“If you don’t have a place to call home, how can you have good health for yourself and your children?” perceptions of housing screening among families who have experienced homelessness

Abstract

Background

The adverse physical and mental health outcomes associated with experiencing homelessness are particularly complex within family units, as poor caregiver health has a spillover effect on children’s health and development. One proposed strategy to facilitate early intervention is to incorporate screening for housing status in primary care settings, followed by connection to appropriate resources. To date, there has been limited research on how families who have experienced or are experiencing homelessness perceive screening for housing status in the primary care setting.

Methods

To gather insights on the perceptions of screening for family housing instability in primary care settings, we interviewed 13 adult participants from four regions of the United States. (U.S.). All participants were primary caretakers (eg,. parents) of children under 18 years old and had experienced homelessness. Interviews were conducted by audio-only internet calls and included questions about participants’ lived experiences of homelessness, acceptability of housing screening in primary care settings and desired housing support services.

Results

Key themes included support for housing screening during primary care visits, an understood link between housing and health, and a desire to be referred to housing services via healthcare sites. Some participants perceived housing screening as an invasion of privacy and were afraid or embarrassment about discussing housing with a provider. Other factors influencing views on housing screening included past experiences with housing screenings (positive or negative), confidence in a healthcare provider’s ability (or lack thereof) to help with housing, and participant trust in a given provider.

Conclusions

Study findings provide valuable insight into how housing screening in primary care settings is perceived by families who have experienced homelessness. Overall, participant views of housing screening in primary care settings were positive, but the presence of some negative perceptions, specifically around fear of screening and privacy concerns, warrant further consideration. Understanding the perceptions, opinions, beliefs, and underlying experiences around housing screening held by families who have experienced homelessness is essential to developing housing screening strategies that are acceptable and effective. This research summarizes valuable perspectives for primary care providers and settings to consider when developing best practices and screening protocols related to patients’ experiences of homelessness.