Homeless Veterans’ Experiences with Substance Use, Recovery, and Treatment through Photo Elicitation

Sestito, Samuel F.; Rodriguez, Keri L.; Saba, Shaddy; Conley, James W.; Mitchell, Michael A.; Gordon, Adam J.

doi:10.1080/08897077.2017.1356422

Cited by 14 publications

(12 citation statements)

References 29 publications

(55 reference statements)

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“…(28) Gabrielian and colleagues discuss the feasibility of a variation on the original HPACT model, describing a co-located HPACT clinic within the Emergency Department of the Greater Los Angeles VA Medical Center rather than in an ambulatory clinic. (29) Other innovations studied and described in the literature include implementation of food insecurity screening initiatives, (30) photo elicitation strategies for recovery, (31) and the MISSION-Vet program within an HPACT. (32) Each of these studies were included in the analysis because they contain original data; showing variation and ongoing innovation within the HPACT clinics.…”

Section: Resultsmentioning

confidence: 99%

Primary Care for Homeless Veterans: A Systematic Review of the Homeless Patient Aligned Care Team (HPACT)

Rosenthal

Howell

Johnson

et al. 2021

Preprint

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BackgroundIn 2011, the Veterans Health Administration (VHA) implemented homeless-tailored primary care medical home models, called the Homeless Patient Aligned Care Teams (HPACT) to improve care for homeless Veterans. The aim of this study was to describe the existing peer-reviewed literature on HPACTs by systematically reviewing studies published since 2011 to date.MethodsWe conducted a systematic review of peer-reviewed studies published from 2011 to June 2019 to evaluate the literature since the inception of the VHA’s Homeless PACT program implementation. We included original research articles evaluating the Homeless PACT and excluded those that did not contain original data.ResultsOf 379 studies screened, 20 studies met our inclusion criteria and were included for analysis. Given wide variability in research designs and outcome measures, a narrative review was conducted. The 20 included studies were categorized into 3 groups: Early HPACT pilot implementations; Association of HPACT clinics with quality and utilization; and Specialized programs within HPACTs. Observational findings suggest reductions in emergency department utilization, improvements in primary care treatment utilization, engagement, and patient experience; but limited rigorous studies exist beyond single site pilots and a few large observational cohort studies.DiscussionThe HPACT model has been successfully implemented in VHA medical centers throughout the country with multiple studies showing increased primary care engagement and improved patient experience; however, further studies are needed about quality, utilization and whether the model can be implemented outside the VHA system.Registration Number/Funding sourcenone

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Section: Resultsmentioning

confidence: 99%

Primary Care for Homeless Veterans: A Systematic Review of the Homeless Patient Aligned Care Team (HPACT)

Rosenthal

Howell

Johnson

et al. 2021

Preprint

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“…The participatory methods in this study were an opportunity to empower formerly homeless people with problematic substance use to take on roles where they were the experts in their environments and actively contributed to producing data. Similar to past research using photo‐elicitation methods (e.g., Padgett et al, 2013; Sestito et al, 2017), the walk‐along and photo‐elicitation interviews were generally well received by participants and offered them a unique opportunity to engage in the study, as well as allowed the research team to understand the context of participants’ comments by physically observing and documenting their environments with them. However, some minor difficulties were encountered with this methodological approach.…”

Section: Discussionmentioning

confidence: 98%

Finding home: Community integration experiences of formerly homeless women with problematic substance use in Housing First

Bassi

Sylvestre

Kerman

2020

Journal Community Psychology

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Aims This study explored community integration among women participating in a Housing First program. Physical, social, and psychological dimensions of community integration were examined. Methods This study used neighborhood walk‐along and photo‐elicitation interviews to explore 16 formerly homeless women's experiences of community integration. Results Participants described limited community integration. Health, poverty, service inaccessibility, and safety concerns shaped how they took part in activities in their neighborhoods. Participants primarily socialized with people in their buildings, though some preferred to keep to themselves. There was minimal sense of neighborhood belonging, with participants not interested in belonging to a community and being judged by others. Conclusion Housing First promoted housing stability but did not contribute to community integration. Participants did not express a strong desire to integrate in their communities. Future research should consider the extent to which community integration remains a priority for marginalized populations, such as formerly homeless women.

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“…Logistical lessons from designing and executing our PEI study, as well as more detailed qualitative methods and results, are outlined in previously published work. 21,22…”

Section: Methodsmentioning

confidence: 99%

Homeless and marginally housed Veteran perspectives on participating in a photo-elicitation research study

Rodriguez¹,

Hedayati²,

Broyles³

et al. 2018

Patient Experience Journal

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Photo-elicitation interviewing (PEI) seems a valuable tool for engaging marginalized populations in research despite documented challenges. Given limited data on acceptability of PEI among homeless and marginally housed Veterans, this evaluation aimed to characterize their research experience. Veterans took photographs about health, health behaviors, and health care which facilitated semi-structured interviews. Their research study experience was assessed via a modified Reactions to Research Participation Questionnaire-Revised (RRPQ-R), along with additional survey and open-ended questions. Of the 20 participants who consented and participated, 16 (80%) completed the exit surveys. Most participants (>88%) indicated favorable experiences and limited drawbacks. Respondents disagreed that participation was difficult or overly time consuming. Many indicated intense or unexpected emotionality. Open-ended responses indicated appreciation of photography, interview experiences, and connection with study staff. Transportation was the most cited barrier. Overall, experiences were reportedly emotionally challenging, but positive. PEI appears to be acceptable to homeless and marginally housed Veterans for eliciting their perspectives.

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Homeless Veterans’ Experiences with Substance Use, Recovery, and Treatment through Photo Elicitation

Cited by 14 publications

References 29 publications

Primary Care for Homeless Veterans: A Systematic Review of the Homeless Patient Aligned Care Team (HPACT)

Primary Care for Homeless Veterans: A Systematic Review of the Homeless Patient Aligned Care Team (HPACT)

Finding home: Community integration experiences of formerly homeless women with problematic substance use in Housing First

Homeless and marginally housed Veteran perspectives on participating in a photo-elicitation research study

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