Year of Award

2026

Document Type

Dissertation

Degree Type

Doctor of Philosophy (PhD)

Degree Name

Public Health

Department or School/College

School of Public and Community Health Sciences

Committee Chair

Jim Caringi

Commitee Members

Lindsay Benes, Maja Pederson, Jeff Peterson, Cherith Smith

Keywords

community based participatory research, Health as expanding consciousness, hermeneutic phenomenology, Homeless, photovoice, praxis

Abstract

Homelessness is a persistent public health challenge shaped by structural inequities, stigma, and exclusion from social and health systems. Community-Based Participatory Research (CBPR) has increasingly been used to center the knowledge of people who are unhoused, yet limited attention has been given to the theoretical frameworks guiding this work across disciplines. The purpose of this dissertation was to examine theories and methods used in CBPR with unhoused populations and to explore the extension of Margaret Newman’s Theory of Health as Expanding Consciousness from a nursing-focused theory to a public health framework for understanding lived experience.

Using a scoping review methodology guided by PRISMA-ScR, peer-reviewed CBPR and participatory studies involving unhoused individuals were systematically identified and analyzed. The review revealed that while equity-oriented and critical frameworks were commonly used, Newman’s Theory of Health as Expanding Consciousness had not previously been applied within public health homelessness research, identifying it as a novel theoretical contribution. Building on these findings, the theory was intentionally adapted to guide a CBPR Photovoice project with people experiencing houselessness, reframing health as a dynamic process of meaning-making, awareness, and pattern recognition situated within social and structural contexts.

Photovoice served as both a methodological and theoretical extension, supporting collective reflection, disruption of stigmatizing narratives, and knowledge generation at individual, community, and systems levels. The applicability and resonance of the theory were then evaluated through eight in-depth qualitative interviews, which examined participants’ experiences of meaning, growth, and expanded consciousness through engagement in the project. Findings suggested that participants demonstrated increased self-awareness, critical understanding of houselessness as a public health phenomenon, and recognition of the value of participatory research in fostering connection and agency.

This dissertation advances Newman’s theory beyond its traditional nursing roots and demonstrates its utility as a public health framework aligned with CBPR principles. By integrating theory, participatory method, and lived-experience evaluation, this work contributes a novel approach for advancing equity-focused public health research with unhoused populations.

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© Copyright 2026 B-Rad Stephen Applegate