Perspectives on an earn-a-bike intervention on transportation, health and self- esteem among men experiencing homelessness

Abstract Introduction Homelessness continues to be a pervasive public health and social justice issue across the nation. Unfortunately, some of the greatest needs of those experiencing homelessness are not met through traditional resources and agencies, which tend to focus on immediate needs such as food and shelter. One pressing—and often unmet—need of people experiencing homelessness is transportation. Access to reliable transportation is crucial to individuals experiencing homelessness who must locate shelter, employment, and medical services for their survival, all while maintaining relationships with loved ones. The specific aim of this study is to determine the bicycle's impact on mobility, physical health, access to health care, social capital, self-esteem, and employment. We are interested in how the participants used the bicycle and how the bicycle may impact perceived physical, financial, and emotional independence as they may contribute to increased perceptions of self-esteem. Methods In order to explore these outcomes, in-depth, open-ended interviews were conducted with 16 men experiencing homelessness who graduated from the earn-a-bike program offered through a local homeless outreach agency. The interviews were recorded, transcribed, and analyzed using Dedoose software. Results Study findings suggest that men experiencing homelessness experience several positive impacts from owning a bicycle and value the independence they gained. Maintaining employment, strengthened social capital, improved health and access to health care services, and increased self-esteem emerged as important outcomes for men experiencing homelessness who are bike owners. For example, men reported being able to stop taking prescription medications and reduce illegal drug use because of their bike use. New unresolved challenges include bike theft, lack of secure parking, and storage. Conclusions This study provides insight into a cost-effective and sustainable intervention to improve transportation, employment opportunity, health, social capital, and self-esteem in men experiencing homelessness. Findings also highlight challenges to bicycle ownership, some that can be mitigated by providing bike locks.