Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study
Background People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in adv...
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| description | Background People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. Methods Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. Results We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. Conclusions Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless. |
| doi_str_mv | 10.1186/s12889-020-09444-4 |
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Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. Methods Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. Results We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. Conclusions Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.</description><identifier>ISSN: 1471-2458</identifier><identifier>EISSN: 1471-2458</identifier><identifier>DOI: 10.1186/s12889-020-09444-4</identifier><identifier>PMID: 32878612</identifier><language>eng</language><publisher>LONDON: Springer Nature</publisher><subject>Addictions ; Coffee ; Collaboration ; Community ; Community health services ; Demographic aspects ; Drug use ; Health aspects ; Health care ; Health care delivery ; Homeless persons ; Homelessness ; Hospitals ; Housing ; Institutions ; Interviews ; Life expectancy ; Life Sciences & Biomedicine ; Medical schools ; Medical students ; Mental disorders ; Mental health ; Mixed methods research ; Morbidity ; Public, Environmental & Occupational Health ; Qualitative analysis ; Qualitative research ; Science & Technology ; Services ; Social aspects ; Social stigma ; Students ; Substance use</subject><ispartof>BMC public health, 2020-09, Vol.20 (1), p.1-1337, Article 1337</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>1</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000568221700001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c540t-4f293124ddb7d080bd4fcf7d1b5f09024d9d8e7778dde374b67ebe33ba5e21c23</citedby><cites>FETCH-LOGICAL-c540t-4f293124ddb7d080bd4fcf7d1b5f09024d9d8e7778dde374b67ebe33ba5e21c23</cites><orcidid>0000-0002-9913-6340</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466795/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466795/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,27929,27930,28253,28254,53796,53798</link.rule.ids></links><search><creatorcontrib>King, Caroline</creatorcontrib><creatorcontrib>Fisher, Cameron</creatorcontrib><creatorcontrib>Johnson, Jacob</creatorcontrib><creatorcontrib>Chun, Arum</creatorcontrib><creatorcontrib>Bangsberg, David</creatorcontrib><creatorcontrib>Carder, Paula</creatorcontrib><title>Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study</title><title>BMC public health</title><addtitle>BMC PUBLIC HEALTH</addtitle><description>Background People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. Methods Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. Results We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. Conclusions Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.</description><subject>Addictions</subject><subject>Coffee</subject><subject>Collaboration</subject><subject>Community</subject><subject>Community health services</subject><subject>Demographic aspects</subject><subject>Drug use</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care delivery</subject><subject>Homeless persons</subject><subject>Homelessness</subject><subject>Hospitals</subject><subject>Housing</subject><subject>Institutions</subject><subject>Interviews</subject><subject>Life expectancy</subject><subject>Life Sciences & Biomedicine</subject><subject>Medical schools</subject><subject>Medical students</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mixed methods research</subject><subject>Morbidity</subject><subject>Public, Environmental & Occupational Health</subject><subject>Qualitative analysis</subject><subject>Qualitative research</subject><subject>Science & Technology</subject><subject>Services</subject><subject>Social aspects</subject><subject>Social stigma</subject><subject>Students</subject><subject>Substance 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Caroline</creator><creator>Fisher, Cameron</creator><creator>Johnson, Jacob</creator><creator>Chun, Arum</creator><creator>Bangsberg, David</creator><creator>Carder, Paula</creator><general>Springer Nature</general><general>BioMed Central Ltd</general><general>BioMed 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recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study</title><author>King, Caroline ; Fisher, Cameron ; Johnson, Jacob ; Chun, Arum ; Bangsberg, David ; Carder, Paula</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-4f293124ddb7d080bd4fcf7d1b5f09024d9d8e7778dde374b67ebe33ba5e21c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Addictions</topic><topic>Coffee</topic><topic>Collaboration</topic><topic>Community</topic><topic>Community health services</topic><topic>Demographic aspects</topic><topic>Drug use</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health care delivery</topic><topic>Homeless persons</topic><topic>Homelessness</topic><topic>Hospitals</topic><topic>Housing</topic><topic>Institutions</topic><topic>Interviews</topic><topic>Life expectancy</topic><topic>Life Sciences & Biomedicine</topic><topic>Medical schools</topic><topic>Medical students</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Mixed methods research</topic><topic>Morbidity</topic><topic>Public, Environmental & Occupational Health</topic><topic>Qualitative analysis</topic><topic>Qualitative research</topic><topic>Science & Technology</topic><topic>Services</topic><topic>Social aspects</topic><topic>Social stigma</topic><topic>Students</topic><topic>Substance use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>King, Caroline</creatorcontrib><creatorcontrib>Fisher, Cameron</creatorcontrib><creatorcontrib>Johnson, Jacob</creatorcontrib><creatorcontrib>Chun, Arum</creatorcontrib><creatorcontrib>Bangsberg, David</creatorcontrib><creatorcontrib>Carder, Paula</creatorcontrib><collection>Web of Knowledge</collection><collection>Web of Science - Science Citation Index Expanded - 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Cameron</au><au>Johnson, Jacob</au><au>Chun, Arum</au><au>Bangsberg, David</au><au>Carder, Paula</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study</atitle><jtitle>BMC public health</jtitle><stitle>BMC PUBLIC HEALTH</stitle><date>2020-09-02</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>1</spage><epage>1337</epage><pages>1-1337</pages><artnum>1337</artnum><issn>1471-2458</issn><eissn>1471-2458</eissn><abstract>Background People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. Methods Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. Results We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. Conclusions Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.</abstract><cop>LONDON</cop><pub>Springer Nature</pub><pmid>32878612</pmid><doi>10.1186/s12889-020-09444-4</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-9913-6340</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Addictions Coffee Collaboration Community Community health services Demographic aspects Drug use Health aspects Health care Health care delivery Homeless persons Homelessness Hospitals Housing Institutions Interviews Life expectancy Life Sciences & Biomedicine Medical schools Medical students Mental disorders Mental health Mixed methods research Morbidity Public, Environmental & Occupational Health Qualitative analysis Qualitative research Science & Technology Services Social aspects Social stigma Students Substance use |
| title | Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study |
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