degree of contact with individuals experience homelessness and have similar decision-making processes. Yet, they are largely siloed from one another making it difficult to generate policies related to issues of homelessness that are informed by both groups. In study one, responses to close- and open-ended responses (N = 1,163) drawn from a survey distributed to law enforcement personnel are analyzed, merged, and interpreted. The second study of this dissertation is an ethnography of outreach workers in Maricopa County, Arizona. The collective findings from these two studies underscore a remarkable similarity between outreach worker and law enforcement decision making, as well as a growing need to strengthen the relationships between these two groups to support longer-term solutions. Co-created training guides and events can be constructed to enhance the relationship between these two groups and to support mutually beneficial outcomes.
Portions of this research were supported by a Law and Science Dissertation Grant, via the National Science Foundation, award SES-2016661 to Arizona State University. This project was also supported by Arizona State University’s Graduate College and Graduate Student and Professional Association’s Graduate Research Program Award. The findings and conclusions are those of the author and do not reflect the position of the National Science Foundation or Arizona State University.
ContributorsBrown, Katharine L (Author) / Telep, Cody W (Thesis advisor) / Lucio, Joanna (Committee member) / Young, Jacob Tn (Committee member) / Arizona State University (Publisher)
Created2023
Description
Human connection is fundamental for a shift toward sustainable societies. Small groups of people working in response to their unique conditions and environment can find joy in the co-creation of a shared existence. A collaborative network of related efforts can contribute to a broader understanding of resilience and adaptation, aiming toward a regenerative relationship with the Earth and all species. Such an approach ameliorates both pervasive loneliness and extreme inequity that have grown from modern consumerist individualism, through a strong focus on trust, respect and authenticity. I have created a structure to pursue these goals as an applied Sustainability researcher and artist. First, I present a tool that measures and guides community-based work to support the values of equity, justice, transformation and connection. I follow this with an in-depth process of qualitative inquiry grounded in an applied participatory design project to gain insight on the act of building connection across perceived divides. Finally, I share “The Building Community:” the group and process I formed with formerly homeless individuals who are co-designing a tiny home ecovillage of transitional supportive housing for homeless human beings in the Skid Row neighborhood of downtown Los Angeles. The Building Community method combines Council-style talking circles with elements of Action and Design research in which equal co-learners embark on a fun and challenging journey to nurture housing security, interconnectedness, and sustainability. The results of this research indicate an opportunity for community-based researchers to further incorporate support for the rights of nature, decolonization efforts and preservation of the commons into their projects. Flexible structure, consistency, balanced effort and shared decision making proved to build a strong foundation for group processes centered on trust. Finally, The Building Community showed that intimate local groups can produce abundant and creative sustainability solutions when partnered with academic guidance and resources. Sustainability scholars have the chance to balance power, amplify voices and make collective visions manifest if they immerse themselves in efforts on the ground.
ContributorsFalstad, Beth Ann Grace (Author) / Cloutier, Scott (Thesis advisor) / Gee, James (Committee member) / Sale, Gregory (Committee member) / Arizona State University (Publisher)
Created2019
Description
Abstract
The following research addresses some of the contemporary problems that individuals experiencing homelessness face; specifically, investigating the decision to forgo shelter services and spend nights in places unfit for human inhabitation, a phenomenon known as sleeping rough. The paper begins with a broad look at the historical roots of homelessness, urbanization and the failure of mental health services, before exploring past attempts at answering the research question, why do the homeless choose to sleep rough? Several seminal studies, most of which were performed in large New York City shelters, gave context to the dangers present within shelters, but, due to both their location and methodologies, failed to capture the nuances of decision making for individuals experiencing homelessness. In order to expand the literature’s understanding of homelessness and the decision to forgo shelters, I conducted 23 in-depth interviews with various individuals embedded in the homeless culture in Phoenix, Arizona, including those experiencing homelessness, shelter employees, service providers, and the police squad designated to work the shelter beat. This thesis also provides information about the unique circumstances of Phoenix shelter services, the majority of which are housed on the Human Services Campus, a cluster of services specialized for homeless outreach. To supplement the information gathered through in-depth interviews, I analyzed crime maps of the Human Services Campus. This information, coupled with the in-depth interviews, helps explain that the homeless avoid the shelter services for a variety of reasons. These include concerns for safety, freedom, and personal property, as well as a longing to maintain dignity and avoid confrontation with shelter staff and security. Mental health and substance abuse implications are also discussed.
ContributorsHughes, Andrew David (Author) / Scott, Michael (Thesis advisor) / Maguire, Edward (Committee member) / Telep, Cody (Committee member) / Arizona State University (Publisher)
Created2021
Description
How to best assist LGBTQ+ young adults experiencing homelessness and reporting sex trafficking victimization is a developing field of knowledge. This study aimed to understand sex trafficking risk factors for LGBTQ+ young adults experiencing homelessness through the 2019 Youth Experiences Survey (2019 YES) and 16 follow-up interviews. The main findings include a) the odds of being LGBTQ+ and experiencing homelessness and reporting sex trafficking victimization were 2.41 times greater (95% CI: 1.22, 4.74) than being a cisgender heterosexual experiencing homelessness and reporting sex trafficking victimization; and b) risk factors that contributed significantly to a binary logistic regression model to predict being an LGBTQ+ young adult experiencing homelessness and reporting sex trafficking victimization included having a current medical issue, having a history of dating violence, having a childhood history of sexual abuse (ACEs sexual abuse), having a history of binging/vomiting, and having a diagnosis of post-traumatic stress disorder (PTSD). The interviews back up quantitative data for contextualization purposes. The findings of this study confirm the need for more services for LGBTQ+ young adults experiencing homelessness and reporting sex trafficking victimization. Additionally, healthcare providers must consider screening for eating disorders among LGBTQ+ young adults experiencing homelessness and reporting sex trafficking victimization. Finally, future research on LGBTQ+ young adults experiencing homelessness and reporting sex trafficking victimization is recommended.
ContributorsHogan, Kimberly Ann (Author) / Roe-Sepowitz, Dominique (Thesis advisor) / Mendoza, Natasha (Committee member) / Anthony, Elizabeth (Committee member) / Arizona State University (Publisher)
Created2022