{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:06:54Z","timestamp":1784124414580,"version":"3.55.0"},"reference-count":52,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Financial barriers and limited cooking facilities are major obstacles to healthy dietary practices among the homeless population. Homelessness is currently at crisis point and up-to-date evidence from multiple stakeholders is needed to address dietary inequalities. The aim of this study was to understand dietary practices, barriers to healthy eating within homeless services from multiple perspectives. Twelve service users and five healthcare and social service providers participated in semi-structured interviews. Data were analysed thematically. Four themes were identified which included: lack of control over diet and food supply; sources of food for the homeless population; practical barriers to good nutrition; and the impact of diet on emotional and physical wellbeing. Frequent consumption of energy-dense, nutrient-poor foods was reported. Food insecurity resulted in perceived depressive symptoms and stress. Barriers to healthy diet included financial constraints and a lack of access to cooking and storage facilities. Our study highlights low levels of food skills and healthy eating knowledge among service users and service providers. In order to address diet-related health disparities, health promotion initiatives should be targeted at building healthy public policy in relation to diet and nutrition and developing food skills with members of this population and service providers.<\/jats:p>","DOI":"10.3390\/ijerph192315976","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T03:49:13Z","timestamp":1669780153000},"page":"15976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diet Quality, Health, and Wellbeing within the Irish Homeless Sector: A Qualitative Exploration"],"prefix":"10.3390","volume":"19","author":[{"given":"Divya","family":"Ravikumar","sequence":"first","affiliation":[{"name":"Discipline of Health Promotion, School of Health Sciences, University of Galway, H91 TK33 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Discipline of Health Promotion, School of Health Sciences, University of Galway, H91 TK33 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Kelly","sequence":"additional","affiliation":[{"name":"Discipline of Health Promotion, School of Health Sciences, University of Galway, H91 TK33 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"ref_1","unstructured":"(2022, July 26). Organisation for Economic Co-Operation and Development HC3.1 Homeless Populations. Available online: https:\/\/www.oecd.org\/els\/family\/HC3-1-Homeless-population.pdf."},{"key":"ref_2","unstructured":"(2021, January 07). The 2019 Annual Homeless Assessment Report (AHAR) to Congress. Available online: https:\/\/files.hudexchange.info\/resources\/documents\/2019-AHAR-Part-1.pdf."},{"key":"ref_3","unstructured":"(2021, January 06). Statutory Homelessness in England: April to June 2020, Available online: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/930534\/Statutory_homelessness_release_Apr-Jun_2020.pdf."},{"key":"ref_4","unstructured":"(2022, August 04). Department of Housing, Planning & Local Government Homelessness Report June 2022, Available online: https:\/\/www.gov.ie\/en\/publication\/5344b-homeless-report-june-2022\/."},{"key":"ref_5","unstructured":"(2022, August 04). Department of Housing, Planning & Local Government Homelessness Report June 2016, Available online: https:\/\/www.gov.ie\/en\/publication\/6abab-homeless-report-june-2016\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1017\/S1368980015002682","article-title":"Nutrition for homeless populations: Shelters and soup kitchens as opportunities for intervention","volume":"19","author":"Koh","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1300\/J052v23n01_01","article-title":"Dietary Intake and Nutritional Status of Older Adult Homeless Women: A pilot study","volume":"23","author":"Johnson","year":"2003","journal-title":"J. Nutr. Elder."},{"key":"ref_8","first-page":"364","article-title":"Nutrition and health services needs among the homeless","volume":"106","author":"Wiecha","year":"1991","journal-title":"Public Health Rep."},{"key":"ref_9","unstructured":"(2021, January 07). Hunger in America|Feeding America. Available online: https:\/\/www.feedingamerica.org\/hunger-in-america."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1017\/S1474746419000150","article-title":"The Housing Situations of Food Bank Users in Great Britain","volume":"19","author":"Clair","year":"2019","journal-title":"Soc. Policy Soc."},{"key":"ref_11","unstructured":"(2021, January 07). Rebuilding Lives\u2014Dublin Simon Community Annual Review 2017. Available online: https:\/\/www.dubsimon.ie\/wp-content\/uploads\/2018\/09\/OnlineAnnualReview2017.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1007\/s11524-012-9708-4","article-title":"The Hunger\u2013Obesity Paradox: Obesity in the Homeless","volume":"89","author":"Koh","year":"2012","journal-title":"J. Urban Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.physbeh.2016.04.025","article-title":"The food-insecurity obesity paradox: A resource scarcity hypothesis","volume":"162","author":"Dhurandhar","year":"2016","journal-title":"Physiol. Behav."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1016\/j.jada.2007.08.006","article-title":"The Food Insecurity\u2013Obesity Paradox: A Review of the Literature and the Role Food Stamps May Play","volume":"107","author":"Dinour","year":"2007","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.jada.2005.04.013","article-title":"What Is the Hunger-Obesity Paradox?","volume":"105","author":"Scheier","year":"2005","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/phn.12180","article-title":"Assessment of Food Intake, Obesity, and Health Risk among the Homeless in Rhode Island","volume":"32","author":"Martins","year":"2015","journal-title":"Public Health Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/003335491312800105","article-title":"Obesity among Chronically Homeless Adults: Is it a Problem?","volume":"128","author":"Tsai","year":"2013","journal-title":"Public Health Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2174\/157340309787048086","article-title":"Cardiovascular Disease Risk Among the Poor and Homeless\u2014What We Know So Far","volume":"5","author":"Jones","year":"2009","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_19","first-page":"547","article-title":"The prevalence of diabetes, pre-diabetes and the metabolic syndrome in an Irish regional homeless population","volume":"106","author":"Scott","year":"2013","journal-title":"QJM"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1079\/PHN2000119","article-title":"Nutrition and health in an adult urban homeless population in Germany","volume":"4","year":"2001","journal-title":"Public Health Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1016\/S0140-6736(14)61132-6","article-title":"The health of homeless people in high-income countries: Descriptive epidemiology, health consequences, and clinical and policy recommendations","volume":"384","author":"Fazel","year":"2014","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100824","DOI":"10.1016\/j.pmedr.2019.100824","article-title":"Fruit and vegetable consumption and emotional distress tolerance as potential links between food insecurity and poor physical and mental health among homeless adults","volume":"14","author":"Hernandez","year":"2019","journal-title":"Prev. Med. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jaac.2014.11.008","article-title":"The Prevalence of Mental Illness in Homeless Children: A Systematic Review and Meta-Analysis","volume":"54","author":"Bassuk","year":"2015","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Fazel, S., Khosla, V., Doll, H., and Geddes, J. (2008). The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050225"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1017\/S0007114517002495","article-title":"Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK","volume":"118","author":"Fallaize","year":"2017","journal-title":"Br. J. Nutr."},{"key":"ref_26","unstructured":"(2020, December 07). Food Access and Nutritional Health among Families in Emergency Homeless Accommodation. Available online: https:\/\/www.focusireland.ie\/wp-content\/uploads\/2014\/08\/Shareand-Hennessy-2017-Food-Access-Report-%E2%80%93-MainReport-FINAL.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s10460-009-9191-z","article-title":"Environment influences food access and resulting shopping and dietary behaviors among homeless Minnesotans living in food deserts","volume":"27","author":"Smith","year":"2009","journal-title":"Agric. Hum. Values"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1017\/S1368980008004102","article-title":"The art of grocery shopping on a food stamp budget: Factors influencing the food choices of low-income women as they try to make ends meet","volume":"12","author":"Wiig","year":"2009","journal-title":"Public Health Nutr."},{"key":"ref_29","unstructured":"(2021, January 07). Hungry for Change: Social Exclusion, Food Poverty and Homelessness in Dublin; A Pilot Research Study. Available online: https:\/\/www.drugsandalcohol.ie\/6002\/1\/Focus_Ireland__Hungry_for_change_part_1.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research","volume":"42","author":"Palinkas","year":"2015","journal-title":"Adm. Policy Ment. Health"},{"key":"ref_31","unstructured":"(2022, November 16). What Is Sleeping Rough?, Available online: https:\/\/www.mendip.gov.uk\/article\/7983\/What-is-Rough-Sleeping."},{"key":"ref_32","unstructured":"Galletta, A., and Cross, W.E. (2013). Mastering the Semi-Structured Interview and Beyond: From Research Design to Analysis and Publication, New York University Press."},{"key":"ref_33","unstructured":"(2022, November 16). QSR International Pty Ltd. NVivo (Version 12). Available online: https:\/\/www.qsrinternational.com\/nvivo-qualitative-data-analysis-software\/home."},{"key":"ref_34","unstructured":"Microsoft Office 2022 (2022, November 16). Microsoft One Drive. Available online: https:\/\/www.microsoft.com\/en-ie\/microsoft-365\/onedrive\/online-cloud-storage."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_36","unstructured":"(2022, November 16). FoodCloud: Food Waste Hurts Our Planet. Available online: https:\/\/www.google.com\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiI4uf4mrP7AhXRRMAKHWHjC8gQFnoECAoQAQ&url=https%3A%2F%2Ffood.cloud%2F&usg=AOvVaw28NJ30OCsIqvtkwUZ9ggVu."},{"key":"ref_37","unstructured":"(2022, August 21). Full Irish Breakfast. Available online: https:\/\/www.loveirishfood.ie\/recipes\/full-irish-breakfast\/."},{"key":"ref_38","unstructured":"(2021, August 14). Homelessness. Citizens Information Board. Available online: https:\/\/www.citizensinformation.ie\/en\/housing\/losing_your_home\/homelessness.html."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1023\/A:1022176402357","article-title":"Applying Cluster Analysis to Test a Typology of Homelessness by Pattern of Shelter Utilization: Results from the Analysis of Administrative Data","volume":"26","author":"Kuhn","year":"1998","journal-title":"Am. J. Community Psychol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/002214650804900102","article-title":"Homelessness and Hunger","volume":"49","author":"Lee","year":"2008","journal-title":"J. Health Soc. Behav."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/j.1365-277X.1993.tb00389.x","article-title":"The dietary intake of homeless males sleeping rough in Central London","volume":"6","author":"Rushton","year":"1993","journal-title":"J. Hum. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"265S","DOI":"10.1093\/ajcn\/82.1.265S","article-title":"The economics of obesity: Dietary energy density and energy cost","volume":"82","author":"Drewnowski","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1177\/089011710602100107","article-title":"Shelter Environment and Placement in Community Affects Lifestyle Factors among Homeless Families in Minnesota","volume":"21","author":"Richards","year":"2006","journal-title":"Am. J. Health Promot."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1016\/j.socscimed.2007.06.013","article-title":"Environmental, parental, and personal influences on food choice, access, and overweight status among homeless children","volume":"65","author":"Richards","year":"2007","journal-title":"Soc. Sci. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1080\/02673843.2018.1538885","article-title":"Unaccompanied homeless youth have extremely poor diet quality and nutritional status","volume":"24","author":"Hatsu","year":"2018","journal-title":"Int. J. Adolesc. Youth"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"455","DOI":"10.5993\/AJHB.40.4.7","article-title":"Health Risk Factors and Desire to Change among Homeless Adults","volume":"40","author":"Taylor","year":"2016","journal-title":"Am. J. Health Behav."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.appet.2014.01.010","article-title":"Defining food literacy and its components","volume":"76","author":"Vidgen","year":"2014","journal-title":"Appetite"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"S361","DOI":"10.2105\/AJPH.2013.301558","article-title":"Cooking, Healthy Eating, Fitness and Fun (CHEFFs): Qualitative Evaluation of a Nutrition Education Program for Children Living at Urban Family Homeless Shelters","volume":"103","author":"Rodriguez","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/j.1525-1446.2007.00631.x","article-title":"Education in a Homeless Shelter to Improve the Nutrition of Young Children","volume":"24","author":"Yousey","year":"2007","journal-title":"Public Health Nurs."},{"key":"ref_50","unstructured":"(2022, November 16). Pathway to Eradicating Homelessness, Increasing Social Housing Delivery and Supporting Social Inclusion, Available online: https:\/\/www.gov.ie\/en\/publication\/90de3-pathway-to-eradicating-homelessness-increasing-social-housing-delivery-and-supporting-social-inclusion\/."},{"key":"ref_51","unstructured":"(2022, November 16). Homeless Action Plan Framework for Dublin 2022 to 2024. Available online: https:\/\/councilmeetings.dublincity.ie\/mgConvert2PDF.aspx?ID=37308."},{"key":"ref_52","unstructured":"(2022, November 16). Housing for All\u2014A New Housing Plan for Ireland, Available online: https:\/\/www.gov.ie\/en\/publication\/ef5ec-housing-for-all-a-new-housing-plan-for-ireland\/."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/23\/15976\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:30:09Z","timestamp":1760146209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/23\/15976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":52,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["ijerph192315976"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192315976","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,30]]}}}