Dissertation
Understanding empowerment in permanent supportive housing: a mixed methods examination of tenants' experiences and outcomes
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Spring 2026
Abstract
Chronic homelessness continues to rise in the United States, often leaving individuals feeling powerless due to systemic barriers and disempowering service experiences. While permanent supportive housing (PSH) is widely regarded as an effective and empowering intervention, research examining its impact on tenant empowerment is fragmented. Without a comprehensive understanding of how PSH supports or hinders empowerment, service providers may unintentionally undermine the empowerment process. In response, this study explores the construct of psychological empowerment within the context of permanent supportive housing. This study aims to understand (1) the effect of permanent supportive housing on perceived empowerment scores and (2) tenant experiences of psychological empowerment over time. Using a convergent mixed methods design, this study conducted a secondary analysis of data from a longitudinal, quasi-experimental PSH program evaluation. I used mixed multilevel modeling to assess changes in empowerment. I used framework analysis and a priori codes based on the psychological empowerment framework and a longitudinal change matrix to guide the qualitative analysis. Finally, I integrated the qualitative and quantitative results to provide a summary of tenants’ changes in perceived empowerment over time in PSH.
I found no significant difference in empowerment between single-site PSH tenants and the comparison group over time. However, qualitative analysis identified immediate and gradual changes in tenants’ psychological empowerment, reflected in improved autonomy over daily living activities, skill development, health-related behavioral changes, and collaborative relationships with PSH staff. Tenants’ experiences also highlighted personal, community, and structural factors outside the intervention that impact empowerment, including personal health, stigma, and the availability of transportation and affordable housing.
This study offers a more comprehensive illustration of psychological empowerment and how it changes over time in PSH. Results show that this intervention affects empowerment in ways beyond choice in housing and services. Dissonance between the qualitative and quantitative results underscores the challenge of measuring complex constructs and suggests that the empowerment scale may not be sensitive enough to detect meaningful changes in this population and context. Future research should develop and test a modified empowerment scale tailored to this setting to more accurately identify empowerment and capture changes over time.
Details
- Title: Subtitle
- Understanding empowerment in permanent supportive housing: a mixed methods examination of tenants' experiences and outcomes
- Creators
- Abigail Heaton
- Contributors
- Aislinn Conrad (Advisor)Megan Gilster (Committee Member)Miriam Landsman (Committee Member)Shannon L Watkins (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Social Work
- Date degree season
- Spring 2026
- Publisher
- University of Iowa
- Number of pages
- xiv, 190 pages
- Copyright
- Copyright 2026 Abigail Heaton
- Language
- English
- Date submitted
- 04/28/2026
- Description illustrations
- color illustrations
- Description bibliographic
- Includes bibliographical references (page 128-147).
- Public Abstract (ETD)
People with disabilities who have been homeless for a long time often feel powerless to make changes in their lives. Permanent supportive housing (PSH) is an empowering program that provides long-term housing with supportive services. However, research on how PSH affects empowerment is limited. Without understanding how PSH supports or restricts empowerment, service providers may unintentionally work against tenants’ efforts to gain control over their lives.
This study looks at how PSH affects tenants’ empowerment over time, using both a validated measurement tool and tenants’ experiences gathered through repeated interviews over three years. Overall, I found that PSH improves tenants’ empowerment and supports their efforts to live the lives of their choosing; however, tools used to measure empowerment among people who have experienced chronic homelessness must be relevant to their life experiences to detect changes.
- Academic Unit
- School of Social Work
- Record Identifier
- 9985176870502771
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