Souls in Extremis: Enacting Processes of Recovery from Homelessness Among Older African American Women.

In a midwestern city of the USA, the authors implemented the Leaving Homelessness Intervention Research Project-and its eight subprojects-to further understand homelessness as experienced by older minority women, develop intervention strategies to facilitate the movement of the participants out of homelessness, and illuminate the women's recovery process. After reviewing the social issue of homelessness among older African American women in the USA, and offering a framework on recovery and qualitative themes of recovery among participants involved in the Telling My Story subproject, the authors present a four-factor model of recovery-focused practice. The model reflects two recovery paradigms: one that is responsive to the negative consequences people experience as a result of their exposure to extreme situations, such as homelessness, and a proactive one in which assistance is designed to help people in recovery advance their own self-development and move forward their process of individuation.

The relationship between spiritual resources and life attitudes of African American homeless women.

Little is known about the relationships between spiritual resources and life attitudes of homeless African American women. Spiritual resources may serve as protective factors for women leaving homelessness. This descriptive study examines spiritual resources, life attitudes, and selected demographics of 160 African American women who were homeless in the Midwestern United States. Participants ranged in age from 30-62 years of age and reported being homeless 1-9 times, with a mean of 1.94 (SD = 1.53) times. The authors draw inferences for how spiritual resources and life attitudes can influence women's efforts to leave homelessness and identify implications for nursing practice.

Self-efficacy as a unifying construct in nursing-social work collaboration with vulnerable populations.

The authors consider self-efficacy practice as an organizing construct guiding nursing-social work action research in partnership with older homeless and formerly homeless African-American women. The authors, both academics who together have worked with members of this vulnerable population for a decade and a half, report on their unifying action research perspective immersed in self-efficacy theory. We examine how our adaptations of Bandura's classic four sources of self-efficacy form a distinctive intervention practice designed to help older African-American women emerge from homelessness. We amplify the incorporation of the four sources (vicarious experience and exposure to powerful role models, emotional arousal and accompanying catharsis, verbal persuasion, and role performance) into a grand strategy useful in working collaboratively with members of vulnerable populations, so they can achieve outcomes that improve their functional health, well-being and ultimately their quality of life.

Building a registry of research volunteers among older urban African Americans: recruitment processes and outcomes from a community-based partnership.

PURPOSE OF THE STUDY: An emerging strategy for increasing public participation in health research is volunteer registries. Using a community-based participatory research framework, we describe recruitment processes and outcomes in building a research volunteer registry of older urban African Americans. The specific research question examined retrospectively was: How does a community outreach partnership between older residents and academic researchers of the Healthier Black Elders Center facilitate recruitment of older urban African Americans for a research volunteer registry? DESIGN AND METHODS: We adapted program evaluation methods, specifically, the logic model, for clarifying how community outreach health education activities supported development of a research volunteer registry of older urban African Americans. RESULTS: Paralleling the 7 years in which an annual health reception was held, enrollees in a research volunteer registry increased from 102 to 1,273 enrollees. IMPLICATIONS: Targeted outreach to underrepresented groups to build a registry of volunteers for health research may be a promising strategy for addressing recruitment disparities in African Americans' research participation.

Self-care production experiences in elderly African Americans with hypertension and cognitive difficulty.

PURPOSE: The purpose of this qualitative descriptive study was to explore self-care production experiences in older African Americans who, despite some cognitive dysfunction, were able to produce hypertension-related self-care behaviors or blood pressure control successfully. DATA SOURCES: Participants were 10 urban, community-dwelling older African Americans, 60-89 years of age, living in a Midwest region of the United States. A semi-structured interview was conducted in participants homes' using Kvale's "conversational discourse" approach. Oral recordings were transcribed and analyzed for themes and codes. CONCLUSIONS: Elders' experiences with the production of self-care were characterized by three themes: preparation, monitoring, and evaluation. Self-care production was found to be cognitively challenging consistent with the finding that 60% of the participants had difficulty with a cognitive task requiring complex cognitive skills. This finding may explain why the production of self-care became a social phenomenon in which elders demonstrated resourcefulness in seeking assistance from surrounding support systems. IMPLICATIONS FOR PRACTICE: Nurse practitioners can support better health outcomes in older adults with hypertension by using valid and reliable measures for assessing complex cognitive skills, assessing individuals' progress in self-care production, and identifying individuals' use of social and professional supports to produce self-care.

Building a responsive network of support and advocacy for older African American homeless women through developmental action research.

This paper describes the Leaving Homelessness Intervention Research Project (LHIRP), a multimodal intervention that addresses the structural barriers and personal issues older African American women face in overcoming homelessness in a large mid-western city of the United States. The project incorporates a developmental action research design in partnership with homeless and formerly homeless women. Through developmental testing of interventions, LHIRP identifies promising practices at the individual, group life, intentional community, and city levels. The paper offers a rationale for the integration of both developmental research and action research, particularly community-based participatory inquiry. The authors document the nature of the helping network, identify and describe the project's aims, organizing framework, and methods that document the lived experience of homelessness. Action research strategies that support the design and intervention activities are described, as are the tools used to test promising practices that are useful in helping older women transition and remain out of homelessness. The paper identifies the knowledge products of the intervention project including lexicon, theory, and frameworks, considers the vicious cycle that serves as an advanced organizer of relevant intervention, illuminates core principles, and examines the importance of the web of affiliation that the project seeks to form among participants, staff, and technical assistants.

The telling my story quilting workshop: innovative group work with older African American women transitioning out of homelessness.

This article examines the use of a quilting workshop as a strategy for helping older African American women address the consequences of their homeless experience. In this examination, four studies are addressed: the original, the re-analysis, the interviews, and the quilting intervention. The relationship of quilting to group work and social support is described, and the use of quilting in the Telling My Story homeless research project is demonstrated. The researchers used the lay definition of quilting that implies the general meaning of attaching many disparate and unique pieces of material together into a whole. The researchers also describe the relevance of the group work method inherent in the quilting workshop in helping women successfully transition out of homelessness and progress in their recovery from its consequences.

Five dimensions of faith and spiritually of older African American women transitioning out of homelessness.

BACKGROUND: Homelessness among older African American women is emerging as a serious social problem. The increasing cost of living, diminishing community resources, and shrinking retirement benefits, as well as reduced social services are resulting in greater numbers of older minority women becoming homeless. AIMS: This investigation explores the relevance of faith and spirituality to an advocacy assessment designed to help participants resolve issues that operate as barriers to their leaving and staying out of homelessness. METHODS: A substudy of a larger research and development project was undertaken, in which qualitative interview methods were used to illuminate the role of faith and spirituality resources in the lives of 84 older homeless African American women. Comparative thematic analysis of illustrative cases was undertaken to better understand the role of faith and spirituality in the women's lives and in how they used faith and spirituality in coping with homelessness. FINDINGS: Five dimensions of faith and spirituality, (a) identity and beliefs; (b) affiliation and membership; (c) involvement; (d) practices; and (e) benefits, served as promising resources in understanding life spaces of homeless minority women and identified promising advocacy strategies. Two cases describe the realities of homelessness for older minority women endeavoring to transition out of homelessness and illustrate how faith and spirituality can buffer stress, facilitate coping, and sustain motivation. CONCLUSIONS: How older homeless African American women use their faith and spiritual resources to cope with demands of homelessness, challenges of transition, and recovery from the multiple traumas resulting from being homeless makes the assessment of faith and spirituality an important part of the advocacy process.

Enabling older homeless minority women to overcome homelessness by using a life management enhancement group intervention.

This paper describes the importance of a life management enhancement (LME) group intervention for older minority women in developing personal control and self-confidence in social relationships as they overcome homelessness. Women in the treatment group showed significantly greater personal control and higher levels of self-confidence following the six-week intervention than women in the control group. Increasing personal control and developing self-confidence in social relationships can help individuals achieve desired outcomes as a result of their actions, efforts, and abilities. These attributes can help women increase and sustain appropriate coping methods and overcome homelessness.