{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:19:25Z","timestamp":1783437565405,"version":"3.54.6"},"reference-count":59,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Washington State University College of Nursing"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The lived experiences of homeless and unstably housed women, including their health-related priorities, are understudied in smaller metropolitan and rural communities. In this study, we partnered with a day center for women who experience homelessness in Spokane, Washington. We used Photovoice, a community-based participatory action research method, to explore the health-related concerns, needs, and behavior of women who are homeless or unstably housed. Participant-generated photographs and group interview data were analyzed using thematic analysis. Three themes were generated: \u201cThese are my supports\u201d, \u201cI\u2019m trying to make my health better\u201d, and \u201c[My] choices are very limited\u201d. The themes illustrated individual, interpersonal, community, and societal strengths and vulnerabilities aligned with the social ecological model. Participants demonstrated resourcefulness, creativity, and hope as they strived toward health improvement. Trauma-informed, strengths-based approaches that respect the autonomy of homeless and unstably housed women and that amplify their voices are needed to minimize power imbalances in research, policy, and practice. This includes an imperative for healthcare and social work programs to ready graduates to deliver effective, empathic services by increasing their knowledge of social determinants of health and of the stigma faced by marginalized communities. Moreover, collaborating with these communities when designing, implementing, and evaluating services is critical.<\/jats:p>","DOI":"10.3390\/ijerph21020195","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T03:36:17Z","timestamp":1707363377000},"page":"195","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-7811","authenticated-orcid":false,"given":"Jessica L.","family":"Mackelprang","sequence":"first","affiliation":[{"name":"Department of Psychological Sciences, Swinburne University of Technology, Melbourne 3122, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7659-2634","authenticated-orcid":false,"given":"Janessa M.","family":"Graves","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA 98195, USA"},{"name":"College of Nursing-Spokane, Washington State University, Spokane, WA 99201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halle M.","family":"Schulz","sequence":"additional","affiliation":[{"name":"College of Nursing-Spokane, Washington State University, Spokane, WA 99201, USA"},{"name":"Honors College, Washington State University, Pullman, WA 99164, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,8]]},"reference":[{"key":"ref_1","unstructured":"City of Spokane (2023, November 22). 2019 Everybody Counts Point-in-Time Count. 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