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Research ArticleOriginal Research

A Sector Wheel Approach to Understanding the Needs and Barriers to Services among Homeless-Experienced Veteran Families

Roya Ijadi-Maghsoodi, Sophie Feller, Gery W. Ryan, Lisa Altman, Donna L. Washington, Sheryl Kataoka and Lillian Gelberg
The Journal of the American Board of Family Medicine March 2021, 34 (2) 309-319; DOI: https://doi.org/10.3122/jabfm.2021.02.200331
Roya Ijadi-Maghsoodi
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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Sophie Feller
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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Gery W. Ryan
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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Lisa Altman
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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Donna L. Washington
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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Sheryl Kataoka
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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Lillian Gelberg
From the VA Health Service Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA (RI-M, LG); UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA (RI-M, SK); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA (RI-M, SF, SK); Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (GWR); Office of Healthcare Transformation and Innovation, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LA, LG); Department of Medicine, David Geffen School of Medicine at UCLA (LA, DLW); UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA (SK); Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA (LG); and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (LG).
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    Figure 1.

    Sector Wheel for Under-Resourced Populations. This was used as a data elicitation tool to ensure that participants could share a wide range of concerns about sectors of a family's life affected by homelessness while allowing the participant to take control over the interview. The tool was developed with input from parents with a history of homelessness and homeless service providers. During the interview, the participant moved the arrow on the Sector Wheel, selecting the order of sectors to discuss based on comfort and preference. All sectors were covered in the interview. The Sector Wheel was used from February to September 2016 during the interviews with parents and providers.

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    Table 1.

    Demographic Characteristics of Veteran Parent Participants Interviewed from February to September 2016 (n = 18)

    %
    Sex
        Male50
        Female50
    Race/ethnicity
        Non-Hispanic Black17
        Hispanic/Latino/any race39
        Non-Hispanic White28
        Two or more races/non-Hispanic11
        Unknown6
    Age, years
        Mean (range)40 (25 to 56)
    Average number of children/youth in custody
        Mean (range)1.6 (1 to 4)
    Marital status
        Single28
        Married/living with significant other44
        Divorced28
    Housing status
        Transitional housing facility50
        Permanent housing50
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The Journal of the American Board of Family     Medicine: 34 (2)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 2
March/April 2021
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A Sector Wheel Approach to Understanding the Needs and Barriers to Services among Homeless-Experienced Veteran Families
Roya Ijadi-Maghsoodi, Sophie Feller, Gery W. Ryan, Lisa Altman, Donna L. Washington, Sheryl Kataoka, Lillian Gelberg
The Journal of the American Board of Family Medicine Mar 2021, 34 (2) 309-319; DOI: 10.3122/jabfm.2021.02.200331

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A Sector Wheel Approach to Understanding the Needs and Barriers to Services among Homeless-Experienced Veteran Families
Roya Ijadi-Maghsoodi, Sophie Feller, Gery W. Ryan, Lisa Altman, Donna L. Washington, Sheryl Kataoka, Lillian Gelberg
The Journal of the American Board of Family Medicine Mar 2021, 34 (2) 309-319; DOI: 10.3122/jabfm.2021.02.200331
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Keywords

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