Social Responses to Stigma
Status: Not yet recruiting

The Social Responses to Stigma study will explore experiences of stigma and discrimination amongst people who are homeless in south London, and then seek to understand how this stigma is created, mediated or mitigated within health, social, housing and legal care and support systems and social contexts.

The methodology is an ethnographic case study of the south London care and support system and its social context. The study will use a range of methods for data collection: interviews with people who are homeless, delivery stakeholders, and policy makers; a survey of peoples' experiences; observation within selected care sites; and gathering of documentary sources.

The study will be implemented through two parallel studies. The first, with KCL-REMAS approval, will operate in non-NHS sites. The second, with NHS-IRAS approval, will operate in NHS sites. The protocols are aligned with adaptations for each type of site.

A linked method to develop theory is cross-case comparison between South London and Vancouver, Canada, through secondary data analysis to linked studies ongoing there. The study will be ongoing from 2022 until January 2025. The project is funded in two phases, with potential to extend the study by a further three years, to January 2028.

The results of the study will inform the design of a novel intervention strategy to address the social dimensions of stigma. Subject to additional funding applications, the intervention strategy will be piloted and evaluated from 2025 onwards. The study results will be disseminated through scientific publications, public reports and a range of public and policy engagement activities.

Eligibility:
- EligibilityCriteria: People who are homeless  Inclusion Criteria:  Homelessness, in line with UK Government definitions, will be understood in an expansive way, to include past or current experiences of:  People who are rough sleeping (meaning people without homes who sleep outside or somewhere not designed for habitation) people who are temporary residents of hostel accommodation (such as emergency night shelters, short-stay hostels, longer stay hostels, domestic violence safe houses, safe houses for victims of modern slavery and probation hostels) people who are in unsupported temporary accommodation (such as B&Bs), People who use day centres that provide support (such as food, showers, clothing and advice) for people experiencing homelessness People staying temporarily with family and friends ('sofa surfing'), and people with a history of homelessness (as defined by the groups above) who are at high risk of becoming homeless again because of ongoing complex health and social care needs.  The study will include people over the age of 18 (and exclude those under this), and with no upper age limited.  Participants would be principally based in, or frequently spend time in, the three boroughs of Lambeth, Lewisham and Southwark. Reflecting the effort to explore analytical generalisability of findings, the study may also include people with experience of homelessness beyond the three boroughs (but would still need to have experience, and be aged over 18).  Exclusion Criteria:  Unable to give informed consent  Stakeholders Stakeholders are defined as individuals 1) working in care and support services, or services that engage people who are homeless, and whether that is in delivery, planning or management of these, or 2) with experience or position that gives insight to processes of care and support, engagement or in stigma itself. This will include staff working across health, welfare and judicial settings, including providers as well as administrative and reception staff in these settings. Those involved in policy, such as commissioners, councillors will also be included. We will also include community activists, family members and others otherwise actively engaged in issues relating to homelessness as stakeholders.  The study will include people over the age of 18 (and exclude those under this), and with no upper age limited.  Participants would be principally based in, or frequently spend time in, the three boroughs of Lambeth, Lewisham and Southwark. Reflecting the effort to explore analytical generalisability of findings, we may also include stakeholders beyond the three boroughs. - HealthyVolunteers: Accepts Healthy Volunteers - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult - StudyPopulation: The population is derived from people using or working in services relating to homelessness and health in south London. - SamplingMethod: Non-Probability Sample