Teaching Medical Students and Residents about Homelessness: Complex, Evidence-Based, and Imperative

Brenner, Adam M.; Guerrero, Anthony P. S.; Beresin, Eugene V.; Coverdale, John; Balon, Richard; Louie, Alan K.; Roberts, Laura Weiss

doi:10.1007/s40596-016-0571-6

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…This research builds on past work to understand how medical students and the institutions they are a part of can better care for people who are houseless, including through the development of socially-conscious medical schools as a whole [30][31][32][33]. Medical students have pushed to improve didactic [20,[23][24][25][26] and clinical [25,[27][28][29] opportunities to care for people who are houseless. These programs have helped support the professional development and education of other medical students, but have not always given space to community members to make their needs, preferences, and experiences heard.…”

Section: Discussionmentioning

confidence: 99%

“…Extensive research from medical schools and students across the country has sought to take advantage of each of these role-characteristics to improve care for people who are homeless within institutions. This research focused primarily on improving attitudes and knowledge around houselessness among medical students [17][18][19][20][21][22]; altering didactic medical education to include training on caring for people who are houseless or otherwise excluded from care [20,[23][24][25][26]; facilitating opportunities to care for people who are houseless in clinical settings [25,[27][28][29]; and more broadly improved the social accountability of medical schools and the institutions they are a part of [30][31][32][33]. These efforts are significant not only for enacting change at the institutional level, but also for preparing the next generation of physicians to provide full-spectrum and empathic care to people who are houseless.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study

et al. 2020

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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 semistructured 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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study

et al. 2020

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“…Training institutions have a responsibility to ready health, mental health, and social service trainees to provide effective, empathic care for impoverished clients upon graduation [50]. This involves educating trainees on the stigma these individuals experience [51] and ensuring they are well positioned to advocate policy changes that serve these populations.…”

Section: Implications For Policy and Practicementioning

confidence: 99%

Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women

Mackelprang,

Graves,

Schulz

2024

IJERPH

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The lived experiences of homeless and unstably housed women, including their health-related priorities, are understudied in smaller metropolitan and rural communities. In this study, we partnered with a day center for women who experience homelessness in Spokane, Washington. We used Photovoice, a community-based participatory action research method, to explore the health-related concerns, needs, and behavior of women who are homeless or unstably housed. Participant-generated photographs and group interview data were analyzed using thematic analysis. Three themes were generated: “These are my supports”, “I’m trying to make my health better”, and “[My] choices are very limited”. The themes illustrated individual, interpersonal, community, and societal strengths and vulnerabilities aligned with the social ecological model. Participants demonstrated resourcefulness, creativity, and hope as they strived toward health improvement. Trauma-informed, strengths-based approaches that respect the autonomy of homeless and unstably housed women and that amplify their voices are needed to minimize power imbalances in research, policy, and practice. This includes an imperative for healthcare and social work programs to ready graduates to deliver effective, empathic services by increasing their knowledge of social determinants of health and of the stigma faced by marginalized communities. Moreover, collaborating with these communities when designing, implementing, and evaluating services is critical.

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“…Homelessness constitutes poorer health outcomes due to the complex psychosocial state that impacts biological outcomes and care management. 2 Complex and advanced medical conditions not only persist in this population but also are often exacerbated by socioeconomic issues. 3 Systemslevel barriers such as lack of a primary care physician, health insurance, and access to care, coupled with individual-level barriers such as implicit biases, misconceptions, and distrust between both physicians and homeless patients, provide a unique challenge for the health care system.…”

Section: To the Editormentioning

confidence: 99%

Being Housed Versus Having a Home: Navigating Health Care for Unsheltered Patients

Wongpaiboon,

Shelton

2024

Fam Med

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Teaching Medical Students and Residents about Homelessness: Complex, Evidence-Based, and Imperative

Cited by 3 publications

References 21 publications

Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study

Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study

Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women

Being Housed Versus Having a Home: Navigating Health Care for Unsheltered Patients

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