"I Run inside the Buildings": Adolescents Striving for Healthy Living in a Family Homeless Shelter

Background and Purpose: This poster presents a qualitative study of healthy behaviors and outdoor activity among adolescents experiencing homelessness. People in families with children represented roughly a third of all individuals experiencing homelessness in the United States in 2017. Children living in family shelters experience extreme poverty and deprivation, and the institutional setting denies them access to the outdoors, healthy play, and nutritious food, all of which can lead to long-term health disparities. In preparation to pilot test a community garden intervention to mitigate these risks, we conducted focus groups with adolescents living in emergency family shelters. Our primary research questions were: 1) how do you engage in healthy behaviors (e.g., nutritious food choices, physical activity)?; and 2) what does nature mean to you?

Methods: Following IRB approval, the authors conducted two focus groups at two emergency family shelters with eight adolescents (ages 13-17; 100% African American; 3 males) during January and February of 2018. Participants received $5 for their time. The two authors co-facilitated both focus groups, which included five questions with probes. They conducted a direct content analysis of the data separately, and then met to review results and reach consensus on emergent themes.

Results: Three themes emerged from the data: i) healthy means what you eat; ii) physical activity is happy normal; iii) nature is ever-present but abstract. Generally, the adolescents identified diet and nutrition as most related to and influential over one’s health. For example, the adolescents quickly described healthy as “eating apples… being on a diet”, “be[ing] careful what you eat”, “…putting, like, nutrients in your body to make sure that you have enough.” Many of them talked about how they used to play sports, run, be fast, or physically feel good, and reported wanting to return to more physical activity and sports. Two girls, who play basketball, said that playing sports makes them feel “normal”. The adolescents said that they get nature by getting “fresh air”, although they were unable to articulate what exactly that was. Finally, when asked how much time they spend in nature, the clearest response was, “not that much.”

Implications: Findings highlight the fact that adolescents staying at family shelters value healthy activities and the benefits these activities offer, but they struggle to access the resources or opportunities, as well as the knowledge, that they need to lead a healthy lifestyle. The adolescents equated health primarily with nutrition, but reported that they rarely received fresh vegetables beyond a bag of salad at the shelters. Moreover, several agreed that health is important, but, in comparison to all they have going on in their lives, they generally rate their health as a mid to low priority. This may be in part due to reduced access to fresh food and outdoor spaces. When asked where food comes from, one participant replied, “donations”. Future research into the under-explored issues of healthy living among adolescents experiencing family homelessness may examine how shelter environments contribute to short- and long-term health disparities among these youth.