abstract: 'Background

  Persons experiencing homelessness and vulnerable housing or those with

  lived experience of homelessness have worse health outcomes than

  individuals who are stably housed. Structural violence can dramatically

  affect their acceptance of interventions. We carried out a systematic

  review to understand the factors that influence the acceptability of

  social and health interventions among persons with lived experience of

  homelessness.

  Methods

  We searched through eight bibliographic databases and selected grey

  literature sources for articles that were published between 1994 and

  2019. We selected primary studies that reported on the experiences of

  homeless populations interacting with practitioners and service

  providers working in permanent supportive housing, case management,

  interventions for substance use, income assistance, and women- and

  youth-specific interventions. Each study was independently assessed for

  its methodological quality. We used a framework analysis to identify key

  finding and used the GRADE-CERQuaI approach to assess confidence in the

  key findings.

  Findings

  Our search identified 11,017 citations of which 35 primary studies met

  our inclusion criteria. Our synthesis highlighted that individuals were

  marginalized, dehumanized and excluded by their lived homelessness

  experience. As a result, trust and personal safety were highly valued

  within human interactions. Lived experience of homelessness influenced

  attitudes toward health and social service professionals and sometimes

  led to reluctance to accept interventions. Physical and structural

  violence intersected with low self-esteem, depression and

  homeless-related stigma. Positive self-identity facilitated links to

  long-term and integrated services, peer support, and patient-centred

  engagement.

  Conclusions

  Individuals with lived experience of homelessness face considerable

  marginalization, dehumanization and structural violence. Practitioners

  and social service providers should consider anti-oppressive approaches

  and provide, refer to, or advocate for health and structural

  interventions using the principles of trauma-informed care. Accepting

  and respecting others as they are, without judgment, may help

  practitioners navigate barriers to inclusiveness, equitability, and

  effectiveness for primary care that targets this marginalized

  population.'
affiliation: 'Pottie, K (Corresponding Author), Bruyere Res Inst, CT Lamont Primary
  Hlth Care Res Ctr, Ottawa, ON, Canada.

  Pottie, K (Corresponding Author), Univ Ottawa, Dept Family Med, Ottawa, ON, Canada.

  Magwood, Olivia; Saad, Ammar; Alkhateeb, Qasem; Gebremeskel, Akalewold; Rehman,
  Asia; Hannigan, Terry; Sun, Annie Huiru; Kendall, Claire; Pottie, Kevin, Bruyere
  Res Inst, CT Lamont Primary Hlth Care Res Ctr, Ottawa, ON, Canada.

  Leki, Vanessa Ymele, MyHlth Ctr, PET CT Dept, Mississauga, ON, Canada.

  Kpade, Victoire, McGill Univ Montreal, Fac Med, Montreal, PQ, Canada.

  Saad, Ammar; Kendall, Claire; Pottie, Kevin, Univ Ottawa, Sch Epidemiol \& Publ
  Hlth, Ottawa, ON, Canada.

  Pinto, Nicole, Univ Guelph, Dept Populat Med, Guelph, ON, Canada.

  Kendall, Claire; Ponka, David; Pottie, Kevin, Univ Ottawa, Dept Family Med, Ottawa,
  ON, Canada.

  Kendall, Claire, OHRI, Ottawa, ON, Canada.

  Kendall, Claire, St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada.

  Kozloff, Nicole, Univ Toronto, Ctr Addict \& Mental Hlth, Toronto, ON, Canada.

  Kozloff, Nicole, Univ Toronto, Dept Psychiat, Toronto, ON, Canada.

  Kozloff, Nicole, Univ Toronto, Inst Hlth Policy Management \& Evaluat, Toronto,
  ON, Canada.

  Tweed, Emily J., Univ Glasgow, MRC CSO Social \& Publ Hlth Sci Unit, Glasgow, Lanark,
  Scotland.'
article-number: e0226306
author: Magwood, Olivia and Leki, Vanessa Ymele and Kpade, Victoire and Saad, Ammar
  and Alkhateeb, Qasem and Gebremeskel, Akalewold and Rehman, Asia and Hannigan, Terry
  and Pinto, Nicole and Sun, Annie Huiru and Kendall, Claire and Kozloff, Nicole and
  Tweed, Emily J. and Ponka, David and Pottie, Kevin
author-email: kpottie@uottawa.ca
author_list:
- family: Magwood
  given: Olivia
- family: Leki
  given: Vanessa Ymele
- family: Kpade
  given: Victoire
- family: Saad
  given: Ammar
- family: Alkhateeb
  given: Qasem
- family: Gebremeskel
  given: Akalewold
- family: Rehman
  given: Asia
- family: Hannigan
  given: Terry
- family: Pinto
  given: Nicole
- family: Sun
  given: Annie Huiru
- family: Kendall
  given: Claire
- family: Kozloff
  given: Nicole
- family: Tweed
  given: Emily J.
- family: Ponka
  given: David
- family: Pottie
  given: Kevin
da: '2023-09-28'
doi: 10.1371/journal.pone.0226306
files: []
issn: 1932-6203
journal: PLOS ONE
keywords-plus: 'PEOPLES VIEWS; FRAMEWORK; PROGRAM; SERVICE; WOMEN; CARE; PERSPECTIVES;

  GENDER; DETERMINANTS; PERCEPTIONS'
language: English
month: DEC 30
number: '12'
number-of-cited-references: '105'
orcid-numbers: 'Magwood, Olivia/0000-0003-0262-5621

  Tweed, Emily J./0000-0001-6659-812X

  Saad, Ammar/0000-0002-3145-4596

  Sun, Annie H./0000-0003-2002-7115

  Gebremeskel, Akalewold Tadesse/0000-0001-5141-8018

  Pottie, Kevin/0000-0002-1874-8346

  Ponka, David/0000-0003-0902-8520

  Kozloff, Nicole/0000-0003-1389-1351'
papis_id: 934691cef4ef66099d9610f8575fe1cf
ref: Magwood2019commontrust
researcherid-numbers: 'Pottie, Kevin/ABC-4385-2020

  LI, LINGJUAN/IAR-7701-2023

  Magwood, Olivia/IST-7319-2023

  '
tags:
- relevant
- review
times-cited: '40'
title: 'Common trust and personal safety issues: A systematic review on the acceptability
  of health and social interventions for persons with lived experience of homelessness'
type: Review
unique-id: WOS:000515092200015
usage-count-last-180-days: '2'
usage-count-since-2013: '24'
volume: '14'
web-of-science-categories: Multidisciplinary Sciences
year: '2019'