Date Presented 04/23/2023

This qualitative study explores the current strategies parents living in supportive housing use to manage their mental and physical health, the impact parenting has on health management, and how parents’ control affects their motivation.

Primary Author and Speaker: Rose Digiulio

Contributing Authors: Laura Vanpuymbrouck

PURPOSE: Families with a history of homelessness living in permanent supportive housing (PSH) have an increased risk of complex medical needs, complicating their health management. The history of trauma, lack of resources, and additional health needs creates a multi-generational cycle of worse health outcomes (Moore et al., 2015). There is little research exploring health management strategies of families in PSH. Therefore, this study aims to identify how occupational therapy practitioners (OTPs) can support families in PSH to increase participation in the occupations of health management.

DESIGN: This qualitative study occurred at a PSH organization. Participants were recruited through convenience sampling methods. Inclusion criteria were: (1) current PSH resident, (2) parent/primary guardian of a child aged 0-17, and (3) English speaker. Exclusion criteria was self-identifying cognitive or communication impairment limiting communication during an interview.

METHOD: This exploratory cross-sectional study examined supports and barriers to health management experienced by parents in PSH through semi-structured interviews. Braun and Clarke’s (2006) six steps of thematic analysis were used by two researchers to systematically analyze transcriptions to form themes.

RESULTS: Themes and corresponding subthemes that emerged during analysis include locus of control with subthemes of external locus and internal locus; impact of parenting with subthemes of burden and motivation; and everyday health strategies.

CONCLUSION: The perspectives from this study demonstrate the strengths and additional demands parents in PSH experience that affect their participation in health management occupations.

IMPACT STATEMENT: A better understanding of current behaviors provides valuable information to OTPs and other providers on sources of motivation and strategies to provide strengths-based family-centered care to support increased participation in healthy behaviors in this complex context.


Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

Gutman, S., Berg, J., Amarantos, K., Chen, E., Schlugar, Z., & Peters, R. (2017). Assessing home safety fall and accident risk in the prematurely aging, formerly homeless population. American Journal of Occupational Therapy, 71(4_Supplement_1), 7111510202p1–7111510202p1.

Marshall, C. A., Boland, L., Westover, L. A., Wickett, S., Roy, L., Mace, J., Gewurtz, R., Barbic, S., & Kirsh, B. (2020). Occupational experiences of homelessness: A systematic review and meta-aggregation. Scandinavian Journal of Occupational Therapy, 27(6), 394–407.

Moore, T. G., McDonald, M., Carlon, L., & O’Rourke, K. (2015). Early childhood development and the social determinants of health inequities. Health Promotion International, 30(suppl 2), ii102–ii115.