Multistage Psychometric Testing of the Homeless Health Access to Care Tool

Abstract

People experiencing homelessness find it challenging to access the healthcare they so desperately need. To address this, we have developed the Homeless Health Access to Care Tool, which assesses health related vulnerability (burden of injury and/or illness and ability to access healthcare) and can be used to prioritize people for access to healthcare. Here, we report the initial psychometrics of the Homeless Health Access to Care Tool. To assess interrater reliability, clinician participants were invited to instinctually rate the health-related vulnerability of 18-fictional case studies and then apply the Homeless Health Access to Care Tool to these same case studies. To assess convergent validity, the Homeless Health Access to Care Tool and the tool it was adapted from, the Australian Vulnerability Index Service Prioritization Decision Assistance Tool were administered to people experiencing homelessness. Feedback was sought from the participants receiving these two tools and from those administering them. The Homeless Health Access to Care Tool demonstrated a high interrater reliability and internal consistency. Participants using and receiving the Homeless Health Access to Care Tool reported it as straightforward, unintrusive and clear. Median time of administration was 7 min 29 s (SD 118.03 s). Convergent validity was established for the Homeless Health Access to Care Tool with a moderate correlation (r = 0.567) with the total score of the Australian Vulnerability Index Service Prioritization Decision Assistance Tool. Findings suggest that the Homeless Health Access to Care Tool is feasible and reliable. Larger samples are required to report construct validity.