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Health Care
Fam Community Heatth
Vol. 28, No. 1, pp. 51-63 © 2005 Uppincott Williams & Wilkins, Inc.

Health-Promoting Behaviors of Sheltered Homeless Women
Meg Wilson, PhD, RN
To expand the body of knowledge and provide further insight into the complex area of homelessness and health, health practices of sheltered homeless women were investigated using a crosssectional, descriptive, and non-experimental design using Pender 's Health Promotion Model as the theoretical framework. The sample (w = 137) was weU educated, mostly unemployed, primarily single, and homeless due to relationship problems/conflict per self-report. Homeless women were noted to practice health-promoting behaviors in all areas but scored the lowest on physical activity and nutrition. Significantfindingsreflected women 's personal strengths and resources in the areas of spiritual grovrth and interpersonal relations. Keywords: health disparities, health promotion,

hometessness, quantitative research, women 's health

acute and chronic physical disorders and mental health/emotional issues. '" '" Few studies address the positive health practices of this vulnerable population. The ptirpose of this study was to describe sociodemographic and personal characteristics, health practices, and health-promoting behaviors in a population of sheltered homeless women in a specific Midwest geographical region to increase awareness, understanding, and provide further insight into the complex area of homelessness and health. The theoretical framework for this study was based upon Pender 's revised Health Promotion Model." The Health Promotion Model (HPM) provides a framework to examine influences on participation in healthpromoting behaviors and provides direction From the Department of Nursing, School of Health for effective interventions. The HPM illusSciences, University of Saint Francis, Fort Wayne, trates that each person is a multidimensional Indiana. holistic individual who continually interacts The author


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Reichenbach EM, McNamee MJ, Seibel LV, The community health nursing implications of the selfreported health status of a local homeless population. Public Health Nursing. 1998;15:398-405. 8. Sachs-Ericsson N, Wise E, Debrody CP, Paniucki HB, Health problems and service utilization in the homeless,/OKrwo/ of Health Care for the Poor & Underserved. 1999;10:443-454. 9. Schaffer MA, Mather S, Gustafson V Service learning: A strategy for conducting a health needs assessment of the homeless.yoMraa/ of Health care for the Poor & Underserved. 2000; 11:385-399, 10, Wojtusik L, White MC, Health Status, needs, and health care barriers among the homeless. Journal of Health Care for the Poor & Underserved. 1998;9:l40-153, 11. Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice, 4th ed. Upper Saddle River, NJ: Prentice Hall; 2002, 12. Phelan JC, Link BG, Who are the "homeless"? Reconsidering the stability and composition of the homeless population. 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US Department of Health and Human Services, Healthy People 2010. Washington DC: US Government Printing Service; 2000, 20. Gelberg L, Andersen RM, Leake BD, Health care access and utilization. Health Services Research. 2000;3:1273-1302. 21. Clarke PN, Williams CA, Percy MA, Kim YS. Health and life problems of homeless men and women in the Southeast. Journal of Community Health Nursing. 1995;12:101-U0. Health-Promoting Behaviors of Sheltered Homeless Women 22, Kushel MB, Vittinghoff E, HaasJS. Factors associated with the health care utilization of homeless persons. JAMA. 2001;285:200-206. 23, Segal SP, Gomory T, Silverman CJ, Health status of homeless and marginally housed users of mental health self-help agencies. Health & Social Work. 1998;23:445-452, 24, Nyamathi A, Leake B, Gelberg L, Sheltered versus nonsheltered homeless women: Differences in health, behaviors, victimization, and utilization of care. 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Research in Nursing & Health. 1997;20:107-117, 31, Lucas JA, Orshan SA, Cook E Determinants of healthpromoting Bebavior among women ages 65 and above living in the community. Scholarly Inquiry of Nursing Practice. 2000;l4:77-100, 32, Bagwell MM, Bush HA, Health conception and health promotion in blue collar workers, AAOHN Journal. 1999;47:512-518, 33, Stuifbergen AK, Becker HA, Health promotion practices in women with multiple sclerosis: Increasing quality and years of healtby life. Physical Medicine and Rehabilitation Clinics of North America. 2001;12(l):9-22, 34, Martinelli AM, Testing a model of avoiding environmental tobacco smoke in young adults. Image: Journal of Nursing Scholarship. 1999;31:239-242, 35, Shinn M, Weitzman BC, Stojanovic D, et al. Predictors of homelessness among families in New our City: From shelter request to housing stability. Am Journal of Public Health. 1998;88:l651-l657, 36, US Census Bureau, Homelessness: Programs and the people they serve. Available at: http://www,census, gov/prod/www/nshapc/NSHAPC4a,html, Accessed April 10, 2002, 63 37, Stein JA, Andersen RM, Koegel P Predicting health services utilization among homeless adults: A prospective analysis,/oMrwa/ of Health Care for the Poor & Underserved. 2OOO;ll:212-23O, 38, Carter JH, Cuvar K, McSweeney M, Storey P, Stockman C, Health-seeking behavior as an outcome of a homeless population. Outcomes Management for Nursing Practice. 2001 ;5:140-144, 39, Centers for Disease Control and Prevention Primary Prevention Working Group, Primary prevention of Type 2 diabetes by lifestyle intervention: implications for bealth policy. Annuals of Internal Medicine. 2OO4;14O(ll):951-957, 40, Kannel WB, Prevalence and implications of uncontrolled systolic hypertension. Drugs Aging. 2003;20(4):277-286, 41, Levine RS, Black-white inequalities in mortality and life expectancy, 1033-1999: Implications for Healthy People 2010, Public Health Rep. 2001;ll6(5):474483, 42, McMahan DA, Health issues of Allen County. Paper presented at St, Joseph Community Health Foundation Recognition Luncheon, Fort Wayne, Indiana; 2002, 43, Fowler SB, Hope and a health-promoting lifestyle in persons with Parkinson 's Disease,/oMm«/ of Neuroscience Nursing. 2002;29(2):l 11-116, 44, Jefferson VW, Melkus, GD, SpoUett GR, Healthpromotion practice of young black women at risk for diabetes. The Diabetes Educator. 2000;2:295-302, 45, Acton GJ, Malathum P, Basic need status and healthpromoting self-care behavior in adults. Western Journal of Nursing Research. 2000;22:796-8n, 46, Waite PH, Hawks SR, Gast JA, Tbe correlation between spiritual well-being and health behaviors. Am Journal of Health Promotion. 1999;13:159-162, 47, ReimerJB, Van Cleve L, Galbraith, M, Barriers to wellchild care for homeless children under age 13, Public Heath Nursing. 1995;12:6l-66, 48, Boland CS, Social support and spiritual well-being: Empowering older adults to commit to bealthpromoting behaviors,/oMma/ of Multicultural Nursing and Health. 2OOO;6(3): 12-23, 49, Caton CL, Hasin D, Shrout PE, et al. Risk factors for homelessness among indigent urban adults witb no history of psychotic illness: A case-control study. Am Journal of Public Health. 2000;90:258-263, 50, Kar SB, Pascual CA, Chickering KL, Empowerment of women for health promotion: A meta-analysis. Social Science & Medicine. 1999;49:l431-l46O, 51, Morrell-Bellai R, Goering PN, Boydell KM, Becoming and remaining homeless: A qualitative investigation. Issues in Mental Health Nursing. 2000;21:581-604, 52, Styron RH, Janoff-Bulman, Davidson L, "Please ask me how I am" experiences of family homelessness in the context of single mothers ' lives. Journal of Social Distress and the Homeless. 2000;9:l43-l65,
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