Impact of Social Determinants on Parent Sense of Competence in Mothers Experiencing Homelessness or Housed Poverty

PURPOSE: Families constitute 34% of the homeless population and typically include a female single parent. In the United States, 2.5 million children are homeless. Occupational therapy emphasizes ecological perspectives and, more recently, social determinants as critical influences on clients’ health and well-being. Assessing social determinants enhances providers’ perspectives of marginalized populations and occupations such as parenting young children who are homeless. This study explored the influence of social determinants on mothers’ parent sense of competence (PSOC), including cognitions of self-efficacy and satisfaction as a parent. Maternal social determinants included mother’s age, housing status, number of children, residential moves, employment, relationship status, and education. Three questions were asked: Do mothers’ social determinants and PSOC differ between mothers who are homeless and mothers who are poor but housed? What is the relationship between social determinants and PSOC in mothers who are homeless or poor but housed? Does one or a combination of social determinants predict mothers’ PSOC?

METHOD: In this two-group cross-sectional design study, participants included 45 homeless and 46 low-income housed mothers with a preschool child. A social determinant scale and the PSOC scale were administered to all mothers. The 16-item PSOC scale has a maximum score of 96. Descriptive and inferential statistics, including t test, chi-square, correlation, and multiple regression, were used to evaluate the data.

RESULTS: Mothers who were homeless had experienced a greater number of moves (p < .001), more abuse (p < .01), less employment (p < .001), and less stable primary relationships (p < .01) and were less likely to be a student (p < .001) than mothers who were poor but housed. Age, ethnicity, number of children, education level, and time spent in foster care of homeless mothers were no different from poor housed mothers. Homeless mothers scored lower on the PSOC satisfaction score (p < .01) and the PSOC total score (p < .05). In contrast, there was no difference in PSOC self-efficacy score between the two groups of mothers. Housing (r = .29, p < .001; r = .27, p < .01) and employment (r = .31, p < .001; r = .27, p < .01) were associated with greater satisfaction and total PSOC scores, respectively. Fewer mother moves (r = –.29, p < .01) and greater education (r = .18, p < .05) were associated with higher PSOC total scores. No significant main effect differences were found (analysis of variance) between the two housing groups among any of the social determinant predictor variables of the regression model.

CONCLUSION: Homeless mothers’ dissatisfaction with parenting may result from a lack of permanent housing or partner support or from mandatory school, work, or shelter requirements. Homeless mothers face challenges in providing the basics of shelter and food for their children, possibly impacting parenting satisfaction. While no one social determinant predicted PSOC in mothers, either homeless or poor but housed, a stable relationship, no abuse, fewer moves, employment, and increased education appear to provide a positive influence PSOC. Findings support the inclusion of social determinants in the assessment of parenting occupations and family-centered intervention strategies and involvement of parents as informants in planning home, school, and community programs for homeless families.

IMPACT STATEMENT: Inclusion of social determinants in practice expands occupational therapy perspectives of the environment’s impact on PSOC and mothering critical to health and well-being, particularly for marginalized populations such as mothers and children who experience homelessness.