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Improving the Mental Health of Women Who are Homeless: A Multi-Level Public Health Resilience-Building Intervention

Homelessness is a public health issue, as over half a million people in the United States are unhoused on any given night and homelessness is associated with physical and mental health comorbidities (Sleet & Francescutti, 2021).  The public health issue of homelessness extends to my own community of Alachua County, Florida; the most recent Point in Time Survey, conducted by the North Central Florida Alliance for the Homeless and Hungry, conducted one night in January 2018, reported 641 homeless persons in Alachua County (Alachua – North Central Florida Alliance for the Homeless and Hungry, 2023).  Additionally, the Alachua County Community Health Needs Assessment (2020) reported homelessness as the top health problem for residents of Alachua County, identified by 44% of respondents and ranked first among all four income brackets surveyed.

Approximately 1/3 of those who are homeless identify as female.  There were increases in homelessness throughout the COVID-19 pandemic, especially among women, as women experiencing homelessness increased 6% between 2020 and 2022 compared to a 1% increase among men in the same time period (The U.S. Department of Housing and Urban Development, 2022).  Women who are homeless are more likely to experience mental health issues, as a study by Riley et al. (2021) found that about half of homeless women reported suffering from anxiety and/or depression.

The CDC Social-Ecological Model was used to develop a yoga-based intervention to build resilience and improve the mental health of women who are homeless at the individual, relationship, community, and societal levels (The Social-Ecological Model, 2022).  At the individual level, women who are homeless in Alachua County will be offered yoga classes with focus on stress management to improve mental health.  For an interpersonal intervention, class participants will also discuss ways to peacefully resolve relationship conflict and the instructor will facilitate fostering positive relationships between the women in class.  A community level intervention includes training yoga class participants to teach yoga and stress management and conflict resolution techniques to others in their community when they become housed and leave Grace.  Finally, at the societal level, the intervention will advocate to lawmakers and apply to national grant programs for additional funding to support yoga programs for persons who are homeless.  The intervention also aims to alter societal attitudes and reduce stigma among women who are homeless related to seeking care for mental health.

These classes will be held locally at the Grace Marketplace homeless shelter and will be donation-based due to the generosity of community support.  Marketing materials developed for the intervention include a radio ad to garner monetary donations from the community and well as encourage community members to volunteer as yoga instructors and class helpers.  A poster was also created to be placed in the Grace women’s dorms, Grace Clinic, and Grace Café that will provide information on the prevalence of mental health problems among women who are homeless and the benefits of yoga and its positive impact on mental health.

References

Alachua – North Central Florida Alliance for the Homeless and Hungry. (2023). https://www.ncfalliance.org/re...rvices-data/alachua/

Riley, E. D., Dilworth, S. E., Satre, D. D., Silverberg, M. J., Neilands, T. B., Mangurian, C., & Weiser, S. D. (2021). Factors Associated With Symptoms of Depression and Anxiety Among Women Experiencing Homelessness and Unstable Housing During the COVID-19 Pandemic. JAMA Network Open, 4(7), e2117035. https://doi.org/10.1001/jamanetworkopen.2021.17035

Sleet, D. A., & Francescutti, L. H. (2021). Homelessness and Public Health: A Focus on Strategies and Solutions. International Journal of Environmental Research and Public Health, 18(21), 11660. https://doi.org/10.3390/ijerph182111660

The Social-Ecological Model: A Framework for Prevention |Violence Prevention|Injury Center|CDC. (2022, January 18). https://www.cdc.gov/violencepr...ecologicalmodel.html

The U.S. Department of Housing and Urban Development. (2022). The 2022 Annual Homelessness Assessment Report (AHAR to Congress) Part 1: Point-In-Time Estimates of Homelessness, December 2022.

WellFlorida Council. (2020). Alachua County Community Health Needs Assessment.

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