Abstract
Individuals experiencing homelessness face significant health inequalities. They are often met with stigma and exclusion in everyday life, including in health and social care settings. As a result of this marginalisation, homeless populations can be unfairly labelled as ‘hard to reach’ and misrepresented in research. Public health research increasingly aims to address health inequalities by engaging vulnerable and excluded groups in the research process. However, researchers lack specific guidance on navigating ethical and methodological issues when conducting research with the homeless community. This paper discusses practical barriers to including individuals experiencing homelessness in research. It then presents an emerging framework that discusses relevant literature, best practices from adapted frontline homelessness health and social care support, and perspectives from those with lived experiences of homelessness. We propose a flexible framework adaptable to different research methods and realistic conditions encountered when working with homeless participants. The framework employs a stepwise approach to research design, based on principles of equitable involvement, safeguarding vulnerable populations, and empowering those experiencing homelessness. Starting with research inputs, the framework recommends expert collaboration and contributions from individuals with lived experience. During the research, it suggests that researchers consider (1) practical exclusionary factors, (2) minimising distress and re-traumatisation risks, (3) open communication and rapport, (4) maintaining professional conduct, (5) strong community partnerships, (6) informed consent in context, (7) intersectionality and tailored approaches. It also encourages (10) community dissemination and (11) advocacy for individuals experiencing homelessness regarding research outputs. The framework highlights the ethical and methodological considerations researchers need to address when including individuals experiencing homelessness in their studies. It is a broadly accessible resource for qualitative researchers designing projects involving populations experiencing homelessness within health and social care research.
Keywords
Introduction
Homelessness is a persistent and multifaceted societal issue (Gordon et al., 2024; Hovmand et al., 2019; Mitchell et al., 2023). This significant public health concern is closely linked to extreme poverty and exacerbates health inequalities (Begum et al., 2024; Marmot, 2018). A growing body of evidence demonstrates the intersection between homelessness and multiple adverse life events, leading to the concept of ‘multiple exclusion homelessness’ (England et al., 2024; Fitzpatrick et al., 2011). Many individuals experiencing multiple exclusion homelessness suffer from poor health, often at a much younger age than the general population (Mantell et al., 2023). Similarly, in Scotland, the average life expectancy for people experiencing homelessness is significantly lower than the general population, with estimates suggesting it’s around 45 years for men and 43 for women, compared to the national average of 79.4 for men and 83.1 for women (Scotland, 2024). Numerous factors may contribute to the premature death rates among homeless adults, including multiple long-term conditions, alcohol and drug dependence, and mental health problems (Tweed et al., 2021, 2022). Therefore, research on homelessness and health is complex and requires careful consideration, requiring researchers to address the above exclusion issues at every stage of study design and execution.
Barriers to Including People Experiencing Homelessness in Research
As people experiencing homelessness are generally positioned as ‘vulnerable’ within research relationships, there is a recognised need to transform research from a ‘top-down’ researcher-led encounter to a ‘bottom-up’ participant-led encounter (Aldridge, 2014; Norman & Pauly, 2013). Decades of ‘top-down’ research and policymaking have not ended homelessness, as the gap between those affected by policy and those developing it must be addressed to achieve meaningful solutions regarding the factors contributing to homelessness (Hub, 2016). Individuals who have experienced homelessness and housing vulnerability are uniquely qualified to inform research design (Lambdin-Pattavina et al., 2020; Norman & Pauly, 2013). However, when included in the research process, those with lived experience can often encounter unaddressed barriers that hinder active participation, such as power dynamics that foster a lack of confidence and mistrust in the research process (Čanigová, 2022). This article will discuss and propose ways to tackle these barriers by proposing a framework for researchers to ensure the inclusive participation of individuals experiencing homelessness.
Research on homelessness must consider contextual factors that may hinder participation in studies aimed at accurately representing the voices of those experiencing homelessness. A well-documented barrier to the involvement of individuals facing homelessness in research is their mistrust of the research process and those conducting the study (Lashley, 2024; Odoh et al., 2020; Rea, 2023). Homeless populations often encounter increased social, psychological, and physical risks due to the stigma associated with identifying as members of a homeless group, which renders them more reluctant to disclose their identities to researchers (Ellard-Gray et al., 2015; Rea, 2023). Additionally, research topics of a sensitive nature exacerbate the challenges researchers face in engaging homeless populations, as potential participants tend to be more reticent to take part (Edwards, 2021).
In homelessness research, some of the critical issues that investigators encounter include cognitive impairment, mental health and substance misuse disorders; challenges with transportation and scheduling; concerns regarding adequate compensation for study participants; the necessity of safety protocols for study staff; and issues related to protecting the wellbeing of these potentially vulnerable adults (Ojo-Fati et al., 2017).
However, little research describes the non-methodological, practical elements of existing studies that detail the incorporation of the lived experiences of people experiencing homelessness. Other factors that may hinder or facilitate the successful inclusion of this group in research include the geographic location of study sites, sampling and recruitment techniques, definitions of homelessness, and the involvement of participants in the design research. Considering these factors, funding and resources must be tailored to the needs of individuals experiencing homelessness who participate in research (Odoh et al., 2020).
Approaches to Including People Experiencing Homelessness in Research
In recent years, health and social care research has increasingly incorporated co-development and co-production approaches that involve those with lived experience (Kaehne et al., 2018; Masterson et al., 2022). Community-based participatory research, a research method gaining prominence in public health fields, involves community members as collaborators in the study design (Collins et al., 2018; Tobias et al., 2013). Recent systematic reviews suggest that this collaborative research model enables more effective, culturally relevant, and sensitive implementation compared to traditional research frameworks (Collins et al., 2018; Curry et al., 2021).
Researchers and practitioners have employed codesign approaches under various terms, including cocreation, coproduction, co-research, experience-based codesign, human-centred design, participatory research, and collaborative and community-based research (Bowen et al., 2013; Greenhalgh et al., 2016; Littlechild et al., 2014). The terms are linked to sets of core principles regarding the value of lived experience, collaboration, and building on the capabilities of all those involved (Moll et al., 2020; Slattery et al., 2020). Moreover, co-production in research seeks to involve the target audience in shaping its intended outcomes through the conceptualisation, delivery, and dissemination of the study (Filipe et al., 2017). Co-production prioritises enabling individuals with lived experience of homelessness to work safely outside the traditional research power dynamics by recognising the unique expertise and perspectives those with lived experience possess (“Promoting lived experience expertise in mental health research,” 2025). The ultimate aim is to integrate this knowledge in substantial and meaningful ways to create impactful research informed by real-life experiences (Slay, 2013).
While co-produced research is not sufficient in and of itself, it represents an important step in ensuring that the voices of people experiencing homelessness are heard within policy and academia (Hub, 2016). However, many argue that a significant portion of the ‘patient-oriented research’ in this area is still conducted with relatively little engagement or a low level of patient participation, who often have a minor advisory or consultation role and may be used in a tokenistic manner (Lanni et al., 2024). Thus, structural factors affecting research design and outcomes could benefit from a higher-level framework distinct from a single methodology to guide this input.
Aims: Towards Maximal Inclusion of People Experiencing Homelessness in Research
In this article, we aspire to contribute to the field of homelessness research by; (1) Highlighting the need for introducing a framework for researchers and organisations to aid the inclusive participation of people experiencing homelessness, regardless of the chosen methodology. (2) Discussing the literature we commonly engage with and through the lens of our experience as researchers, homelessness practitioners and the lived experience of homelessness and develop this into guiding principles for ethical inclusion of people experiencing homelessness in research in the UK. (3) Provide researchers with a broadly accessible stepwise working framework for planning, conducting and disseminating research for people experiencing homelessness underpinned by equity, empowerment and safeguarding.
Overall, we propose a flexible framework that can be adjusted to the research method and anticipates realistic conditions for conducting studies with homeless participants. Our aim is that this working framework will be further workshopped and dialogued within the research community and with experts by experience, and continue to evolve and change regularly with the research landscape
We foresee the framework aiding novice investigators in designing studies that avoid common barriers and pitfalls that hinder trust within marginalised communities and uphold the highest agreed standards of engagement.
Framework Development
Framework Conception
Applied Example of the Framework for Ethical Inclusion of People Experiencing Homelessness: ‘Evaluation of a Digital Resource for People Experiencing Homelessness in Scotland’
To achieve the research aim of the aforementioned study, the authors needed to recruit and retain participants who were often described as ‘hard to reach’ and who faced the intersectionality of multiple exclusionary factors. During the development of our study, we recognised the lack of practical guidance on how to develop and conduct research with individuals experiencing homelessness. Our initial academic literature searches revealed discussions on sampling the homeless population, but no comprehensive guidance for researchers within a UK context (17, 20, 39-41) (Appendix 1). We identified a gap for a practical guide to inclusion, to address ethical concerns, planning, design, data collection, dissemination, and research impact, specifically in the UK context. The design of our study required instruction beyond standard institutional guidance, which was tailored for conducting research with this particular population in Scotland. This prompted initial reflective discussions among the research team (EA, SWM, ED, CS, MW). EA has many years of experience working in front-line services in homelessness, and is undertaking a PhD supervised by SWM, ED, CS, and MW, who are senior academic researchers with extensive expertise in mixed-methods research in underserved populations, including people experiencing homelessness. SWM is also a general practitioner and has worked as a clinician in homeless and inclusion health services in Scotland. From the expertise and during the initial discussions, the research team proposed a set of core principles to underpin the framework.
Iterative Literature Searches
With the core guiding principles of equity, empowerment and safeguarding set (Figure 1), we began to outline some of the practical elements that were crucial to previous studies. We then discussed these developing considerations with the Lived Experience Consultant (LEC) (Section ‘Lived Experience Input'). When we had a rough draft of the framework components and common themes, we initiated an iterative process of exploring the existing literature and taking stock of the literature that we regularly cited in our work. Due to our professional backgrounds, several key references were attained by serendipity (Atkinson et al., 2015) (Appendix 4). While our search for literature iteratively spanned the entire course of the framework conception and development (Jan 2024 to March 2025), we aim to adhere to the reporting recommendations for literature synthesis proposed by Atkinson et al. (Atkinson et al., 2015). The terminology and reporting of citation searching uses the TARCiS Checklist (Hirt et al., 2024; TARCiS, 2025). The Framework’s Core Guiding Principles for including People Experiencing Homelessness in Research. The Three Principles are Equitable Involvement, Safeguarding Vulnerable Populations and Empowering People Experiencing Homelessness
Where there was a gap in our professional knowledge or we sought expansion from our seed references (Appendix 4-Seed References), we conducted small-scale scoping searches. For each search iteration, we search two databases (Medline and Scopus) to identify academic evidence specific to a framework subtheme. At the beginning of the study, Google Scholar was searched for the grey literature framework and throughout the development of the framework, we employed Advanced Google Searches. Similarly to the academic searches, the grey literature searches were conducted iteratively as necessitated by the iterative development of the framework. The authors recognise a further research need for a formalised systematic search of the grey literature and plan to do this during the next phase of the framework’s development. During the iterative literature searches, we sought to detail the practical approaches to assessing participant capacity, building community partnerships, and addressing researchers’ positionality to homelessness. We adopted our core principles and loose screening criteria during the informal screening process. In addition, the geographic context of the UK was prioritised during searching and screening so that the results were applicable to a UK context. Screening was conducted manually due to the small volume of relevant search results.
We wish to acknowledge the expertise and significant contributions of third-sector service provision organisations such as Homeless Link (Hub, 2016) and Homeless Hub (Hub, 2007) (Appendix 2), which have developed some guidelines specifically for engaging with individuals experiencing homelessness in an empowering manner. Some of these principles aligned with those we felt were appropriate for an approach to inclusive research (i.e., empowerment); others had to be adapted from a more service provision-centric approach to be applicable to inclusive research. However, where we can credit their original work, we have tried to do so throughout, including iterative citation searching.
After completing the iterative searches, we redrafted and reformatted the framework for a final time in collaboration with LEC and applied it to our study (Section 4).
Lived Experience Input
Our evaluative study (applied case study- Section 4) invited an individual with lived experience of homelessness to contribute to the design and conduct of our research. When discussing their role, they self-nominated the title of Lived Experience Consultant (LEC). As the work shifted towards developing and drafting the framework, we secured additional funding to remunerate additional LEC contributions. The first author held several meetings with the LEC at key stages of the development (as outlined aboves above) to propose the framework and provide an opportunity for them to suggest edits, additions and changes to the language. Notably, they proposed a simpler segmentation of the research phases depicted in the framework, which we adopted to keep the language accessible to a lay audience. Additionally, the final draft of the manuscript was reviewed and amended by the LEC.
A Framework for including People Experiencing Homelessness in Research
Framework Introduction
Following lived experience consultation, reflective discussion, implementation of our frontline professional learnings, and iterative literature searches, we proposed a working framework for including people experiencing homelessness in research. In the following sections, we outline the framework in a step-by-step and chronological sequence of the research process, each supported by the literature identified during development (Figure 2). The phases were developed inductively from literature and lived experience input (Section 2.3). The sequence represents and summarises the conception, conduct and completion of research projects. A Framework for the Ethical Inclusion of People Experiencing Homelessness in Research
In the following sections, we outline the framework in a stepwise and chronological sequence of the research process (Figure 2). The framework was underpinned by the guiding principles of equitable involvement, safeguarding vulnerable populations and empowering people experiencing homelessness (Figure 1). The authors recognised the necessity to foreground these particular guiding principles in addition to standard institutional ethics due to longstanding harmful power dynamics and the tokenistic involvement of people experiencing homelessness. First, ‘equitable involvement’ acknowledges that institutions have failed to adequately support individuals experiencing homelessness, which may compromise their trustworthiness in the eyes of potential participants, leading to downstream problems for study recruitment, retention, and data quality (Padwa et al., 2023; Woodhall-Melnik et al., 2018).
Second, homelessness can lead to experiences of marginalisation, dehumanisation, and exclusion (Magwood et al., 2020; Toolis et al., 2022). Therefore, research activities that support empowerment and help facilitate personal fulfilment and a sense of meaning derived from a research partnership are prioritised within the framework (Magwood et al., 2020; Padwa et al., 2023). Thirdly, within homelessness services, ‘safeguarding’ is often understood broadly as ensuring people’s safety. However, impactful research requires a radical social justice perspective on safeguarding, adding an important dimension to the framework. A radical approach to safeguarding requires careful reflection on the participant’s experiences and a critical consideration of the broader context for safeguarding, including their experiences of and responses to social inequalities and injustices (Taylor, 2024). To transparently demonstrate how this framework upholds the three core ethical principles of equity, empowerment, and safeguarding, the framework’s summary diagram (Figure 2) highlights which components promote each of these pillars.
Framework Anchor
Lived Experience Input
People are homeless because of deep societal inequalities. For people with lived experience of homelessness, these injustices and inequalities are visible, while for those with privilege, they may be more difficult to perceive (Hub, 2016). Impactful research will only be possible if lived experience priorities and insights are brought to the forefront (Barker & Maguire, 2017). Partnering with individuals who have personally experienced homelessness can enhance many phases of the research process, particularly ones that are challenging for scholars (Padwa et al., 2023). Therefore, lived experience input is present at every research stage of the proposed framework and is coined ‘the anchor’ to all the proposed approaches (Figure 2).
The lived experience of homelessness is a complex phenomenon, given the vast array of unique experiences across multiple types of homelessness (Barker & Maguire, 2017). Despite the wide range of experiences of people experiencing homelessness, all experiences are valid and valuable for involvement in research (Fletcher et al., 2022). However, sharing potentially emotive experiences can retrigger trauma and how it may impact an individual’s sense of psychological safety (McGeown et al., 2023). Therefore, research teams should ensure that lived experience input is supported and prioritises the well-being of the person sharing their experiences (Crooks et al., 2024). An extensive list of trauma-informed recommendations for incorporating lived experience into research is provided by McGoewn et al. (Appendix 3) (McGeown et al., 2023).
To maximise the inclusion of people who experience homelessness in research, the framework recommends incorporating lived experience input into research planning and design. This is a common feature of co-production (Link, 2022). Homeless Link defines co-production as a strengths-based approach – that means empowering people with lived experience to recognise their strengths and talents and ensuring professionals recognise those strengths. It is proposed that there are five degrees of lived experience: informed by research, consulted by researchers, engaged in the research project, co-designing the research, and co-producing research (Link, 2022). This highlights that, where co-production is not a feasible study design, alternative means exist for incorporating lived experience input into research design. This framework encourages co-production, but it sets a minimum standard for involvement at all stages. As discussed in Phase 2 (below), lived experience input is essential in understanding the practical challenges in recruiting people experiencing homelessness, including mistrust of institutions, informed consent, and attrition. Finally, in Phase 3 (below), in line with the’ nothing for us, without us’ principles, the research impact should be informed and produced in partnership with lived experience (Hub, 2016).
Regardless of the mechanism for involvement, the value of an individual with lived experience must be equivalent to that of any other contributor to the research project. For this essential input, researchers should anticipate the compensation and support required to properly include individuals with lived experience (Hub, 2016). The guiding ethical principle in remuneration for participation in research is that compensation should not be so high as to be coercive but should reflect the value of the input (Garcia et al., 2013).
Phase 1: Research Design
Expert Collaboration
Social support services and street outreach advocates can often be significant assets in studies involving homeless populations. Additionally, outreach advocates provide valuable insights about the target population, and understanding this population in advance is essential for conducting ethical research (Castañeda & Smith, 2023).
Researchers should consider partnering with third-sector organisations to discuss the feasibility of the planned research. Including social support workers with extensive experience working with individuals experiencing homelessness in the research team could provide valuable ongoing insights throughout the project’s duration (Massie et al., 2018). Furthermore, researchers could consider formally enlisting the assistance of mental health and public health professionals, as well as academic experts on the topic, as contractors and advisors during the research conception phase. Alternatively, they may informally consult with local grassroots organisations if deemed more appropriate in the context (Greene, 2022). Whether informal or formal, such collaboration should be transparently agreed upon by both parties, fairly compensated, and meaningfully discussed in research papers (Hub, 2016).
Phase 2: Recruitment and Data Collection
During participant recruitment and data collection, the framework outlines several special considerations that should be given to participants experiencing homelessness to maximise inclusion (Figure 2).
Practical Exclusionary Factors for People Experiencing Homelessness
Research on homelessness needs to account for contextual factors that may inhibit study participation (Padwa et al., 2023). For the ethical inclusion of people experiencing homelessness, research must address resources and assess barriers in the population.
Assess Barriers
Researchers may find that access challenges exist within the homeless population due to various physical, emotional, and social difficulties, such as living in remote or unstable locations, dealing with stigmatising conditions, and experiencing social isolation (Crooks et al., 2024). To address this issue, several authors have commented on sampling within the homeless population (Barker & Maguire, 2017; Crooks et al., 2024; E. Toolis et al., 2022). Authors should make flexible and relevant decisions based on qualitative or quantitative methods.
A further ethical consideration for individuals experiencing homelessness is that they typically lack access to private space and spend much of their lives in the public realm (Runnels et al., 2009). Researchers do not have special rights or privileges to intrude into the lives of those who are homeless simply because they are in public spaces such as parks, town centres, and pavements. Researchers must demonstrate respect for the right to privacy and security of people who are homeless; this right must be reflected in recruitment methods and research methodology (Hub, 2023). Additionally, flexibility in scheduling data collection appointments, courteous and caring messaging, and frequent contact have all contributed to reducing attrition in research studies involving individuals experiencing homelessness (Bonevski et al., 2014).
Resource Barriers
Practical barriers frequently hinder vulnerable populations from participating in research or other research interventions (Bonevski et al., 2014; Lashley, 2024). Resource constraints on participation include the lack of transportation, insufficient childcare, and the necessity to prioritise basic survival while managing competing demands over research involvement (Chevreau et al., 2021; Lashley, 2024). Researchers should consider addressing these issues in their planning and budgets as a practical approach to inclusivity. For instance, small transport or childcare grants, as a standard practice, could facilitate more equitable participation. Furthermore, those without reliable access to email or phones find it significantly more challenging to schedule and follow up (Ellard-Gray et al., 2015). Multiple methods of communication for participants, including telephone, email, postal address, and contact persons such as community gatekeepers or support workers, can assist with this (Odierna & Schmidt, 2009).
Minimising Distress and Risk Re-traumatisation
Many individuals experiencing homelessness lead complex lives marked by violence, abuse, and trauma (Wiewel & Hernandez, 2022). While researchers should exercise caution against generalisations, it is estimated that up to one-third of homeless adults face some form of mental illness, with rates of depression and suicide significantly higher among this population than in the general public (Tweed et al., 2022). Researchers engaging with homeless individuals must acknowledge that participants may be grappling with various mental health issues, trauma, distress, or depression, and they should take proactive measures to avoid imposing further mental strain or distress (Adams et al., 2022; Rennels & Purnell, 2015). Ensuring that any involvement in research concerning the emotive and personal aspects of homelessness is safe, supportive, and prioritises the individual’s wellbeing is crucial. Adopting a trauma-informed approach is fundamental to this (Bransford & Cole, 2019; Crooks et al., 2024).
Trauma-informed recommendations for researchers encompass training (see the Professionalism and Conduct section), collaborative research designs, consideration of the environments in which research is conducted, awareness of distress management approaches, and the integration of trauma sensitivity into research policies, frameworks, and leadership. It is also essential to remain vigilant regarding interpersonal approaches and establish and protect psychological safety throughout the research process (Isobel, 2021; McGeown et al., 2023).
Researchers must be attuned to the potentially stressful impact of their activities, monitor the responses of research participants, and ensure that necessary support is available should research questions, the research experience, and/or the conduct of the researcher lead to episodes of distress. Support may include ensuring that research participants have access to, and are informed about, counselling and assistance following the research encounter (Hub, 2023).
Research participants may experience temporary distress while responding to questions about traumas or traumatic topics. Conversely, others report personal benefits, such as feelings of validation, catharsis, or altruism, from the research process and advocate for the continuation of such projects. Therefore, researchers must also permit individualised and self-actualised approaches to participation for people experiencing homelessness (Hub, 2007; Runnels et al., 2009). The homeless hub offers a valuable overview of paradigms for best practices in trauma-informed research (Hub, 2007) (Appendix 5).
Open Communication and Rapport
Individuals experiencing homelessness are more likely to have communication needs than the general population (Andrews & Botting, 2020). The National Institute for Health and Care Excellence (NICE) has produced national guidance for health and care professionals working with individuals experiencing homelessness, emphasising the importance of using appropriate language and tailoring communication to individual needs (Guideline NG214, 2022). Researchers must be aware of the increased risk of communication difficulties and complex trauma in homeless populations (Ward et al., 2023). For example, participants may not be fully aware of the significance of the research and the importance of including marginalised groups in the study. The researcher needs to provide messaging that communicates to key constituents and communities of interest the importance of the study (see informed consent) (Lashley, 2024). Below, several other communication factors are discussed.
Rapport
Researchers should establish rapport with potential participants before attempting to recruit them, which can help alleviate participant mistrust of the research process (Ellard-Gray et al., 2015). Working with trusted partners may aid and expedite this process. However, researchers cannot assume that community organisations will have the time, resources, or willingness to assist with relationship building or recruitment, even if the organisation or its patrons are likely to benefit from the research (Ellard-Gray et al., 2015).
Transparent and Fair Compensation
There are no clear guidelines for determining the appropriateness of incentives, resulting in significant variation in monetary amounts for research payments, even within the same study (Garcia et al., 2014). Therefore, researchers should involve individuals with lived experience in deciding on compensation methods for their research (Link, 2022). The boundaries surrounding the offering of support and assistance, including the use and extent of incentives, should be carefully evaluated and incorporated into the development of a written research protocol (Umamaheswar 2018). Furthermore, engaging in open and transparent discussions with participants is essential to ensure that compensation will not adversely affect their current benefits (NIHR, n.d).
Assurances of Confidentiality
Here, confidentiality refers to the ethical practice of protecting the personal information of individuals experiencing homelessness who participate in research studies, ensuring their identities remain private and their sensitive details are not disclosed without their consent. Communication in this process is crucial due to the vulnerability of this population and the potential risks associated with disclosing personal information, which could impact access to services or safety (Dickins, 2025). When study samples are recruited from small or closed communities, ensuring confidentiality and anonymity becomes more challenging. Therefore, researchers should carefully consider any identifying factors that may be included in published findings (Lashley, 2024).
Additionally, persons engaged in illegal behaviours may fear public exposure (Bonevski et al., 2014). Individuals may have concerns that participating in a research study could expose them to potential discrimination or legal repercussions (Lashley, 2024). Researchers should clearly communicate that any illegal disclosures made during data collection cannot be concealed to deter this matter from occurring altogether (Ellard-Gray et al., 2015).
Upholding Professional and Sensitive Conduct
The complexity of homelessness necessitates that researchers possess some understanding of the lived experience of homelessness before commencing their involvement, as naivety and a lack of preparedness can potentially be dangerous or harmful for all involved (Crooks et al., 2024). Academic researchers may find it beneficial to gain “experiential knowledge” and begin to comprehend the realities of homelessness through proxy exposure to individuals’ experiences (Blackburn et al., 2018). To collect data ethically, investigators must understand the homeless condition adequately and move beyond society’s stereotypes. Therefore, cultural competency training is a crucial component of research staff training. This staff training may include guidance on addressing bias, redirecting a participant’s attention, approaching emotionally charged topics, and managing emotional distress. Techniques may include debriefing and role-play (Chevreau et al., 2021). Researchers may engage peer researchers who have experienced similar marginalisation to assist with data collection, such as conducting interviews and providing emotional support throughout the interview process (Brown et al., 2020).
Further, training research staff in various additional day-to-day challenges this population encounters and their relationship to professional boundaries is vital. For example, clarifying how to discuss participant incentives and the practice of offering study remuneration may be perceived or interpreted as coercive (Ojo-Fati et al., 2017). People in homeless situations are dehumanised in their everyday lives. By listening to them and treating respondents as human beings with valuable contributions, an investigator can contribute to building self-respect and hope (Castañeda & Smith, 2023).
Strong Community Partnerships
Researchers should adopt a community-driven approach to understand better the community’s needs and values (Garcia et al., 2014). This could involve co-production, participatory action research, or comprehensive guidance on data collection from community organisations (Dickins, 2025). Collaborating with trusted organisations can help alleviate hesitancy or mistrust of the research process. Staff members offer valuable insights into the population, provide practical support and suggestions, and can be regarded as genuine partners in research (Chevreau et al., 2021).
Phase 1 seeks expert input well in advance of data collection or recruitment. However, strong community partnerships are incorporated in Phase 2 of the framework to foster ongoing, sustainable relationships that promote bilateral trust and benefit. To build trust within the community, researchers must demonstrate transparency in all decision-making and actions taken (Runnels et al., 2009). Researchers conducting community engagement should strive to establish (or maintain) substantive and meaningful relationships. Representatives from the organisation(s) should seek to co-create a collaborative approach. The time required for engagement is typically substantial and needs to be supported with resources (Hub, 2023). Frequent engagement throughout the research process keeps community partners informed and up-to-date (Bonevski et al., 2014). For ongoing community engagement, researchers must devise an effective mechanism for updating the community and establishing a channel for receiving suggestions. For instance, a community advisory group can provide key stakeholders with a dedicated space to offer recommendations and advice (Runnels et al., 2009).
Convenience samples may be obtained through collaborations with community organisations and drawing from their client base (Hoppitt et al., 2012; Lashley, 2024). However, participants recruited through partner organisations should be reassured that if they decide not to participate, it will not impact their existing support from these organisations (Chevreau et al., 2021).
Informed Consent in Context
The concept of informed consent, which entails educating participants about the potential benefits and risks associated with participating in a study are regarded as the foundation of ethical research (Sutrop & Lõuk, 2020). Researchers must ethically determine whether participants can assess any potential benefits or harms resulting from their decision to participate in research. For individuals experiencing homelessness, developmental or mental health issues may impair judgment and decision-making (Clapton et al., 2014; Iacono & Murray, 2003; Morton & Cunningham-Williams, 2009). Additionally, substance use disorders (SUDs) are more prevalent among those experiencing homelessness compared to the general population (Aldridge & Charles, 2008; Stablein et al., 2021; Tweed et al., 2022). Therefore, there is an increased likelihood that a participant may be incapacitated due to excessive alcohol or drug use and may not be able to provide informed consent (Aldridge & Charles, 2008). Importantly, in these circumstances, researchers should acknowledge that the capacity to consent is not stable but can vary depending on the context (Runnels et al., 2009). Consequently, decisions regarding the inclusion of participants with physical, mental, or cognitive impairments may need to be based on screening assessments conducted in the field (Taylor, 2014). Researchers should design and implement protocols for managing participants with identified physical or mental health concerns arising from these screenings. The protocol should include referrals to community resources equipped to address these concerns. For example, the research team could partner with a mental health professional to provide services who would be available to meet with participants or research team members to address mental health concerns that may arise during the study (Lashley, 2024).
The primary purpose of informed consent is to ensure that the subject has a sufficient opportunity to consider participation and that the information is presented in language understandable to the subject (Sutrop & Lõuk, 2020). Low literacy may also complicate informed consent, making participants uniquely vulnerable on multiple levels (Runnels et al., 2009). Thus, research information and consent forms should be written at a level and in a language that is comprehensible to the participant; adequate informed consent is attained, and no ethical violations occur (Gounis, 1996). In addition, researchers could provide a verbal synopsis of the informed consent form before presenting it to participants to read, ensuring they have understood it through simple questioning or by reviewing the consent form with them (Runnels et al., 2009). Despite the assumption that people experiencing homelessness are substance dependent or experience mental illness, most individuals experiencing homelessness are capable of understanding and responding to documents asking for informed consent (Castañeda & Smith, 2023).
Intersectionality and Individualised Approaches
People experiencing homelessness are a demographically, geographically, and experientially heterogeneous population (Lanni et al., 2024; Matthews et al., 2019). To promote inclusive and ethical research, participant researchers must grasp these intersectional challenges and overlapping inequalities [36, 37]. Mistrust in the research may also be exacerbated by failing to consider this intersectionality (Winker & Degele, 2011). Winker and Degele’s multilevel intersectional analysis framework examines how homeless identities are discursively and symbolically constructed within social policy, shaping institutionalised and systemic barriers to approaches concerning homelessness (Winker & Degele, 2011). Therefore, cultural responsiveness and tailored adaptations are critical for ensuring practices effectively include the entirety of the spectrum of the experiences of homelessness.
When conducting research with people experiencing homelessness, researchers must account for race, ethnicity, gender, sexual identity, age, disability, and criminality in conceptual frameworks, methods, and analysis as part of protocol development (Heaton, 2025; Otiniano Verissimo et al., 2023; Robinson, 2023). For additional consideration, Heaton et al. make several intersectional recommendations for research (adapted): (1) Apply an intersectional-conscious framework to inform decision-making throughout the research process and guide the study’s conceptual model, (2) Specific reporting on how intersectional categories are conceptualised, operationalised, and defined, (3) Situate results within the larger context of systemic marginalisation and stigmatisation (Heaton, 2025). Homelessness researchers could apply these adapted recommendations to their work to foreground intersectionality
Practically, intersectional identities can make certain homeless populations ‘harder to reach’ or ‘invisible’, notably women of colour and individuals from the LGBTQ + community (Cronley, 2022; Fraser et al., 2019; Hess et al., 2025; Robinson, 2023). One possible practical consideration to ameliorate the challenge of inclusion is partnering with the non-mainstream ‘safe spaces’ often created by voluntary organisations (Hess et al., 2025; Magill, 2023). Safe spaces assume that not every service will cater for the heterogeneity of marginalised populations and promote identity-affirming specialist support (Benbow et al., 2019; Brais & Maurer, 2022).
Phase 3: Impact
This framework posits that the work done after data collection and analysis is equally as important as the measures taken during the research period. The framework aims to create a stronger link between homelessness research, policy, and practice as a priority throughout the research process (Gaetz, 2014). However, the knowledge of how to mobilise research for a more significant impact on policy and practice is not as well understood for conceptual, methodological, and historical reasons (Davies et al., 2005; Moll et al., 2020). Practical approaches to knowledge mobilisation and inclusive research impact must not only seek to reimagine how research content is produced and distributed but must also address the barriers that users face in accessing and utilising research knowledge. Barriers include lack of time, resources, skills, organisational support, and the perception that research is not valuable, timely, or relevant (Davies et al., 2005).
The framework outlines two significant milestones that all researchers exploring homelessness should be able to demonstrate upon completing their research.
Dissemination to Stakeholders
As with participatory research methods, this framework emphasises the accessible dissemination of research findings back to the community (Isobel, 2021). Firstly, communicating study findings can help alleviate some marginalised groups’ mistrust of research (H. McGeown et al., 2023). For instance, Dickins (2025) states that participants desired to know upfront what types of data would be collected, how it would be collected, for what purposes, and, once collected, how it would be managed and disseminated. Sharing this information was crucial in ensuring that participants felt their privacy and confidentiality were protected, thereby reducing the sense of potential danger associated with trusting the research team (Dickins, 2025). Corbie-Smith et al. (2004) suggested relaying research results in formats that are accessible to and useful for the community being researched (Corbie-Smith et al., 2004).
Dissemination approaches can centre on providing easily accessible summaries of the study to participants and service users, and these are currently being created, including short briefings, videos, press releases, and items in relevant newsletters (Foster et al., 2021).
Advocacy for People Experiencing Homelessness
Provided that researchers are committed to engaging with vulnerable participants in more inclusive and democratic ways, personal and philosophical tensions will inevitably need to be addressed (Moll et al., 2020). Researchers must consider how to secure funding for and conduct studies that do not easily fit into established agendas or academic demands. They should also explore ways to challenge dominant research design and production modes when employing methods and approaches that often conflict with recognised ‘ways of doing’ research. Data collection should not be viewed merely as a means to an end but rather as a process of engaging with often-silenced groups. Researchers can make a positive impact on the well-being of these groups (Ellard-Gray et al., 2015).
In the context of applied or social action research, where the aim is for the research to be transformative in some manner, researchers must also negotiate ways to remain faithful to the experiences and needs of homeless research participants, as well as how to represent their needs appropriately and accurately. Additionally, they must develop strategies to ensure that the messages derived from the research can effectively advocate for evidence-based, person-centred solutions (Kanak et al., 2023).
Important Stipulations
In developing the framework, the authors have endeavoured not to generalise about the homeless population. However, we have highlighted prevalent issues as they raise awareness and encourage mindfulness regarding the marginalisation and vulnerability of many individuals experiencing homelessness within this framework. It is crucial that researchers, and consequently research designs, avoid incorporating assumptions and stereotypes that mainstream society has internalised regarding those who are homeless. Our aim is for this framework to foster the genuine and meaningful inclusion of individuals experiencing homelessness in research; therefore, we have sought to provide tangible actions rather than tokenistic or performative gestures.
Framework Applied: Evaluation of a Digital Resource for People Experiencing Homelessness in Scotland
To exemplify the framework, we describe our study as a case study in which the first author applied the framework detailed in the previous section. The framework was conceptualised and developed during the planning of our mixed methods, predominantly qualitative study, which is yet to be published. The study evaluated the experiences of older people experiencing homelessness with a digital signposting platform in Scotland. The authors recognised the intersecting vulnerabilities of this population and the need for an inclusive approach. Table 1 summarises how the framework was applied to our study and provides practical examples to illustrate the component principles and phases of the framework. At the time of writing, the impact phase of this is ongoing and therefore detailed in the future tense here.
Throughout the summary table, we have attempted to reference where the approach or principle of the approach has been adapted from (i.e literature in the above framework description). Where there is no citation, the approach comes from reflective discussion with the research team and the lived experience consultant.
Limitations and Future Work
Limitations
To the best of our knowledge, this paper is the first of its kind to synthesise, summarise, and present all the practical factors of including people experiencing homelessness in research within a proposed framework for researchers. However, it has some limitations. While lived experiences offer valuable input, they come from a single source. Moving forward, to better address intersectionality, we plan to workshop the framework with a larger, more diverse group of individuals with lived experiences.
The development of the framework was initially driven by a recognised need in our own work. As a result, much of the relevant literature was explored iteratively prior to creating the framework. Due to the immediate nature of the process and constraints of time and resources, a formal systematic review of the literature was not undertaken. This means some potentially significant sources might have been missed. Additionally, a few key references were found by serendipity, which introduces a risk of selection bias. This underscores the importance of carrying out a systematic review of both academic and grey literature, following set inclusion criteria, rather than relying on an iterative approach. The authors note that research on homelessness increasingly adopts co-production and participatory action approaches. As previously stated, we intend the framework to complement these approaches and be diverse enough to adapt to other methodologies. Lastly, the primary focus was on the UK; future adaptations of the framework will aim to be flexible across different contexts.
Future Work
As previously stated framework was developed through a single research project. While the research team pooled their collective expertise, there is a need to workshop the framework more extensively with other dedicated professionals in the field. In future work, we aim to expand the input to better reflect the research community it serves. The framework suits our qualitative, one-off, semi-structured interview methodology. By collaborating with a broader network of researchers, we aim to refine and expand the framework to accommodate other methods more effectively.
Individuals with substantial experience in homelessness research may possess an intrinsic understanding of all the considerations; however, we aimed to identify and compile these principles to serve as a resource for novice and seasoned researchers. Our framework is designed to encompass the fundamentals of inclusion, and we hope it can be periodically updated and adapted to reflect the current landscape and best practices in homelessness research. The introduction of this framework is presented as an open discussion regarding the inclusion of people experiencing homelessness in research.
Conclusions
This framework is the first to attempt synthesising available literature, integrating lived experience and professional insight to create an accessible and practical tool for supporting the more equitable inclusion of people experiencing homelessness in research in the UK. We posit a framework that anchors (1) lived experience input at every research phase. (2) Expert collaboration, along with input from lived experience, during the research design. During data collection, we propose researchers consider (3) Practical exclusionary factors for people experiencing homelessness, (4) Minimising distress and risk re-traumatisation, (5) Open communication and rapport, (6) Upholding professional and deft conduct, (7) Strong community partnerships, (8) Informed consent in context (9) Intersectionality and individualised approaches. Similarly, in research outputs, the framework prompts (10) community dissemination and (11) advocacy for people experiencing homelessness. This framework guides researchers who aim to engage with homeless populations. We have endeavoured to outline and provide solutions to some of the practical challenges one may encounter. The framework aims to enable researchers to proactively design their studies around the unique needs of people experiencing homelessness, allowing for equitable, empowering and safe inclusion in research. The proposed framework is flexible and is presented as part of the ongoing dialogue on homelessness research that seeks to promote the inclusion of people experiencing homelessness. The introduction of this framework is presented as an open discussion to the homelessness research community, and the authors envisage a ‘living framework’ that continues to adapt and iterate periodically with the research landscape.
Supplemental Material
Supplemental Material - Towards an Inclusive Research Framework for People Experiencing Homelessness
Supplemental Material for Towards an Inclusive Research Framework for People Experiencing Homelessness by Emily Adams, Kevin Chalmers
Footnotes
Ethical Consideration
The exemplar study referenced was granted ethical approval by the Edinburgh Medical School Research Ethics Committee (EMREC) and underwent a sponsorship review by the Academic and Clinical Central Office for Research and Development (ACCORD), a joint office between the University of Edinburgh and NHS Lothian, in October 2024.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the Legal & General Group, which provided a research grant to establish the independent Advanced Care Research Centre at the University of Edinburgh. The funder had no role in the conduct of the study, interpretation, or the decision to submit for publication. The views expressed are those of the authors and not necessarily those of Legal & General.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Disclaimer
The views expressed are those of the authors and not necessarily those of Legal & General.
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