"IT HAPPENS OUT HERE" - THE VICTIMIZATION EXPERIENCES AND HEALTH CHALLENGES OF WOMEN WHO ARE HOMELESS

The Homeless Women’s Health and Victimization Study was a collaborative community-based research project that has filled a crucial gap in knowledge about the violence and abuse experienced by women utilizing emergency shelters in the East Lancaster area of Fort Worth, Texas. This study was also an invaluable learning experience for UNT Health Science Center graduate students. Participation in the study was offered as a service learning project and volunteer opportunity in the School of Public Health. Students were involved in every stage of the study and were able to experience lessons related to the practice of Behavioral and Community Health that simply cannot be taught in a classroom. Since the initial release of data to community stakeholders, there have been remarkable changes made by homeless service providers in response to our report. Presbyterian Night Shelter has made changes to their policies that allow more women to stay inside the shelter during the day. They have also made changes to the facility to provide more beds for women and keep the women’s area more secure. YWCA has reallocated their resources to increase their number of emergency beds in order to provide emergency shelter options outside of the East Lancaster area. The Fort Worth Police Department has also responded by implementing a night patrol and outreach program in the East Lancaster area. The findings of this study have also helped the Day Resource Center for the Homeless become the first homeless outreach program in Texas to receive funding from the Victims of Crime Act to address homeless women’s safety. This study has embodied what it means for a health science center to work together with our community to identify problems and find solutions. Purpose (a): The Homeless Women’s Health and Victimization Study was conducted in order to explore the unique experience of violence and victimization among homeless women and the effects these experiences have on physical and mental health. Methods (b): This study utilized non-random, purposive sampling of women utilizing emergency shelter services in the East Lancaster area of Fort Worth, Texas. A total of 150 face-to-face interviews were conducted with homeless women by trained volunteers from December 2012 to May 2013. The interview consisted of closed and open ended questions covering recent victimization, service utilization, mental and physical health, healthcare utilization, prior abuse, transactional sex, and personal safety and health strategies. Quantitative data analysis was performed using statistical software and a grounded theory approach was used for qualitative data analysis. Results (c): The majority (60.1%) of participants reported at least one form of physical or sexual violence, stalking, threats, or verbal abuse in the last 12 months. One in 6 women (17.3%) reported experiences that meet the legal definition of rape in Texas, 46% were physically or sexually attacked, 20.7% reported intimate partner violence. These attacks have had significant health consequences, with 23% of women reporting injuries incurred as a result of their attacks. In addition, 78% of women reporting recent abuse and 88.5% of women reporting recent rape met the threshold for psychiatric distress. There was a clear relationship between prior victimization and recent violence. Among those reporting physical or sexual violence in the past 12 months, the majority were abused as a child (62.5%) or abused by an intimate partner (65%). Conclusions (d): Violence and victimization is a painful reality for many of the women experiencing homelessness in our community. The homeless services delivery system and community stakeholders must work together to identify solutions that will improve the safety of women on East Lancaster, as well as help women leave the East Lancaster region.