Methods: This study used a community-based participatory action framework to conduct 10 virtual focus groups with 47 key initiative stakeholders (focus group m=5; 12:24 hours total transcript). Questions were divided into three parts: descriptive (e.g., roles, events), evaluative (e.g., processes, adaptations, and reflections), and imaginative (e.g., proposed improvements, innovations, and possibilities). Question development, data collection and qualitative content analysis were conducted by a team of students and researchers from Saint Louis University and Washington University in St. Louis.
Results: It became clear during the focus groups and analysis that radical imagination was a central concept in understanding the success of OWH, and we identified four interrelated thematic elements that facilitated it: collective identity, shared authority, trust, and openness. Participants reported feeling a sense of collective identity and purpose in the face of the crises that gave them collective authority to act, but also reported leveraging established, trusted relationships to share authority over various aspects of the initiative to flexibly meet needs as they developed. Openness to a variety of approaches spurred collaborative creativity in crowdsourcing funding, sharing resources, and handling difficult situations without involving outside authorities, and, when combined with collective identity, promoted trust in each other’s authority. Participants shared that these elements helped shift OWH from a simple shelter operation to a re-imagining of the system itself. For two weeks, shelter operations shifted from a siloed, limited-availability model of services to a radically-collaborative, multi-disciplinary, minimal-barrier system. During OWH, all shelters remained open 24 hours, coordinated placements internally, and provided expanded services through rotating medical and social service teams. OWH increased equity by collectively raising funds, sharing resources (including space), and fairly paying typically unpaid volunteer and peer positions. This model resulted in smoother transitions from ER to shelter and higher placements in permanent supportive housing and substance use disorder treatment than is typically seen during normal operations. Participants radically imagined multiple future conceptualizations of cross-disciplinary collaborations, shared space and resources, and novel solutions to the issues that arose during OWH.
Conclusions: OWH presents a case study in how a radically-imaginative collaborative initiative can battle inequities and build solutions that can significantly reduce the barriers to entering shelter while expanding operations through a combination of collective identity, shared authority, trust, and openness. While OWH was short-term and initiated during a crisis, this model could be adapted to other situations.