Identifying occupation-based needs and services for individuals experiencing homelessness using interviews and photovoice.

BACKGROUND: Homelessness can impact society and individuals in many ways. OBJECTIVE: The purpose of this project was to examine the current occupation-based needs and services among persons experiencing homelessness (PEH) in a major city. METHODS: Researchers conducted semi-structured interviews with eight PEH residing in a homeless shelter. Three questions were asked of each participant: What daily personal activities have been most impacted since undergoing homelessness? Which services have been most helpful to you in overcoming homelessness? What other services might you find helpful to individuals experiencing housing insecurity? Researchers also gathered qualitative data utilizing a Photovoice component in which twelve PEH had the opportunity to photograph one object and provide a quote associated with the meaningful object. RESULTS: Under-addressed areas of occupation, services received, and services requested were identified. Findings suggest that areas of occupation most impacted by homelessness include instrumental activities of daily living (IADLs), activities of daily living (ADLs), leisure, social participation, and rest and sleep. Services received included case management and often met basic self-care needs of PEH. Services requested included group therapy, restructuring of the shelter to support individualization, and staff training. CONCLUSIONS: Occupational therapy practitioners have the skill set to assess needed services among PEH. Meaningful objects captured by the clients via Photovoice may relate to past, present and future satisfaction despite being homeless.

Homelessness: Understanding unmet needs and identifying resources.

BACKGROUND: Graduate occupational therapy students collaborated with an Area Health Education Center (AHEC) to address occupational therapy's role in intervening for individuals who are homeless. OBJECTIVE: The purpose was to provide educational resources on specific needs related to health and wellbeing to individuals who are homeless. METHODS: A variety of methods were used to gather information on common needs of the homeless population related to health and wellbeing, community integration, and development of routines. Initial data was collected through the use of a needs assessment for nine participants with thirteen questions followed with a weekly visit to a homeless shelter. The weekly visits allowed the students to build rapport and trust with the residents to gain an understanding of individual perspectives and barriers to occupation. RESULTS: The students worked with residents how to best access community based resources and services related to occupational needs. Specific needs were identified, and further resources were provided to support community integration, independent living, and self-management. CONCLUSIONS: Preliminary findings provided a basic understanding of the foundational needs of individuals to be used to support future research linking occupational therapy to the homeless population to achieve individual goals, improve health and wellbeing, and enhance life skills management.

Incorporating Injury Prevention Into Energy Weatherization Programs.

Clients receiving weatherization/energy services with an added injury prevention home assessment with modifications/repairs experienced a decline in falls and thus fall-related costs. Interventions in 35 homes were associated with significant reductions in falls from baseline to 6 months postintervention (from 94% to 9%; P < .001) and falls with calls for assistance (from 23% to 3%; P < .02). The decline in falls with calls for assistance in the intervention group was significant when adjusted for a comparison group effect (P = .07). At a median cost of $2058 per home, the addition of an injury prevention component led by an occupational therapist offers the potential to avoid expensive fall-related medical costs (lift assistance, hospital transport and admission, long-term care). Integration of injury prevention into weatherization work, which targets lower-income seniors with high energy use, offers potential to reduce costly hospitalizations and poor health outcomes.

PHOTOVOICE: Reducing pedestrian injuries in children.

Pedestrian injury is the second leading cause of injury related death for children. The purpose of this research project was to determine the effectiveness of pedestrian and road traffic safety education with children, as part of the Walk This Way program through Safe Kids USA. Through the implementation of PHOTOVOICE, a project that captured children's narratives coinciding with a photograph, children engaged in community exploration to identify pedestrian hazards in their communities and explore possible solutions utilizing their photography and narrations. Children participated in an engaging educational session, a community fieldtrip, and reflection. Results concluded that, despite a small increase in post test scores, an increase in awareness of hazards in the community and successful identification of community hazards was achieved. The goal of this research project was determine the effectiveness of a hands-on pedestrian and road traffic safety educational program with children. The results of this research project will be integrated with similar projects completed across the country through the program Walk This Way with Safe Kids USA. Both this research project and the Walk This Way program aim to promote behavior change in children and create safer communities to reduce pedestrian related injury. The overall goal of this research project andthe Walk This Way program is to increase education on a national level in regards to pedestrian safety for children and provide a basis for lobbying for public policy changes pertaining to road and pedestrian safety.

Using daily routines to promote medication adherence in older adults.

PURPOSE: To understand the medication routines used by older adults taking four or more medications daily. METHOD: One hundred forty-nine community-dwelling older adults were interviewed about the individual routines, storage locations, equipment, and assistance that enabled their adherence to a medication regimen. A subsample of 84 older adults was observed completing one medication routine in their home environments. FINDINGS: Medication habits were embedded in mealtime, wake-up, and sleep routines for 91% of the sample. Participants developed unique, individualized behaviors for taking medications that were choreographed within broader daily routines. The primary locations for storing medications were the kitchen and bathroom. Equipment used to promote adherence was primarily pillboxes or self-made adaptations. More than 50% of the entire sample required some type of assistance related to medication adherence. IMPLICATIONS: Findings support the role of occupational therapists in collaborating with clients to develop individualized medication routines to promote medication adherence.