Understanding the experience of place: Expanding methods to conceptualize and measure community integration of persons with serious mental illness

Department of Psychology, University of South Carolina, 224 Barnwell College, 1512 Pendleton Street, Columbia, SC 29208, USA.
Health & Place (Impact Factor: 2.81). 11/2008; 15(2):520-31. DOI: 10.1016/j.healthplace.2008.08.011
Source: PubMed


Community integration research explores community contexts and factors that encourage or hinder individuals with serious mental illness (SMI) from actively participating in community life. This research agenda can be advanced by using mixed-methods that better document the relationships between contextual factors and individual experience. Two such methods were applied to a mixed-methods study of 40 adults with SMI living in independent housing in the Southeastern United States. Their contextualized experiences of community integration were measured by applying innovative participatory mapping and Geographic Information Systems (GIS) mapping techniques. Use of these methods in conjunction with one another facilitated the creation of activity spaces, which can measure geographic accessibility and help to represent an individual's experience of place and degree of mobility. The utility of these newly applied methods for better understanding community integration for persons with SMI is explored and implications for using these measures in research and practice are discussed.

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Available from: Bret Kloos, Mar 17, 2014
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    • "Examples of research looking at urban design have focused on neighborhood characteristics such as racial composition, crime, access to services, inclusion and exclusion in public spaces and places, neighborhood incivilities, crowding, poverty and sprawl (Dear and Wolch, 1987; Evans et al., 2003; Wong and Stanhope, 2009; Townley and Kloos, 2011; Tsai et al., 2011; Whitley and Prince, 2005; Yanos, 2007). The relationship between mental health recovery and geographic mobility has also been examined (Chan et al., 2014; Townley et al., 2009; Vallée et al., 2011). Within much of this literature, place has been understood as a bounded local entity fixed in space and time. "
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    ABSTRACT: Photo-elicitation interviews (PEIs) were conducted to explore the role of place in recovery - specifically, narrative identity reconstruction - among persons with complex needs. PEIs with 17 formerly homeless adults with co-occurring disorders in New York City produced 243 photos. Content analysis of photos revealed three categories - apartment, neighborhood and people. Two narrative themes - having my own and civic identity - were mapped onto the apartment and neighborhood categories, respectively. Three additional cross-categorical narrative themes were identified: (re)negotiating relationships and boundaries, moving beyond old identities and future possibilities. Housing was central across themes. Understanding of recovery is enhanced when viewed through participant-controlled visual methods. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Health & Place 05/2015; 33. DOI:10.1016/j.healthplace.2015.03.002 · 2.81 Impact Factor
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    • "Pilot and feasibility studies have demonstrated the capacity of GPS to locate health behaviours, with a potential to better understand environmental influences [26]. For example, GPS units have been used to track travel patterns among adolescents [27, 28], analyze walking among adults [29], analyze bicycling routes in relation to existing road infrastructures [30], mobility patterns among older adults [31, 32], link mobility with mental health outcomes [33, 34], analyze active transportation [35–37] or relations between PA, and the built environment [38, 39]. GPS data have also been used to validate parent-reported questionnaires on children's activity locations [40], with results showing significant place misclassifications in parent-reported activity locations and times, thus underscoring the usefulness of GPS systems for obtaining reliable information on activities and locations. "
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    ABSTRACT: Background. While increasing evidence links environments to health behavior, clinicians lack information about patients' physical activity levels and lifestyle environments. We present mobile health tools to collect and use spatio-behavioural lifestyle data for personalized physical activity plans in clinical settings. Methods. The Dyn@mo lifestyle intervention was developed at the Sainte-Justine University Hospital Center to promote physical activity and reduce sedentary time among children with cardiometabolic risk factors. Mobility, physical activity, and heart rate were measured in free-living environments during seven days. Algorithms processed data to generate spatio-behavioural indicators that fed a web-based interactive mapping application for personalised counseling. Proof of concept and tools are presented using data collected among the first 37 participants recruited in 2011. Results. Valid accelerometer data was available for 5.6 (SD = 1.62) days in average, heart rate data for 6.5 days, and GPS data was available for 6.1 (2.1) days. Spatio-behavioural indicators were shared between patients, parents, and practitioners to support counseling. Conclusion. Use of wearable sensors along with data treatment algorithms and visualisation tools allow to better measure and describe real-life environments, mobility, physical activity, and physiological responses. Increased specificity in lifestyle interventions opens new avenues for remote patient monitoring and intervention.
    International Journal of Pediatrics 01/2014; 2014(9):328076. DOI:10.1155/2014/328076
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    • "Community integration refers quite simply to the notion that individuals with disabilities should have opportunities to live, work, engage with others, and enjoy recreational activities in the same manner as peers without disabilities (Wong and Solomon 2002). In addition to fostering the achievement of normative goals (e.g., employment, education , social support, successful community tenure), there is emerging evidence that community integration facilitates positive mental health, life satisfaction, reduced loneliness, and increased sense of acceptance from community members (Abdallah et al. 2009; Granerud and Severinsson 2006; Prince and Gerber 2005; Townley et al. 2009; Ware et al. 2007). "
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    ABSTRACT: Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted-focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.
    American Journal of Community Psychology 05/2013; 52(1). DOI:10.1007/s10464-013-9578-2 · 1.74 Impact Factor
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