Kennedy, Fiona and Murray, Deirdre and Ní Cheallaigh, Clíona and Romero-Ortuno, Roman and Gavin, Sinéad and Broderick, Julie (2026) Exploring the impact of targeted exercise in women experiencing homelessness, addiction and mental health challenges: a mixed-methods feasibility study. BMJ Open, 16, (2), e103060. https://doi.org/10.1136/bmjopen-2025-103060.
External website: https://bmjopen.bmj.com/content/16/2/e103060.long
OBJECTIVE: Low physical functioning and frailty are prevalent in non-geriatric vulnerable populations such as people experiencing homelessness, addiction and mental health challenges. The objective of this study was to explore the feasibility and impact of a targeted exercise intervention with protein supplementation for women experiencing homelessness, addiction and mental health challenges.
DESIGN: Mixed-methods feasibility study in women's-only day service for people with homelessness and addiction issues, in Dublin, Ireland. Participants were women experiencing homelessness, addiction and mental health challenges.
INTERVENTIONS: The intervention was a 10-week supplementation pre-post programme (LEAP-W). Qualitative interviews were conducted following the intervention with programme participants and key stakeholders.
PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was feasibility measured by recruitment, retention, adherence, safety and acceptability, and secondary outcomes measured pre-post intervention change in physical function, pain, nutritional and frailty status, and overall health status.
RESULTS: Overall, 33 participants were recruited. Data generated demonstrated that LEAP-W was feasible by its safety, acceptability and high retention in certain subgroups, and high adherence to the exercise and protein supplement; its impact was demonstrated by pre-post intervention improvement in multiple domains (strength (chair stand test), balance (the single leg stance test), pain and quality of life/mental health (mental component summary of the Short Form-12; 95% CI, p<0.05)). Three themes emerged from the qualitative inquiry: (1) the power of exercise; (2) challenges to engagement and (3) the LEAP approach, driven by the trauma-informed and low threshold approach.
CONCLUSION: Targeted exercise interventions with trauma-sensitive, flexible design can be successfully delivered and yield impact in women with complex needs who experience homelessness, addiction and mental health challenges. Service design should be considered when delivering interventions to this population. Further higher-powered longitudinal studies are warranted.
F Concepts in psychology > Psychological stress / emotional trauma / adversity
G Health and disease > State of health > Mental health
G Health and disease > Substance use disorder (addiction)
HJ Treatment or recovery method > Alternative treatment method (holistic)
HJ Treatment or recovery method > Recreation therapy (bibliotherapy, music, dance, drama, play, art, sport, exercise)
HJ Treatment or recovery method > Treatment outcome
J Health care, prevention, harm reduction and treatment > Treatment and maintenance > Treatment factors
J Health care, prevention, harm reduction and treatment > Type of care > Mental health care (Psychiatry / Psychology)
MA-ML Social science, culture and community > Social condition > Homelessness > Homeless services
T Demographic characteristics > Woman (women / female)
T Demographic characteristics > Homeless / unhoused person
VA Geographic area > Europe > Ireland
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