Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre
Abstract Background People experiencing homelessness also experience poorer health and frequently attend acute care settings when primary health care would be better equipped to meet their needs. Existing scholarship identifies a complex mix of individual and structural‐level factors affecting prima...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | Health Expectations |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/hex.13858 |
| _version_ | 1797633209047973888 |
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| author | Stefanie Plage Kirsten Baker Cameron Parsell Rose‐Marie Stambe Ella Kuskoff Arif Mansuri |
| author_facet | Stefanie Plage Kirsten Baker Cameron Parsell Rose‐Marie Stambe Ella Kuskoff Arif Mansuri |
| author_sort | Stefanie Plage |
| collection | DOAJ |
| description | Abstract Background People experiencing homelessness also experience poorer health and frequently attend acute care settings when primary health care would be better equipped to meet their needs. Existing scholarship identifies a complex mix of individual and structural‐level factors affecting primary health care engagement driving this pattern of health services utilisation. We build on this existing knowledge, by bringing the spatio‐temporal configurations of primary health care into focus. Specifically, we interrogate how space and time inflect situated practices and relations of care. Methods This study took an ethnographic approach and was conducted 2021–2022 at an inclusive health and wellness centre ("the Centre") in Southeast Queensland, Australia. The data consists of 46 interviews with 48 people with lived experience of homelessness, including participants who use the services offered at the Centre (n = 26) and participants who do not (n = 19). We also interviewed 20 clinical and non‐clinical service providers affiliated with the Centre and observed how service delivery took place. Interviews and observations were complemented by visual data, including participant‐produced photography. All data were analysed employing a narrative framework. Results We present three interrelated themes demonstrating how space and time affect care, that is ‘staying safe’, ‘feeling welcome’ and ‘being seen’. ‘Staying safe’ captures the perceptions and practices around safety, which sit in tension with making service users feel welcome. ‘Feeling welcome’ attends to the sense of being invited to use services free of judgment. ‘Being seen’ depicts capacities to see a health care provider as well as being understood in one's lived experience. Conclusion Spatio‐temporal configurations, such as attendance policies, consultation modalities and time allocated to care encounters afford differential opportunities to nurture reciprocal relations. We conclude that flexible service configurations can leverage a relational model of care. Patient or Public Contribution Service providers were consulted during the design stage of the project and had opportunities to inform data collection instruments. Two service providers contributed to the manuscript as co‐authors. People with lived experience of homelessness who use the services at the inclusive health centre contributed as research participants and provided input into the dissemination of findings. The photography they produced has been featured in an in‐person exhibition, to which some have contributed as consultants or curators. It is hoped that their insights into experiences of welcomeness, safety and being seen will inform flexible and relational primary health care design, delivery, and evaluation to better cater for people experiencing housing instability and poverty. |
| first_indexed | 2024-03-11T11:50:51Z |
| format | Article |
| id | doaj.art-7179ba3fad2f457fa0029029ea858f87 |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-03-11T11:50:51Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-7179ba3fad2f457fa0029029ea858f872023-11-09T06:54:54ZengWileyHealth Expectations1369-65131369-76252023-12-012662620262910.1111/hex.13858Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centreStefanie Plage0Kirsten Baker1Cameron Parsell2Rose‐Marie Stambe3Ella Kuskoff4Arif Mansuri5ARC Centre of Excellence for Children and Families over the Life Course Indooroopilly AustraliaAustralian Research Centre in Complementary and Integrative Medicine The University of Technology Sydney Broadway AustraliaARC Centre of Excellence for Children and Families over the Life Course Indooroopilly AustraliaARC Centre of Excellence for Children and Families over the Life Course Indooroopilly AustraliaARC Centre of Excellence for Children and Families over the Life Course Indooroopilly AustraliaInclusive Health and Wellness Hub South Brisbane AustraliaAbstract Background People experiencing homelessness also experience poorer health and frequently attend acute care settings when primary health care would be better equipped to meet their needs. Existing scholarship identifies a complex mix of individual and structural‐level factors affecting primary health care engagement driving this pattern of health services utilisation. We build on this existing knowledge, by bringing the spatio‐temporal configurations of primary health care into focus. Specifically, we interrogate how space and time inflect situated practices and relations of care. Methods This study took an ethnographic approach and was conducted 2021–2022 at an inclusive health and wellness centre ("the Centre") in Southeast Queensland, Australia. The data consists of 46 interviews with 48 people with lived experience of homelessness, including participants who use the services offered at the Centre (n = 26) and participants who do not (n = 19). We also interviewed 20 clinical and non‐clinical service providers affiliated with the Centre and observed how service delivery took place. Interviews and observations were complemented by visual data, including participant‐produced photography. All data were analysed employing a narrative framework. Results We present three interrelated themes demonstrating how space and time affect care, that is ‘staying safe’, ‘feeling welcome’ and ‘being seen’. ‘Staying safe’ captures the perceptions and practices around safety, which sit in tension with making service users feel welcome. ‘Feeling welcome’ attends to the sense of being invited to use services free of judgment. ‘Being seen’ depicts capacities to see a health care provider as well as being understood in one's lived experience. Conclusion Spatio‐temporal configurations, such as attendance policies, consultation modalities and time allocated to care encounters afford differential opportunities to nurture reciprocal relations. We conclude that flexible service configurations can leverage a relational model of care. Patient or Public Contribution Service providers were consulted during the design stage of the project and had opportunities to inform data collection instruments. Two service providers contributed to the manuscript as co‐authors. People with lived experience of homelessness who use the services at the inclusive health centre contributed as research participants and provided input into the dissemination of findings. The photography they produced has been featured in an in‐person exhibition, to which some have contributed as consultants or curators. It is hoped that their insights into experiences of welcomeness, safety and being seen will inform flexible and relational primary health care design, delivery, and evaluation to better cater for people experiencing housing instability and poverty.https://doi.org/10.1111/hex.13858Australiahousing instabilityprimary health carequalitative researchrelations of careservice delivery |
| spellingShingle | Stefanie Plage Kirsten Baker Cameron Parsell Rose‐Marie Stambe Ella Kuskoff Arif Mansuri Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre Health Expectations Australia housing instability primary health care qualitative research relations of care service delivery |
| title | Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre |
| title_full | Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre |
| title_fullStr | Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre |
| title_full_unstemmed | Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre |
| title_short | Staying safe, feeling welcome, being seen: How spatio‐temporal configurations affect relations of care at an inclusive health and wellness centre |
| title_sort | staying safe feeling welcome being seen how spatio temporal configurations affect relations of care at an inclusive health and wellness centre |
| topic | Australia housing instability primary health care qualitative research relations of care service delivery |
| url | https://doi.org/10.1111/hex.13858 |
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