Evaluation of Health on a Budget: A Health Promotion Program for Women Experiencing Homelessness

Abstract

Introduction: In 2015, the researcher created Health on a Budget, a five-session health promotion class to empower homeless women to live heathier lives on a budget. After enhancing the curriculum using the Theory of Planned Behavior (Ajzen, 1991), the researcher reintroduced the program in 2016 and evaluated its effectiveness. Methods: The researcher worked with stakeholders to identify key topics: health literacy in nutrition, portion control, cooking, exercise, and oral and foot hygiene. The researcher created objectives, lesson plans, and evaluation surveys that aligned with the Theory of Planned Behavior. At the conclusion of each session, participants completed a survey that determined the completion of the objectives. Results: Ten women residing at the Center for Transforming Lives shelter in Fort Worth participated in Health on a Budget in 2016. As a whole, the participants met all of the knowledge objectives, 80% of the attitude objectives, 80% of the behavioral intention objectives, 40% of perceived behavioral control objectives, and 20% of subjective norm objectives. Overall, the program had the greatest effect on the participants' knowledge, attitudes, and intentions to perform healthy behaviors. Discussion: The program was well-received by the participants, and the shelter stakeholders were very pleased with the program development and outcomes. Although the participants met most of the objectives, it is unclear if the women will take the knowledge they have and use it to change their day-to-day behaviors because of the complexity of their environment and circumstances. Changing shelter policies to improve the food environment and the nutritional content of the food would be more effective in promoting the health behaviors of residents in the short term. Long term, the provision of stable housing would allow women to begin improving their physical, mental, and emotional health through programs like Health on a Budget.