Persons struggling with housing remain significantly disadvantaged when considering access to health care. Effective advocacy for their needs will require understanding the factors which impact their health care, and which of those most concern patients themselves. A qualitative descriptive study through the lens of a transformative framework was used to identify barriers and facilitators to accessing health care as perceived by people experiencing homelessness in the regional municipality of Niagara, Canada. In-person, semi-structured interviews with 16 participants were completed, and inductive thematic analysis identified nine barriers and eight facilitators. Barriers included affordability, challenges finding primary care, inadequacy of the psychiatric model, inappropriate management, lack of trust in health care providers, poor therapeutic relationships, systemic issues, and transportation and accessibility. Facilitators included accessibility of services, community health care outreach, positive relationships, and shelters coordinating health care. Knowledge of the direct experiences of marginalized individuals can help create new health policies and enhance the provision of clinical care.

Background: Regional medical campuses are often located in geographic regions that have different populations than the main campus, and are well-positioned to advocate for the health needs of their local community to promote social accountability within the medical school. Methods:At the Niagara Regional Campus of McMaster University, medical students developed a framework which combined research, advocacy, and theatre to advocate for the needs of the local population of the regional campus to which they were assigned. This involved a qualitative study using semi-structured interviews with homeless individuals to explore their experience accessing the healthcare system and using a transformative framework to identify barriers to receiving quality healthcare services. Findings from the qualitative study informed a play script that presented the experiences of homeless individuals in the local health system, which was presented to health sciences learners and practicing health professionals. Participants completed two instruments to examine the utility of this framework. Results:Research-based theatre was a useful intervention to educate current and future health professionals about the challenges faced by homeless individuals in the region. Participants from both shows felt the framework of research-based theatre was an effective strategy to promote change and advocate for marginalized populations. Conclusion:Research-based theatre is an innovative approach which can be utilized to promote social accountability at regional medical campuses, advocating for the health needs of the communities in which they are located, with the added bonus of educating current and future health professionals.

The project brought together a group of hearing‐impaired children who were the only hearing aid users in their schools. All the children were in Year 5 or Year 6 and were at Stage 3 or Stage 5 of the Department for Education and Employment Code of Practice (DfEE, 1994). This project had two aims: to decrease the social isolation of hearing‐impaired pupils in mainstream schools, and to support their transition to secondary school. The programme comprised seven 90‐minute sessions. Its effectiveness was evaluated by use of questionnaires and informal feedback from parents and schools. Immediate feedback suggested the primary gainers were the parents of the children concerned. However, long‐term observation of the children indicated that the objectives of the project were fulfilled. The project leaders were a teacher of the deaf, an educational psychologist and an assessment advisory teacher for special educational needs. Copyright © 1999 Whurr Publishers Ltd.