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Abstract

As part of a photo-elicitation interview study, we aimed to describe homeless and marginally housed Veterans’ experiences with health and wellness, health decisions, and health-related behaviors. Twenty Veterans receiving Veterans Affairs Homeless Patient-Aligned Care Team care took photographs depicting health and wellness, then used their photographs to discuss the same topics in 30-60 minute audio-recorded, semi-structured photo-elicitation interviews. Transcripts were analyzed using template analysis. Veterans described eight dimensions related to their health and wellness; physical, social, and environmental were most commonly discussed, followed by emotional, intellectual, spiritual, occupational, and financial wellness. Photographs contained literal and metaphorical depictions that were positively-oriented, comprehensive, and reflective. Of central importance was overcoming external and internal obstacles to wellness. Photo-narratives may be helpful in educating health care providers and advocating for the needs of homeless and marginally housed Veterans. Integrated primary care services should address the multi-faceted aspects of health and wellness for Veterans.

Keywords

Veterans, Vulnerable Populations, Patient Experience, Primary Health Care, Qualitative Research, Photo-Elicitation

Author Bio(s)

Keri L. Rodriguez, PhD is a medical sociologist and Co-Director of the Qualitative Methods Core in the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. She is also an Affiliate Faculty member in the Division of General Internal Medicine at the University of Pittsburgh School of Medicine. Correspondence regarding this article can be addressed directly to: keri.rodriguez@va.gov.

Lauren M. Broyles, PhD, RN is a former addiction health services researcher at the VA Pittsburgh Healthcare System. She is currently a grant proposal writing consultant with Grant Writers Seminars & Workshops in Buellton, CA. Correspondence regarding this article can also be addressed directly to: lbroyles@grantcentral.com.

Michael A. Mitchell, MA is a qualitative analyst with the Office of Data Analysis, Research, and Evaluation, Allegheny County Department of Human Services, Pittsburgh, Pennsylvania, and a former fellow in the VA’s Interprofessional Advanced Fellowship in Addiction Treatment. Correspondence regarding this article can also be addressed directly to: mitchellm593@gmail.com.

Melissa E. Wieland, PhD, MPH is a Project Coordinator in the Center for Health Equity Research and Promotion (CHERP) at the VA Pittsburgh Healthcare System. Correspondence regarding this article can also be addressed directly to: melissawieland@comcast.net.

Gala True, PhD is an anthropologist and Research Health Scientist at the VISN 16 Mental Illness Research, Education and Clinical Center Southeast Louisiana Veterans Healthcare System, and a Research Associate Professor at the LSU School of Medicine. Correspondence regarding this article can also be addressed directly to: Jennifer.True2@va.gov.

Adam J. Gordon, MD, MPH is a physician and addiction health services researcher at the Department of Veterans Affairs Salt Lake City Health Care System. He is also a Professor of Internal Medicine, Adjunct Professor of Psychiatry, and Chief of Addiction Medicine at the University of Utah School of Medicine. Correspondence regarding this article can also be addressed directly to: adam.gordon@va.gov.

Acknowledgements

This work was supported by a pilot research grant from VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System (PIs: Michael A. Mitchell, Lauren M. Broyles). This work was also supported by Department of Veterans Affairs, Health Services Research & Development (HSR&D) Service, locally initiated research funding (PI: Michael A. Mitchell; 72-079). Finally, this work was supported by the Department of Veterans Affairs, Office of Academic Affiliations Advanced Fellowship Program in Addiction Treatment (Michael A. Mitchell), a Career Development Award (CDA 10-014) from the Department of Veterans Affairs, Health Services Research & Development service (Lauren M. Broyles) and with resources and facilities at the VA Pittsburgh Healthcare System, Pittsburgh, PA. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. Government.

Publication Date

2-23-2019

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

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