Assignment: Fundamentals of qualitative research

Assignment: Fundamentals of qualitative research ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Fundamentals of qualitative research Please read this article and follow the requirement write 1 full page paper. Please read requirement carefully. Due US pacific time, 5/7. Assignment: Fundamentals of qualitative research article.pdf article_requirement.docx To begin this article you should find a peer-reviewed (scholarly) journal article that utilizes qualitative methodology in the study that it describes. The article summary should be 1 – 2 paragraphs long and should include the following elements: Assignment: Fundamentals of qualitative research The topic of article (what is the article about?); A brief summary of the methods that were used to conduct the study; A brief discussion of the findings of the study; and An APA reference for the article. Your presentation should include the same elements. You may choose to use PowerPoint or other forms of visuals for your presentation, but it is not required. Social Science & Medicine 245 (2020) 112724 Contents lists available at ScienceDirect Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed Food insecurity among formerly homeless youth in supportive housing: A social-ecological analysis of a structural intervention T Sarah Brothersa,?, Jess Linb, Jeffrey Schonbergc,d, Corey Drewb, Colette Auerswalde a Department of Sociology, Yale University, 493 College Street, New Haven, CT, 06511, United States San Francisco Department of Public Health, University of California, Berkeley School of Public Health, United States c Department of Anthropology, San Francisco State University, United States d Berkeley Center for Social Medicine, University of California, Berkeley, United States e i4Y (Innovations for Youth), University of California, Berkeley School of Public Health, United States b ARTICLE INFO ABSTRACT Keywords: San Francisco United States Transition-aged youth Homeless youth Food insecurity Housing Permanent supportive housing Qualitative Research A growing body of research indicates that structural interventions to provide permanent supportive housing (PSH) to homeless adults within a Housing First approach can improve their health. However, research is lacking regarding the impact of PSH on youth experiencing homelessness. This article seeks to understand how PSH for youth impacts a basic health need—food security— across multiple levels of the social-ecological environment. In January of 2014, San Francisco, California opened the city’s first municipally-funded PSH building exclusively designated for transition-aged youth (ages 18–24). We conducted 20 months of participant observation and indepth interviews with 39 youth from April 2014 to December 2015. Ethnographic fieldnotes and interview transcripts were analyzed using grounded theory. We present our social-ecological assessment regarding food insecurity for formerly homeless youth in supportive housing. We found that although housing removes some major sources of food insecurity from their lives, it adds others. Many of the participating youth were frequently hungry and went without food for entire days. Mechanisms across multiple levels of the social-ecological model contribute to food insecurity. Mechanisms on the structural level include stigma, neighborhood food resources, and monthly hunger cycles. Mechanisms on the institutional level include the transition into housing and housing policies regarding kitchen use and food storage. Interpersonal level mechanisms include food sharing within social networks. Individual level mechanisms include limited cooking skills, equipment, and coping strategies to manage hunger. Although supportive housing provides shelter to youth, effective implementation of the Housing First/PSH model for youth must ensure their access to an affordable nutritious diet. 1. Introduction Three and a half million youth aged 18 to 25 experience homelessness yearly in the United States (Morton et al., 2018). Assignment: Fundamentals of qualitative research On any given night, 1259 or more transition-aged youth (ages 18–24) are estimated to be homeless in San Francisco (Applied Survey Research, 2017). Youth experiencing homelessness (YEH) suffer significant disparities in morbidity and mortality relative to their housed peers (Institute of Medicine, 2009; Edidin et al., 2012; Auerswald et al., 2016), including a high risk of mental health disorders (Ammerman et al., 2004; Hodgson et al., 2015), sexually transmitted infections, HIV infection (Medlow et al., 2014), and suicide attempts (Rew et al., 2001). YEH’s standardized mortality rates are 3–37 times higher than the general population’s (Allen et al., 1994; Parriott et al., 2013). In addition, YEH suffer from severe food insecurity (Dachner and Tarasuk, 2002; Whitbeck ? et al., 2006), defined as a “limited or uncertain availability of nutritionally adequate and safe foods, or limited or uncertain ability to acquire acceptable foods in socially acceptable ways” (Bickel et al., 2000:6). 1.1. Structural interventions for youth Interventions for YEH have focused primarily on addressing individual determinants of risk through behavioral interventions (Rotheram-Borus et al., 1991; Slesnick et al., 2009). Of these, most focus on modifying individual HIV risk or substance use, and few have proven to be successful for addressing the significant health disparities faced by YEH (Altena et al., 2010). As is the case for all marginalized and excluded youth, health disparities experienced by YEH are determined not only by their Corresponding author. E-mail address: sarah.brothers@yale.edu (S. Brothers). https://doi.org/10.1016/j.socscimed.2019.112724 Received 24 June 2019; Received in revised form 3 December 2019; Accepted 4 December 2019 Available online 09 December 2019 0277-9536/ © 2019 Elsevier Ltd. All rights reserved. Social Science & Medicine 245 (2020) 112724 S. Brothers, et al. individual behaviors but also by their social determinants of health (SDH), which include shelter, educational opportunities, living and working conditions, medical care, local and federal laws and policies, and other social factors that influence health (Marmot et al., 2008; Viner et al., 2012). Youth who lack adequate access to these determinants suffer poorer health than those who have adequate access (Marmot and Wilkinson, 2006). Research on YEH has shown that ongoing, recurrent housing instability and other barriers to SDH are more significantly related to health disparities than any individual risk behaviors (Cheng et al., 2013). However, the majority of current interventions do not address the underlying causes of poor outcomes for youth. The World Health Organization and the Lancet Commission on Adolescent Health have called for structural interventions such as housing to address SDH for YEH (World Health Organization, 2014; Patton et al., 2016; Marmot et al., 2008). Interventions during this critical developmental window can have significant long-term health impacts over the life course (Braveman et al., 2011; Bonnie et al., 2014). As per the Lancet Commission Report on Adolescent Health and Wellbeing, “investments in adolescent health and wellbeing bring a triple dividend of benefits now, into future adult life, and for the next generation of children” (Patton et al., 2016: 2424). Interventions to ameliorate health inequalities for economically marginalized youth, including those experiencing homelessness, are particularly important because they have significant health problems and limited access to resources (Patton et al., 2016). because youth need more than shelter to thrive. Some studies have found that YEH need and want more structure and support than adults (De Rosa et al., 1999; Gaetz, 2014), including training in basic skills, like laundry, food shopping, and money management, to successfully maintain housing (Holtschneider, 2016; Henwood et al., 2018). They also need support to attain the education and job training required to transition into independent adulthood (Gaetz & O’Grady, 2013). Research on youth transitioning out of homelessness has shown that the transition is difficult. One study in Canada found that the youths’ limited education, employment experience, and social capital kept them trapped in subsistence-level precarity even after they attained independent housing (Thulien et al., 2018). Many youth transitioning into housing experience persistent financial insecurity, lack of community integration, a decline in hope, and social isolation (Kidd et al., 2016; Karabanow et al., 2016).Assignment: Fundamentals of qualitative research They often return to homelessness (Milburn et al., 2009). There is limited research specifically focused on the impact of structural interventions such as PSH on youth transitions out of homelessness, including their effects on social determinants of youth health such as food security. 1.4. Food insecurity YEH suffer from persistent food insecurity and hunger (Crawford et al., 2014; Reid and Klee, 1999; Whitbeck et al., 2006; Tarasuk et al., 2009). Their daily lives are constrained by their search for sufficient food (Dachner and Tarasuk, 2002). Food insecurity, in turn, may impact other determinants of health for youth. One study found associations between food security and HIV risk among YEH sex workers (Barreto et al., 2017). Food security has been identified as a key need for youth interventions (Patton et al., 2016) for several reasons: youth who are still growing and maturing have significant nutritional needs and foodrelated behaviors are largely adopted during adolescence. Such behaviors persist throughout the life course, and they are significant determinants of health (Viner et al., 2012). However, although food insecurity is frequently mentioned by participants in studies on formerly homeless youth transitioning into housing (i.e. Garrett et al., 2008), there is little research on how supportive housing impacts youth food insecurity. 1.2. Housing interventions for youth Research regarding the effect of youth housing interventions on SDH is limited because the majority of interventions for youth to date have mainly provided temporary housing through drop-in shelters or transitional housing, which are time-limited housing programs that provide stable housing for up to 24 months and often include skills training and supportive services (Slesnick et al., 2009; De Rosa et al., 1999). Nevertheless, research has shown that even temporary shelter for YEH yields positive benefits, including decreased substance use, improvements in mental health, increased number of days housed, and increased savings and educational and vocational attainment (Kisely et al., 2008; Frankish et al., 2005; Feng et al., 2013; Rashid, 2004). The current gold standard for adult housing provision is the Housing First model, which provides permanent supportive housing (PSH) without requiring that residents change their behaviors or participate in supportive services or programs (Tsemberis and Eisenberg, 2000). The Housing First model has proved successful for improving the health and decreasing the mortality of chronically homeless adults (Wolitski et al., 2010; Bean et al., 2013; Martinez and Burt, 2006; Rog et al., 2014). Recently, there has been increasing interest in providing PSH to youth (Gaetz, 2014). However, Housing First, like most housing models in which young people access emergency, temporary, or more permanent shelter, was designed for adults (Henwood et al., 2018; Kozloff et al., 2016) and it remains unclear how to implement PSH so it will be developmentally appropriate for youth (Munson et al., 2017). YEH are fundamentally different from adults experiencing homelessness in their skill sets, needs, and health issues. The United States Interagency Council on Homelessness has called for a developmentally appropriate system of care specifically for youth (Vilsack et al., 2013). Additional research is needed regarding housing interventions for YEH to inform the development of youth-appropriate models for long-term housing (Altena et al., 2010; Gaetz, 2014; Bonnie et al., 2014). 1.5. Our study To study this issue, we capitalized on a unique natural experiment in San Francisco to evaluate whether and how PSH impacts food insecurity for formerly homeless youth. In 2014, the City and County of San Francisco, in collaboration with a large supportive housing provider, opened the city’s first municipally funded PSH building targeted exclusively to transition-aged youth.Assignment: Fundamentals of qualitative research At the time of this study, residents were required to pay thirty percent of their monthly income as rent. Non-payment of rent was grounds for eviction. We originally hypothesized that supportive housing would diminish food insecurity. However, in our baseline survey data, a majority of respondents reported very low food security, defined as reduced food intake and disrupted eating patterns (Coleman-Jensen et al., 2013), after moving into the building (Johnson et al., 2019). Three-quarters of respondents reported eating fewer meals per day than they wanted and half reported going an entire day without food. Importantly, youth reported their food insecurity had not improved, and for some, had worsened, relative to before they were housed. To understand why the youths’ food insecurity persisted despite housing, we examined our in-depth interviews and ethnographic data, in which food insecurity was a dominant theme. During our data analysis (Charmaz, 1990), it became clear that youth food insecurity was determined on multiple levels. The social-ecological model emerged as the best theoretical framework for the data. Therefore, we employ it for our analysis of how a structural intervention impacts the food security of youth exiting homelessness. 1.3. Transitions into housing One recent study examined a PSH intervention for youth in Canada and found it increased housing stability for YEH with mental illness (Kozloff et al., 2016). However, housing stability alone is insufficient 2 Social Science & Medicine 245 (2020) 112724 S. Brothers, et al. 1.6. Social-ecological model 2.2. Recruitment The social-ecological model allows for close examination of how multiple interactive factors in the broader structural and institutional context, as well as interpersonal relationships and individual beliefs and behaviors, influence health (Bronfenbrenner, 1979; Viner et al., 2012). It is rooted in Bronfenbrenner’s ecological theory of human development (Bronfenbrenner, 1979). Bronfenbrenner emphasized that human development is influenced by multiple environmental and social mechanisms on interactive and interrelated levels. The model is particularly useful for examining mechanisms that influence food security and other significant determinants of health and human development. The social-ecological model includes the broader societal levels that individuals interact with indirectly (the structural and institutional levels) and the levels that individuals interact with directly (the individual and interpersonal levels). The structural level encompasses broader societal norms including stigma, socio-economic forces including social policies, bureaucratic systems, and geographic locations. Mechanisms on the institutional level include local institutions such as schools, social service organizations, and medical clinics. The interpersonal level encompasses social networks including friends, family, and neighbors. The individual level examines how individual behaviors are influenced by knowledge, beliefs, and reactions to stressors (Kaufman et al., 2014).Assignment: Fundamentals of qualitative research The model describes the ways in which factors at each of these levels interact with each other and the developing individual, influencing health needs such as food security and thus health outcomes, both positively and negatively. Here we aimed to understand how a structural intervention designed to ameliorate a key social determinant of health (housing) impacts a basic health need (food security) across multiple levels of the social-ecological model by studying youth transitioning into PSH. All youth living in the housing site were invited to participate. The only inclusion criteria was residence in the building. There were no exclusion criteria. We recruited on a rolling basis by posting fliers in the building, placing them in residents’ mailboxes, and distributing them at monthly meals we hosted. Youth participating in interviews were compensated with $25 in cash and a snack or small meal. We obtained written informed consent from all participants. All study aspects were reviewed and approved by our community collaborators. This study received ethics approval from the UC Berkeley Institutional Review Board. 2.3. Data collection Interviews were conducted at a mean of 3.5 months after youth moved into the building (range: 0–12 months). Prior to each interview, researchers clarified to participants that they were independent of housing staff and supportive service organizations, and individual information was confidential and not shared with supportive services. Four ethnographers (JS, SB, CA, CD) conducted interviews in English after collecting demographic information on gender, race/ethnicity, and age. No residents were non-English speaking. All interviewers had similar training in conducting semi-structured interviews and extensive experience working with vulnerable populations. Interviews took place in a private office in the building or in a location of the participant’s choosing, including nearby coffee shops, restaurants, or the participant’s room. Following grounded theory, interviews were an extended conversation (Charmaz, 2014). To guide the interviews, ethnographers used a set of general concepts, intended to evoke responses detailing how PSH impacted youth health and well-being. These concepts included food security, violence, social services, family and social networks, sexual behavior, health behavior, engagement in care, incomegenerating strategies, and perceptions of PSH. Interviews were 45–120 min in length, audio recorded, and transcribed verbatim, with all identifiers excised. Participant observation included all youth residents of the building, Youth who were not formally enrolled in the study were omitted from the analysis.Assignment: Fundamentals of qualitative research Prior to beginning participant observation, researchers identified themselves to youth. The ethnographic component examined participants’ central concerns with particular attention to general health and well-being, social networks, pets, education, income-generating strategies, drug use, and gender and sexuality. We observed participants in their rooms and the building’s common areas, at the monthly meals we hosted, in hospitals, walking in the neighborhood, visiting shops, procuring food and supplies, and playing with their pets. Ethnographers also ate regularly with participants and accompanied youth in their efforts to obtain education, employment, bank accounts, and medical help. Ethnographers recorded observations in typed fieldnotes. In cases where youth required urgent services, we checked in by phone or in person, notified the building’s staff with youth’s permission, and, if appropriate, referred or accompanied the participant to relevant agencies. After completing baseline data collection, we formally presented our findings to the youth at a dinner we sponsored. 2. Methods These findings represent results from our larger mixed methods longitudinal study of how PSH impacts the health and well-being of YEH, conducted from April 2014 to August 2017. The study was designed to examine the ways a structural intervention might influence a youth’s social environment, health behaviors, acquisition of adult competencies, and ultimately their physical health. This article is drawn from the first 20 months of ethnographic research from April 2014 to December 2015 during which five ethnographers (SB, CA, JL, CD, JS) conducted 1250 h of participant observation in total and completed 39 baseline semi-structured in-depth interviews. 2.1. Setting When the study building opened in January 2014, residency was available to 18 to 24-year-old youth who met the Department of Housing and Urban Development (HUD) definition for chronic homelessness. Chronic homelessness is defined as living with a disabling condition and experiencing continuous homelessness for at least a year or at least four homeless episodes in the past three years. Disabling conditions include substance use disorders, serious mental illness, developmental disabilities, PTSD, and cognitive impairments (US Department of Housing and Urban Development, 2015). Designated local youth service providers referred residents to the building. Voluntary supportive services, including case management and educational and vocational services, were offered on-site. The building followed the “Housing First” model in which all services were opt-in. Sobriety or engagement in … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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