Health-Seeking Challenges Among Homeless Youth

School of Nursing, University of California, Los Angeles, USA.
Nursing research (Impact Factor: 1.36). 05/2010; 59(3):212-8. DOI: 10.1097/NNR.0b013e3181d1a8a9
Source: PubMed


Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults.
The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons.
This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults.
Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general).
Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services.

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    • "Address correspondence to Alicia J. Hauff, DNP, FNP-BC, Family HealthCare, 301 NP Avenue, Fargo, ND 58102. E-mail: of trust in providers, and cultural insensitivity (Christiani, Hudson, Nyamathi, Mutere, & Sweat, 2008; Hudson et al., 2009; Hwang et al., 2010; Roche, 2004). Barriers to health care access lead to worsened health status, and homeless persons tend to prioritize the fulfillment of more basic needs such as shelter and food before seeking health care services (Martins, 2008). "
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    ABSTRACT: The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.
    Journal of Community Health Nursing 05/2014; 31(2):103-117. DOI:10.1080/07370016.2014.901072 · 0.48 Impact Factor
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    • "(Sutherland, Leader Post, August 2011) Street involved youth (SIY) have become a phenomenon, both locally and globally, replete with labels, little understanding, and poorly constructed solutions; hence, an inexact, intractable situation is in play. This population is ill defined, which contributes to a lack of national and global data, including the absence of systematic measures for youth homelessness and, by extension, SIY [1]. Estimating the numbers of SIY, although a necessity, is a challenge due to ambiguity in definitions, inconsistent service use by SIY, and a lack of intentionality to enumerate these individuals. "
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    ABSTRACT: Street Involved Youth (SIY) are part of a diverse, complex, and heterogeneous group which is underestimated, under resourced, and often ignored in programs and planning for health and social wellness. As the numbers of SIY continue to grow, so do the issues and challenges related to the roles of nursing in working with this vulnerable population. Study Intent: The goal was to engage SIY to gather, share, and exchange information (learnings + voice) about experiences, lifestyles, needs, opportunities, and strengths of SIY from their perspectives; and to inform programs/services, policies, and interventions to achieve preferred futures. Method: The project used a qualitative community-based participatory research (CBPR) approach with an arts-based method – specifically music. Results: Two thematic groups with sub-themes were derived. The first thematic grouping is LOCATION which had four sub-themes -'Individual Orientation'; 'Collective (Culture/Sub-culture) Orientation'; 'Behavioral Orientation'; and 'Time Orientation'. The second thematic group is DIRECTION with three sub-themes -'Path of Disempowerment'; 'Path of Empowerment'; and 'Shifting Paths'. Study Limitations: This study was conducted in partnership with a single SIY agency in a relatively small urban setting in Canada. Conclusions: In working with SIY, it is imperative to 'meet them where they are' with research methods that are innovative and engaging. In this study, the use of music as an arts-based method was found to be highly suitable, efficient, and mutually beneficial.
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    • "Barriers reported for access to drug abuse treatment in Latin-American countries include: lack of treatment professionals, services or facilities; perceived stigma; excessive costs; insufficient treatment or medication options; long wait times or limited working and opening hours; geographic distance or lack of transportation options [45]. North American studies have shown the role of geographic locations of services [46,47] and the lack of confidence or trust of patients in the health system as key access barriers [48]. Not considering themselves ill or lack of motivation for treatment [49], and culturally inappropriate service contexts, are additional reasons for not accessing treatment [50]. "
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    ABSTRACT: Crack use is prevalent across the Americas, and specifically among marginalized urban street drug users in Brazil. Crack users commonly feature multiple physical and mental health problems, while low rates of and distinct barriers to help service use have been observed in these populations. This study examined profiles and determinants of social and health service utilization, and unmet service needs, in a bi-city sample of young (18-24 years), marginalized crack users in Brazil. N = 160 study participants were recruited by community-based methods from impoverished neighborhoods in the cities of Rio de Janeiro (n = 81) and Salvador (n = 79). A mixed methods protocol was used. Participants' drug use, health, and social and health service utilization were assessed by an anonymous interviewer-administered questionnaire completed in a community setting; descriptive statistics on variables of interest were computed. Service needs and barriers were further assessed by way of several focus groups with the study population; narrative data were qualitatively analyzed. The study protocol was approved by institutional ethics review boards; data were collected between November 2010 and June 2011. The majority of the sample was male, without stable housing, and used other drugs (e.g., alcohol, marijuana). About half the sample reported physical and mental health problems, yet most had not received medical attention for these problems. Only small minorities had utilized locally available social or health services; utilization appeared to be influenced by sex, race and housing characteristics in both sites. Participants cited limited service resources, lack of needs-specific professional skills, bureaucratic barriers and stigma as obstacles to better service access. However, most respondents stated strong interest and need for general social, health and treatment services designed for the study population, for which various key features were emphasized as important. The study contributes substantive evidence to current discussions about the development and utilization of health and treatment interventions for crack use in Brazil. Based on our data, crack users' social, service needs are largely unmet; these gaps appear to partly root in systemic barriers of access to existing services, while improved targeted service offers for the target population seem to be needed also.
    BMC Health Services Research 12/2013; 13(1):536. DOI:10.1186/1472-6963-13-536 · 1.71 Impact Factor
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