Developing participatory research to understand the health & treatment needs of mid-life & older women experiencing homelessness & substance use in UK

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Current research into homelessness in Scotland has yet to investigate the needs of mid-life and olderwomen who are facing homelessness at the same time as coping with substance use (drugs andalcohol). There is little research that focuses on the challenges faced by women who experiencehomelessness compared with research on homelessness in general and less still that seeks tounderstand the specific health needs of women approaching or in later life (Sutherland et al, 2022). Housing is an important social determinant of health, and there is evidence that shows womenexperiencing homelessness have poorer mental and physical health outcomes than women in the widerpopulation (Beijer & Andréasson, 2010). Moreover, women who are experiencing homelessness aremore likely to have experienced higher rates of diagnosed mental health issues, suicidal ideation andattempts, and childhood trauma than men who are experiencing homelessness (Sosenko et al, 2020;Milaney et al, 2020). Factors such as poor mental health, domestic violence, and family background(Anderson & Raynes, 2004) can impact on women's access to and retention of safe tenancies, whilstadditional barriers to secure housing include structural factors such as poverty, education, employmentand involvement with the criminal justice system (Norman & Pauly, 2013).The Fellowship will help me build on my PhD, moving beyond the health needs and treatmentexperiences of older women in recovery from substance use, to investigate the needs of a particularlymarginalised group of women, namely women experiencing the intersection of homelessness, ageing,and substance use. The PhD sets the foundations for exploring mid-life and older women's healthneeds by recognising the complexity of women's lives, especially among those who live on the marginsof society (Shaw, 2021). The Fellowship will provide an important starting point for planning innovativeparticipatory research with this under-researched and marginalised group. A critical element of theFellowship will include a project working group of mid-life and older women with lived experience in thedevelopment of a grant application for further research. The participation of women with livedexperience will ensure the research proposal is designed to produce meaningful outcomes that willhave practical impacts for women experiencing homelessness and the practitioners who support them. Over the course of the Fellowship I aim to publish the findings from my PhD nationally andinternationally in order to maximise impact and engagement. I will expand my research network anddevelop specific skills in participatory research, project development and grant applications. I will alsoundertake information gathering through a range of networking opportunities, a rapid review ofinterventions to improve practitioner/patient communications, an online survey with practitioners and the preparation of grant applications in order to continue this important line of research. The motivation for this Fellowship application is to develop work that will increase understanding of the intersection ofhomelessness, substance use, health, ageing, and gender.