Meaning Exploration and Well-Being for People Experiencing Homelessness: Program Development and Evaluation Using a Knowledge Translation-Integrated Based Consensual Qualitative Research Approach

Abstract

In Canada there are an estimated 35,000 people experiencing homelessness on any given night and 235,000 people experiencing homelessness each year. A 2020 Nanos Research poll conducted for the Canadian Alliance to End Homelessness, 1 in 20 Canadians say they have experienced homelessness at one point in their life, 36% of Canadians have experienced homelessness themselves or know someone who has experienced homelessness, and over 1 in 5 Canadians report having a friend or acquaintance that has experienced homelessness. In addition to experiencing a range of physical ailments, between 23% and 74% of people experiencing homelessness report having some type of mental illness or problem. While community-based approaches to mental health interventions for people experiencing homelessness are effective, many neither address nor explore the concept of “meaning” and its relevance to their lives, including mental health, substance use intervention, and resilience, itself a contributor to positive mental health. Those programs that do address this topic have not engaged people experiencing homelessness in the development of such programs, which can be detrimental to program use and effectiveness. Using a stakeholder-informed knowledge translation-integrated (KTI) model, the present study integrates learnings on mental health interventions with people experiencing homelessness, Housing First principles, community-based and participatory action principles, and the importance of meaning to well-being with the recommendations of the Mental Health Commission of Canada on knowledge translation, and the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans interrelated ethical principles of respect for persons, concern for welfare, and justice as applied to this vulnerable population. Using a KTI-based consensual qualitative research methodology, a client driven meaning exploration session and a client driven well-being measurement were developed, validated, and evaluated with and for clients of The Ottawa Mission’s Day Program. Based on the stakeholder-generated general themes that emerged from the research, client driven meaning exploration sessions and the validated client driven well-being measurements are likely to be helpful and motivating to clients, and clients stated that they would attend such sessions, use such measures, and participate in the further development of these. The program evaluability assessment indicated that further evaluation of the potential effect of client driven meaning exploration sessions on well-being is merited.