Claudia LaRose, Brandon Balma, Greta Prokosch, Michelle Crandall, Meghan Ford, Marea Perry, Janna Gewirtz O'Brien
Our findings suggest that site-based health empowerment programs embedded within shelters and housing programs may represent an acceptable and promising strategy to increase health care access, improve child and adolescent health, and support reproductive goals. The program underscores the importance of centering the voices of those with lived experiences of homelessness in the cocreation of programs that address their unique health needs.
BACKGROUND: Pregnant and parenting youth experiencing homelessness (PPYEH) and their children face significant health challenges, yet few interventions exist to address their health needs. The purpose of this community-based participatory research was to evaluate the preliminary effectiveness of a site-based health empowerment program to improve health, health care access, and reproductive health among PPYEH living in emergency shelter or transitional living programs.
METHODS: This mixed-methods study included intake, exit, and follow-up surveys with PPYEH, as well as a focus group and semistructured interviews with PPYEH and shelter staff. We conducted descriptive analyses of quantitative data to assess program satisfaction, mental health, contraceptive use and access, and thematic analysis of qualitative data.
RESULTS: Our evaluation demonstrated high program satisfaction, improved mental health, and enhanced access to reproductive resources and acceptability of contraceptive options. PPYEH and staff reported Empowering Parents for Wellness in Shelter connected youth with primary, dental, vision, sexual, and mental health care, which promoted youth resilience and agency in navigating the health care system. PPYEH felt their health improved through increased knowledge of topics including nutrition, allergies, healthy relationships, and sexually transmitted infections. Every interviewed participant recommended expanding Empowering Parents for Wellness in Shelter to other shelters.
CONCLUSION: Our findings suggest that site-based health empowerment programs embedded within shelters and housing programs may represent an acceptable and promising strategy to increase health care access, improve child and adolescent health, and support reproductive goals. The program underscores the importance of centering the voices of those with lived experiences of homelessness in the cocreation of programs that address their unique health needs.