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The experiences of care of people with lived experience of homelessness are rarely embraced to change care delivery. We conducted qualitative group and one-on-one interviews utilizing experience group methodology with 27 people with lived experience of homelessness currently housed in one permanent housing community in central Texas. We analyzed data using an inductive thematic approach to identify shared obstacles and barriers to receiving health care. We then analyzed findings with the capability, comfort, and calm value framework to identify health outcomes that matter most to study participants. Poor access to care, discontinuities in care, distrust in providers, and confusing terminology were identified as the biggest barriers to health. The overwhelming majority of experiences reflected poor health outcomes of calm, the outcome of a health care experience that adds ease to one’s life rather than logistical and administrative chaos. We propose three practical approaches to achieve calm for this population as follows: systems-level embracement of compassionate care, integration of relationship-based care navigation into all levels of care, and building efficient transportation into care design. We conclude that designing health care that works in the lives of people with lived experience of homelessness is critical to address the gaps in care that fuel the health disparity these individuals face compared to people without this lived experience.

The experiences of care of people with lived experience of homelessness are rarely embraced to change care delivery. We conducted qualitative group and one-on-one interviews utilizing experience group methodology with 27 people with lived experience of homelessness currently housed in one permanent housing community in central Texas. We analyzed data using an inductive thematic approach to identify shared obstacles and barriers to receiving health care. We then analyzed findings with the capability, comfort, and calm value framework to identify health outcomes that matter most to study participants. Poor access to care, discontinuities in care, distrust in providers, and confusing terminology were identified as the biggest barriers to health. The overwhelming majority of experiences reflected poor health outcomes of

Advancing Health Equity Through Innovations and Technology This year’s summit was unique given the COVID-19 pandemic: a major global outbreak that has imposed severe restrictions in all aspects of our life. At the outset, we were faced with three mutually exclusive options. First option was to cancel the summit in its entirety: this was the easiest and most obvious choice once the COVID-19 pandemic forced a near total lockdown all over the country with unprecedented disruptions of normal daily activities as the disease announced its thunderous touchdown on United States (US) soil. It was also the most-logical response faced with uncertainty regarding summit logistics and expected poor attendance due to the raging pandemic. Second option was to conduct a digital summit restricted to local audiences at Baylor College of Medicine: this option entailed implementing a virtual summit with attendance restricted to participants from our institution only. It sounded like a reasonable choice but that would impede the presence of diversity of topics, perspectives, insights and experiential learning opportunities, which are what render the summit exciting and worth attending. And finally, the last option was to conduct a digital unrestricted summit open to all interested audiences throughout the US. The conduct of a virtual summit open to all participants from around the country was initially considered daunting given the likelihood of amplified technical problems associated with an array of internet access differentials around the country, which would require a strong Information Technology (IT) presence throughout the sessions. Nonetheless, the attractiveness of going national with a virtual summit, despite the pandemic and logistical challenges, slowly gained converts and became the dominant choice. The response and level of participation in this first virtual summit showed an unanticipated surge despite the increase in registration fees to cover IT costs. This year, we had attendees from all regions of the US as well as from the United Kingdom. The range of topics was quite diverse encompassing health disparities in relation to cancers, nutrition, musculo-skeletal disorders, amputation rates, vaccination uptakes and COVID-19 infections. Various solutions were passionately presented to address these disparities including novel health technologies, community engagement and partnerships, improvement in health literacy and alternative therapeutics. There were no hitches despite the complex breakout sessions, and above all, attendees were satisfied and offered outstanding evaluation scores. This was definitely a summit that metamorphosed from pessimism to a triumphant success! Copyright © 2020 Salihu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

By 2035, U.S. adults > 65 will outnumber children. The growing lack of affordable housing combined with fixed incomes will lead to more older adults residing in public housing. Public housing authorities, in turn, will face growing health and social needs among their residents. In partnership with a local housing authority, we conducted a qualitative study to better understand the health and social needs of older adult public housing residents. We conducted semi-structured qualitative interviews with 27 older adults at two public housing sites in Austin, Texas; we asked about their experience of aging in public housing, their health, healthcare, and community life. Interviews were audio-recorded and transcribed; interviews were systematically coded and verified by a second coder. Themes were identified using comparative analysis. We interviewed 16 females and 11 males (mean age = 71.7 years). We identified three themes. Residents characterized good healthcare as that which is provided by physicians who are consistent educators that listen to residents’ primary concerns. They defined health as being mobile and lacking pain. Finally, they desire more, recurring opportunities to learn about health and connect interpersonally within their housing community; they perceive limited meaningful relationships as a significant contributor to poor health among residents. The older adult public housing residents in our study outlined what good health and healthcare looks like. These themes can be utilized to improve relationships between residents and their healthcare providers. Social isolation can be mitigated through public housing programming that promotes physical and mental acuity.

In the coming decades, the population of adults over 65 in the US will increase dramatically. Many older adults live at or below the poverty level, and the growing lack of affordable housing combined with fixed incomes promises to increase the number of older adults facing combined housing and health challenges. Despite their vulnerability, little is known about the lived experiences of older adults aging in place in public housing. We conducted semi-structured qualitative interviews with 27 older adults at two public housing sites in Austin, Texas to gain an understanding of their thoughts on health, aging, home, community, and problem solving. We conducted interviews in Spanish (n=10) and English (n=17) with 16 female and 11 male interviewees with a mean age of 71.7 years (range 65-85 years). We systematically coded transcribed interviews and used grounded theory to analyze the data. Participants described feeling isolated due to language barriers, cultural perceptions about neighbors, and previous problematic experiences with neighbors leading to intentional isolation for safety. Some, however, spoke of how they acted as community connectors or responded to connectors in the community in ways that reduced their isolation. Participants framed individual problem-solving and personal choices as central to health and wellness. Our findings suggest a way forward for housing authorities, communities, and health systems working together to provide services to these adults. Incorporating their points of view and even co-creating interventions to enhance their health and well-being will make these interventions more successful and welcome.