Title

Research Poster Session - Exploring tenant health and wellness in a supportive housing community: Enhancing intervention through occupational science research

Presenter Information

Abbey Marterella, EMUFollow

Location

Magnolia Room

Start Time

17-10-2013 6:30 PM

End Time

17-10-2013 8:30 PM

Abstract

Permanent supportive housing (PSH) is a community-based care option for persons who were formerly homeless that combines affordable living with additional support services. The primary aims of PSH are to assist tenants with maintaining residential stability and increasing independence. Such services are particularly important for people with serious mental illness (SMI) because they have complex daily living needs and face personal and contextual barriers to community living.1 While research shows that PSH programs benefit both individuals and communities,2 programs vary in their ability to address tenant needs.

This poster communicates a community-engaged research project in a Southeastern Michigan PSH community.3 During initial project conversations, the program administrator stated a desire to move beyond “maintaining housing” and “averting crises” to addressing broader tenant health and wellness issues and supporting “flourishing” in daily life. The fit between the agency’s needs and the focus of the researcher’s home discipline (i.e., occupational science) provided a fruitful opportunity for designing an exploratory qualitative study. The purpose of this study was to develop a nuanced understanding of tenant health and wellness as a starting point for intervention development and service enhancement.

This research draws upon ethnographic methods and constructivist grounded theory analytic strategies.4 Participant recruitment began in May 2012 with agency collaborators identifying initial participants. As the study progressed, additional participants were recruited based on participant suggestions. To date, 17 participants are enrolled in the study, including tenants (n=9), PSH program support staff (n=7), and PSH administrators (n=1). Data were generated at multiple sites (i.e., apartment complexes, private residences) through the use of homogenous focus groups, individual interviews and participant observations. The analytic process used line-by-line, incident-by-incident, and focused coding to identify (a) convergent and divergent perspectives on health as wellness, and (b) barriers to health and wellness. The next phase of the study, which aims to elaborate and refine analytic categories and understandings, will involve participants from the property management company and additional PSH program tenants.

The preliminary findings of this study contribute to the occupational science discourse on occupational justice5 for adults with SMI. Four findings emphasize the centrality of opportunity and control in lifestyle-based wellness intervention. First, tenants and staff had divergent views on what living well entailed in particular situations. Second, for both tenants and staff, it was often impractical to attend to health and wellness beyond shelter, medication, sustenance, and basic activities of daily living. Third, staff members’ mediation between tenants and property managers created a boundary that undermined wellness. Fourth, limiting services to those deemed medically necessary created an inability to provide certain supports. These circumstances highlight the need for transformative social changes that shift wellness interventions past the individual level to the organizational plane. Occupational science has a key role to play in challenging the injustices associated with exclusion from daily occupations and advocating for system change strategies that support participation.

Word count: 472

Keywords:

Mental illness, community-engaged research, health and wellness

Objectives for poster presentation:

1. Disseminate preliminary findings and collaborate with occupational scientists about future directions for this study

2. Discuss occupational justice as it relates to translational research in occupational science

3. Explore the contributions occupational science can make to current conceptualizations of wellness for those with SMI

References

1 Substance Abuse and Mental Health Services Administration. (2010). Permanent supportive housing: The evidence (HHS Pub. No. SMA-10-4509). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved from http://store.samhsa.gov/shin/content//SMA10-4510/SMA10-4510-07-TheEvidence-PSH.pdf

2 Pearson, C., Montgomery, A. E., & Locke, G. (2009). Housing stability among homeless individuals with serious mental illness participating in housing first programs. Journal of Community Psychology, 37(3), 404-417. Retrieved from http://onlinelibrary.wiley.com.ezproxy.emich.edu/doi/10.1002/jcop.20303/pdf

3 Aldrich, R., & Marterella, A. (2012). Community-engaged research: A path for occupational science in the changing university landscape. Journal of Occupational Science, iFirst, 1-16. doi:10.1080/14427591.2012.714077

4 Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Los Angeles: Sage.

5 Townsend, E. (2012). Boundaries and bridges to adult mental health: Critical occupational and capabilities perspectives of justice. Journal of Occupational Science, iFirst, 1-17. doi:10/1080/14427591.2011.639723

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Oct 17th, 6:30 PM Oct 17th, 8:30 PM

Research Poster Session - Exploring tenant health and wellness in a supportive housing community: Enhancing intervention through occupational science research

Magnolia Room

Permanent supportive housing (PSH) is a community-based care option for persons who were formerly homeless that combines affordable living with additional support services. The primary aims of PSH are to assist tenants with maintaining residential stability and increasing independence. Such services are particularly important for people with serious mental illness (SMI) because they have complex daily living needs and face personal and contextual barriers to community living.1 While research shows that PSH programs benefit both individuals and communities,2 programs vary in their ability to address tenant needs.

This poster communicates a community-engaged research project in a Southeastern Michigan PSH community.3 During initial project conversations, the program administrator stated a desire to move beyond “maintaining housing” and “averting crises” to addressing broader tenant health and wellness issues and supporting “flourishing” in daily life. The fit between the agency’s needs and the focus of the researcher’s home discipline (i.e., occupational science) provided a fruitful opportunity for designing an exploratory qualitative study. The purpose of this study was to develop a nuanced understanding of tenant health and wellness as a starting point for intervention development and service enhancement.

This research draws upon ethnographic methods and constructivist grounded theory analytic strategies.4 Participant recruitment began in May 2012 with agency collaborators identifying initial participants. As the study progressed, additional participants were recruited based on participant suggestions. To date, 17 participants are enrolled in the study, including tenants (n=9), PSH program support staff (n=7), and PSH administrators (n=1). Data were generated at multiple sites (i.e., apartment complexes, private residences) through the use of homogenous focus groups, individual interviews and participant observations. The analytic process used line-by-line, incident-by-incident, and focused coding to identify (a) convergent and divergent perspectives on health as wellness, and (b) barriers to health and wellness. The next phase of the study, which aims to elaborate and refine analytic categories and understandings, will involve participants from the property management company and additional PSH program tenants.

The preliminary findings of this study contribute to the occupational science discourse on occupational justice5 for adults with SMI. Four findings emphasize the centrality of opportunity and control in lifestyle-based wellness intervention. First, tenants and staff had divergent views on what living well entailed in particular situations. Second, for both tenants and staff, it was often impractical to attend to health and wellness beyond shelter, medication, sustenance, and basic activities of daily living. Third, staff members’ mediation between tenants and property managers created a boundary that undermined wellness. Fourth, limiting services to those deemed medically necessary created an inability to provide certain supports. These circumstances highlight the need for transformative social changes that shift wellness interventions past the individual level to the organizational plane. Occupational science has a key role to play in challenging the injustices associated with exclusion from daily occupations and advocating for system change strategies that support participation.

Word count: 472

Keywords:

Mental illness, community-engaged research, health and wellness

Objectives for poster presentation:

1. Disseminate preliminary findings and collaborate with occupational scientists about future directions for this study

2. Discuss occupational justice as it relates to translational research in occupational science

3. Explore the contributions occupational science can make to current conceptualizations of wellness for those with SMI