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

目前对苏格兰无家可归问题的研究还没有调查中年和老年妇女的需求，她们在应对物质使用（毒品和酒精）的同时也面临无家可归的问题。与一般无家可归问题的研究相比，很少有研究关注经历无家可归的妇女所面临的挑战，更少有研究试图了解即将或晚年妇女的具体健康需求（Sutherland等人，2022年）。住房是健康的一个重要社会决定因素，有证据表明，经历无家可归的妇女的身心健康结果比更广泛人口中的妇女差（Beijer和Andréasson，2010年）。此外，经历无家可归的女性比经历无家可归的男性更有可能经历更高的诊断心理健康问题，自杀意念和诱惑以及童年创伤（Sosenko等人，2020;Milaney等人，2020）。心理健康状况不佳、家庭暴力、家庭背景等因素（安德森和雷恩斯，2004年）可能影响妇女获得和保留安全的租赁，而获得住房的其他障碍包括结构性因素，如贫困、教育、就业和参与刑事司法系统（诺曼和保利，2013年）。奖学金将帮助我建立在我的博士学位，超越健康需求和治疗经验的老年妇女在恢复物质使用，调查的需求，特别是边缘化群体的妇女，即经历无家可归、老龄化和药物使用交叉的妇女。博士通过认识到妇女生活的复杂性，特别是那些生活在社会边缘的妇女，为探索中年和老年妇女的健康需求奠定了基础（肖，2021年）。该奖学金将提供一个重要的起点，规划创新的参与性研究与这个研究不足和边缘化的群体。该研究金的一个关键要素将包括一个由中年和老年妇女组成的项目工作组，这些妇女在制定进一步研究的赠款申请方面具有实际经验。有生活经验的妇女的参与将确保研究提案旨在产生有意义的成果，对无家可归的妇女和支持她们的从业人员产生实际影响。在奖学金的过程中，我的目标是在国内和国际上发表我的博士研究结果，以最大限度地提高影响力和参与度。我将扩大我的研究网络，并在参与性研究，项目开发和赠款申请方面发展具体技能。我也将通过一系列网络机会收集信息，快速审查干预措施，以改善医生/患者的沟通，与医生的在线调查和准备拨款申请，以继续这一重要的研究路线。这个奖学金申请的动机是发展工作，将增加对无家可归，物质使用，健康，老龄化和性别的交叉点的理解。

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.