Objective: High levels of social and economic deprivation are apparent in many UK cities. There is evidence of certain 'marginalised' communities suffering disproportionately from poor nutrition, threatening health. Finding ways to engage with these communities is essential to identify strategies to optimise wellbeing and life skills. The Food as a Lifestyle Motivator project aimed to pilot creative methods in homeless adults for the examination of food related experiences, in order to facilitate their engagement in wellbeing discourse. Design: Creative Participatory Action Research methods including Photo-Elicitation. Setting: A homeless service provider in Plymouth, UK Method: A sample of homeless service users took photographs of their food activities over a ten-day period, then volunteered to share their photos in focus group discussions to elicit meaning related to their food experiences. Results: Five themes were generated from nine service user narratives, demonstrating that food holds meaning, elicits emotion, and exerts power. The food environment can be a critical social meeting place and food preparation can provide companionship and occupation. Conclusions: As well as being central to many health concerns, food may also be a powerful way to motivate people to change their lifestyle. The participatory methods used in this pilot hold potential to engage effectively with harder-to-reach service users. Discussions about their wellbeing indicate food as a powerful 'catalyst' for inclusion with the potential to empower individuals. This research serves to inform health education practice, design of services, and address (nutritional) health inequalities.

Working in homelessness is a growing area of practice for occupational therapists, however, there is limited literature on the lived experiences of homelessness and occupational engagement Study aim: To explore the lived experience of homeless men in relation to how they engaged in day-to-day occupations when sleeping rough or hostel dwelling Methods: Data were gathered from five men residing in a homeless hostel in the UK. Data collection included semi-structured interviews and photographic diaries. Data were analyzed using Interpretative Phenomenological Analysis Results: Participants described their experiences of occupational engagement whilst sleeping on the streets which included engaging in survival occupations, the significance of apparently ordinary occupations and moving beyond survival occupations. The homeless hostel provided opportunities for occupational engagement that the men perceived in an idiosyncratic manner. The men described benefits of engaging in novel occupations and reengaging in known occupations. Occupational injustices were a common theme that occurred throughout participants experiences Conclusion: This study has highlighted the diversity of occupational engagement for 'roofless' or 'houseless' participants and how different individuals experience occupational adaption Significance: This study has furthered understandings of the concept of 'survival occupations' and the importance of community resources to facilitate occupational engagement whilst homeless.

In this article, we report on our experience of working on an exploratory project where the primary objective was to involve homeless service users with food-based participatory qualitative approaches. The project FLM aimed to explore food experiences and behaviours in a sample of users of homelessness services in a south west UK coastal city, in order to create solutions to improve their wellbeing. A mixture of qualitative methods was used, including observations, photo-elicitation and focus group discussions. We aimed to be participatory and 'creative' in our approach and in our analysis. Here, we focus on detailing and critiquing our approach to the collection and analysis of data.

There is an urgent need to ‘get creative’ with the way we tackle social and nutritional inequalities. The Food as a Lifestyle Motivator (FLM) project has explored the use of creative participatory approaches to engage ‘harder to reach’ communities in dialogues to improve their well-being and life skills. Preliminary findings have confirmed that food can be a powerful catalyst for social inclusion with the potential to empower ‘marginalised’ individuals. Part of this exploratory study has involved two participatory food events (November 2015 and November 2016) run in a local day centre for drug and alcohol rehabilitation. The aim of these events was to bring together key stakeholders (from the service user and provider communities) to exchange food-based knowledge, using collaborative and co-creative participatory approaches. Following ethical clearance, a range of data were collected at the events to assess their ‘social impact’. These consisted of (1) audio interviews (service providers and users), (2) oral surveys (service users and key workers) and (3) observations of social cooking and eating engagement, and creative visual arts (photography, collage, food games and quizzes). In this article, we detail how the range of creative approaches used has successfully engaged individuals (average attendance: n = 80, service users: n = 32) to participate in these food-themed events. We reflect on the overarching themes from data capture of the social and therapeutic aspects of food (activities). We also reflect on the collation (and curation) of findings, systematically critiquing the approaches used, including consideration of ethics, and drivers for engagement. Finally, we consider how the utility of such creative approaches can optimise public engagement activities, not only to enhance research impact but also to inform collaborative developments with and between service users, service providers and other stakeholders, with the potential to lead to transformative food-related changes.

This comment piece is the result of our critical reflections, observations and discussions in relation to occupation and homelessness, inspired by our participation in the fourth conference of Occupational Science Europe and informed by our research and experiences in the field. Whilst we acknowledge the growing contribution of occupational therapy and occupational science to homelessness, our practices have led us to identify a number of complex factors that impact on this work. In this article we discuss issues that influence the participation of homeless persons in everyday life and make suggestions to support occupational participation. At the macro level, we recognise the importance of definitions and categories of homelessness, how legislation can frame the responsibility of homelessness on individuals and poverty as a causal factor. At the meso level, we explore how charity and power differentials within homelessness services influence participation and propose an occupationally informed approach to homelessness services to enhance meaningful participation. Finally, at the micro level, we focus on interactions with individuals and examine the notion of occupational choice for homeless persons and critique traditional rehabilitative approaches. This comment reflects our own critical awakening as occupational therapists situated within a neoliberal society and the value of collaboration between occupational science and occupational therapy. It reinforces the essential role that critical occupational science plays in knowledge generation by attending to the complex structural, cultural and social factors that influence the choices and occupations of homeless persons, which in turn enhances occupational therapy practice.