{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T21:45:41Z","timestamp":1776807941757,"version":"3.51.2"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["P50MD017342"],"award-info":[{"award-number":["P50MD017342"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People experiencing homelessness (PEH) have higher rates of cardiovascular disease (CVD) and cardiovascular (CV)-related deaths than the general population. These deaths may result from modifiable CV health behaviors. This qualitative study investigates barriers and facilitators to engaging in the CV health\u2013promoting behaviors of quitting tobacco, taking prescribed medications, getting healthy sleep, being more active, and eating better.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Participants, and Approach<\/jats:title>\n                    <jats:p>In this manuscript, we share general inductive qualitative findings from interviews with 13 individuals aged 44\u201364, including 3 females, and 10 males, 4 participants identified as White, and 9 as Black or African American, focused on their experiences with CV diagnoses and CV health behaviors while living in a permanent supportive housing facility (PSH) in Minneapolis, MN, in 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>When asked about the barriers and facilitators to the five CV health\u2013promoting behaviors, participants frequently discussed CV health\u2013related topics in categories of alcohol and tobacco use, housing, healthcare experiences, access to food, mobility, transportation, sleep, and social support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants described significant barriers to engaging in CV health\u2013promoting behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10419-1","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T21:12:09Z","timestamp":1776805929000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Experiences of Adults Managing Cardiovascular Health While in Permanent Supportive Housing (PSH): A Qualitative Study"],"prefix":"10.1007","author":[{"given":"Audrey Rose","family":"Hyson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyson","family":"Rodway","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joey","family":"Dagher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia","family":"Barnes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Bryant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew M.","family":"Busch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1083-838X","authenticated-orcid":false,"given":"Katherine Diaz","family":"Vickery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"10419_CR1","doi-asserted-by":"publisher","unstructured":"Al-Shakarchi NJ, Evans H, Luchenski SA, Story A, Banerjee A. Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies. Heart. 2020;106(19):1483-1488. https:\/\/doi.org\/10.1136\/heartjnl-2020-316706","DOI":"10.1136\/heartjnl-2020-316706"},{"key":"10419_CR2","doi-asserted-by":"publisher","unstructured":"Nayyar D, Hwang SW. Cardiovascular Health Issues in Inner City Populations. Can J Cardiol. 2015;31(9):1130-1138. https:\/\/doi.org\/10.1016\/j.cjca.2015.04.011","DOI":"10.1016\/j.cjca.2015.04.011"},{"key":"10419_CR3","doi-asserted-by":"publisher","unstructured":"Sims M, Kershaw KN, Breathett K, et al. Importance of Housing and Cardiovascular Health and Well-Being: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes. 2020;13(8):e000089. https:\/\/doi.org\/10.1161\/HCQ.0000000000000089","DOI":"10.1161\/HCQ.0000000000000089"},{"key":"10419_CR4","doi-asserted-by":"publisher","unstructured":"Baggett TP, Liauw SS, Hwang SW. Cardiovascular Disease and\u00a0Homelessness. J Am Coll Cardiol. 2018;71(22):2585-2597. https:\/\/doi.org\/10.1016\/j.jacc.2018.02.077","DOI":"10.1016\/j.jacc.2018.02.077"},{"key":"10419_CR5","doi-asserted-by":"publisher","unstructured":"Gelberg L, Gallagher TC, Andersen RM, Koegel P. Competing priorities as a barrier to medical care among homeless adults in Los Angeles. Am J Public Health. 1997;87(2):217-220. https:\/\/doi.org\/10.2105\/AJPH.87.2.217","DOI":"10.2105\/AJPH.87.2.217"},{"key":"10419_CR6","doi-asserted-by":"publisher","unstructured":"Kushel MB, Gupta R, Gee L, Haas JS. Housing instability and food insecurity as barriers to health care among low-income americans. J Gen Intern Med. 2006;21(1):71-77. https:\/\/doi.org\/10.1111\/j.1525-1497.2005.00278.x","DOI":"10.1111\/j.1525-1497.2005.00278.x"},{"key":"10419_CR7","doi-asserted-by":"publisher","unstructured":"Manser ST, Sekar P, Bonilla Z, et al. Homelessness and Type 2 Diabetes: A Qualitative Study of Facilitators and Barriers to Self-Management and Medication Adherence. J Gen Intern Med. Published online September 23, 2024. https:\/\/doi.org\/10.1007\/s11606-024-09030-z","DOI":"10.1007\/s11606-024-09030-z"},{"key":"10419_CR8","doi-asserted-by":"publisher","unstructured":"Palar K, Wong MD, Cunningham WE. Competing subsistence needs are associated with retention in care and detectable viral load among people living with HIV. J HIVAIDS Soc Serv. 2018;17(3):163-179. https:\/\/doi.org\/10.1080\/15381501.2017.1407732","DOI":"10.1080\/15381501.2017.1407732"},{"key":"10419_CR9","doi-asserted-by":"publisher","unstructured":"Bark P, Ramasawmy M, Hayward A, et al. Integrated approach to cardiovascular disease in people experiencing homelessness: a qualitative study. Open Heart. 2023;10(1):e002235. https:\/\/doi.org\/10.1136\/openhrt-2022-002235","DOI":"10.1136\/openhrt-2022-002235"},{"key":"10419_CR10","doi-asserted-by":"publisher","unstructured":"Groton DB, Leavitt MA, Opalinski AS. \u201cYou got to eat, but then what you are eating, it\u2019s going to kill you\u201d: Living with hypertension while experiencing homelessness. Public Health Nurs. 2021;38(2):160-166. https:\/\/doi.org\/10.1111\/phn.12799","DOI":"10.1111\/phn.12799"},{"key":"10419_CR11","doi-asserted-by":"publisher","unstructured":"Pratt R, Pernat C, Kerandi L, et al. \u201cIt\u2019s a hard thing to manage when you\u2019re homeless\u201d: the impact of the social environment on smoking cessation for smokers experiencing homelessness. BMC Public Health. 2019;19(1):635. https:\/\/doi.org\/10.1186\/s12889-019-6987-7","DOI":"10.1186\/s12889-019-6987-7"},{"key":"10419_CR12","unstructured":"United States Interagency Council on Homelessness. 2023: A Year of Federal Action to Address the Nation\u2019s Homelessness Crisis. December 15, 2023. Accessed July 24, 2025. https:\/\/www.usich.gov\/news-events\/news\/2023-year-federal-action-address-nations-homelessness-crisis"},{"key":"10419_CR13","unstructured":"United States Interagency Council on Homelessness. Under Biden-Harris Administration, Veteran Homelessness Drops to Lowest on Record. November 11, 2024. Accessed July 24, 2025. https:\/\/www.usich.gov\/news-events\/news\/under-biden-harris-administration-veteran-homelessness-drops-lowest-record"},{"key":"10419_CR14","unstructured":"Stacey K. Rachel Reeves to unveil \u00a339bn housing boost in spending review shake-up. The Guardian. June 10, 2025. Accessed July 24, 2025. https:\/\/www.theguardian.com\/politics\/2025\/jun\/10\/rachel-reeves-to-unveil-39bn-housing-boost-in-spending-review-shake-up"},{"key":"10419_CR15","doi-asserted-by":"publisher","unstructured":"Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes Among People Experiencing Chronic Homelessness. National Academies Press; 2018. https:\/\/doi.org\/10.17226\/25133","DOI":"10.17226\/25133"},{"key":"10419_CR16","doi-asserted-by":"publisher","unstructured":"Vickery KD, Busch AM. Behavioral Medicine Can Help Reduce Premature Mortality among People who Experience Homelessness. Policy Insights Behav Brain Sci. 2025;12(1):13-19. https:\/\/doi.org\/10.1177\/23727322241307857","DOI":"10.1177\/23727322241307857"},{"key":"10419_CR17","doi-asserted-by":"publisher","unstructured":"Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life\u2019s Essential 8: Updating and Enhancing the American Heart Association\u2019s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022;146(5):e18-e43. https:\/\/doi.org\/10.1161\/CIR.0000000000001078","DOI":"10.1161\/CIR.0000000000001078"},{"key":"10419_CR18","doi-asserted-by":"publisher","unstructured":"Ng SL, Baker L, Cristancho S, Kennedy TJ, Lingard L. Qualitative research in medical education: Methodologies and methods. In: Understanding Medical Education: Evidence, Theory, and Practice. 2018:427-441. https:\/\/doi.org\/10.1002\/9781119373780.ch29","DOI":"10.1002\/9781119373780.ch29"},{"key":"10419_CR19","doi-asserted-by":"publisher","unstructured":"Bunniss S, Kelly DR. Research paradigms in medical education research. Med Educ. 2010;44(4):358-366. https:\/\/doi.org\/10.1111\/j.1365-2923.2009.03611.x","DOI":"10.1111\/j.1365-2923.2009.03611.x"},{"key":"10419_CR20","unstructured":"Supportive Housing Information and Resources. Published online June 2024. Accessed March 4, 2026. https:\/\/www.mnhousing.gov\/sites\/default\/files\/documents\/Supportive_Housing_Info_Resource_1043310_6.pdf"},{"key":"10419_CR21","doi-asserted-by":"publisher","unstructured":"Thomas DR. A General Inductive Approach for Analyzing Qualitative Evaluation Data. Am J Eval. 2006;27(2):237-246. https:\/\/doi.org\/10.1177\/1098214005283748","DOI":"10.1177\/1098214005283748"},{"key":"10419_CR22","doi-asserted-by":"publisher","unstructured":"Corbin JM, Strauss A. Grounded theory research: Procedures, canons, and evaluative criteria. Qual Sociol. 1990;13(1):3-21. https:\/\/doi.org\/10.1007\/BF00988593","DOI":"10.1007\/BF00988593"},{"key":"10419_CR23","doi-asserted-by":"publisher","unstructured":"O\u2019Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for Reporting Qualitative Research: A Synthesis of Recommendations. Acad Med. 2014;89(9):1245-1251. https:\/\/doi.org\/10.1097\/ACM.0000000000000388","DOI":"10.1097\/ACM.0000000000000388"},{"key":"10419_CR24","unstructured":"Miles MB, Huberman AM, Salda\u00f1aJ. Qualitative Data Analysis: A Methods Sourcebook. Fourth edition. SAGE; 2020."},{"key":"10419_CR25","doi-asserted-by":"publisher","unstructured":"Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Dir Program Eval. 1986;1986(30):73-84. https:\/\/doi.org\/10.1002\/ev.1427","DOI":"10.1002\/ev.1427"},{"key":"10419_CR26","doi-asserted-by":"publisher","unstructured":"Gonzalez A, Tyminski Q. Sleep deprivation in an American homeless population. Sleep Health. 2020;6(4):489-494. https:\/\/doi.org\/10.1016\/j.sleh.2020.01.002","DOI":"10.1016\/j.sleh.2020.01.002"},{"key":"10419_CR27","doi-asserted-by":"publisher","unstructured":"Huynh N, Kendzor DE, Ra CK, et al. The association of sleep with physical and mental health among people experiencing homelessness. Sleep Health. 2024;10(1):48-53. https:\/\/doi.org\/10.1016\/j.sleh.2023.10.004","DOI":"10.1016\/j.sleh.2023.10.004"},{"key":"10419_CR28","doi-asserted-by":"publisher","unstructured":"Pilla D, Park\u2010Taylor J. \u201cHalfway Independent\u201d: Experiences of formerly homeless adults living in permanent supportive housing. J Community Psychol. 2022;50(3):1411-1429. https:\/\/doi.org\/10.1002\/jcop.22724","DOI":"10.1002\/jcop.22724"},{"key":"10419_CR29","doi-asserted-by":"publisher","unstructured":"Henwood BF, Rhoades H, Dzubur E, Madden DR, Redline B, Brown RT. Investigating Sleep Disturbance and Its Correlates among Formerly Homeless Adults in Permanent Supportive Housing. Med Care. 2021;59(4):S206-S211. https:\/\/doi.org\/10.1097\/MLR.0000000000001446","DOI":"10.1097\/MLR.0000000000001446"},{"key":"10419_CR30","doi-asserted-by":"publisher","unstructured":"Rider JV, Selim J, Garcia A. Health and Disability Among Persons Experiencing Homelessness. Occup Ther Ment Health. 2022;38(1):49-66. https:\/\/doi.org\/10.1080\/0164212X.2021.1975010","DOI":"10.1080\/0164212X.2021.1975010"},{"key":"10419_CR31","doi-asserted-by":"publisher","unstructured":"Rogans-Watson R, Shulman C, Lewer D, Armstrong M, Hudson B. Premature frailty, geriatric conditions and multimorbidity among people experiencing homelessness: a cross-sectional observational study in a London hostel. Hous Care Support. 2020;23(3\/4):77-91. https:\/\/doi.org\/10.1108\/HCS-05-2020-0007","DOI":"10.1108\/HCS-05-2020-0007"}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10419-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-026-10419-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-026-10419-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T21:12:12Z","timestamp":1776805932000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-026-10419-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":31,"alternative-id":["10419"],"URL":"https:\/\/doi.org\/10.1007\/s11606-026-10419-1","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"assertion":[{"value":"24 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants provided written informed consent prior to their enrollment in the study. The study was conducted in accordance with all applicable regulations and approved by the Institutional Review Board of Hennepin Healthcare Research Institute (Ethics Code: IRB-FY2022-373).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human Ethics and Consent to Participate"}},{"value":"The authors declare that they have no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}