A Community–Academic Collaboration to Support Chronic Disease Self-Management among Individuals Living in Permanent Supportive Housing

Abstract

PRACTICAL TOOLSamong those predisposed for chronic disease. 3 The transient nature and daily living conditions of individuals experiencing homelessness may interfere with their ability to effectively manage their chronic illness as they are often forced to respond to periodic crises and prioritize immediate daily living and survival needs, making the long-term planning required for continuity or preventive care unfeasible. Those individuals who are able to access health care may find that the delivery of these services is often fragmented and may be interrupted when structural factors prohibit access to care. [4][5][6] Thus, burdened with often insurmountable barriers, those experiencing homelessness

Addressing health disparities of individuals experiencing homelessness in the U.S. with community institutional partnerships: An integrative review

“…Out of the 16 studies, 13 described sustained partnerships that continued at the time of publication and three studies discussed pilot studies or partnerships between organizations and facilities that only occurred at one time (Lashley, 2008; Owusu et al, 2012; Schick et al, 2020). The types of health services provided to homeless populations included preventative care, mental health, acute and chronic medical care, oral health, foot care, HIV care, case management, medication prescriptions, and health education (Table 1).…”

“…Student‐centered outcomes included satisfaction with experiences providing care (Arndell et al, 2014), commitment to serving the underserved (Batra et al, 2009; Schoon et al, 2012), and increases in psychiatric knowledge (Owusu et al, 2012) and causes of homelessness (Schoon et al, 2012). Outcomes that focused on the patient population consisted of increases in health care visits and screenings (Lashley, 2007, 2008; McCann, 2010), improved knowledge on topics of diabetes and oral health (Lashley, 2008; Schick et al, 2020), management of chronic symptoms of hypertension and diabetes (Yaggy et al, 2006), housing status, and connection to health services (Lincoln et al, 2009). Studies that examined both patient and student outcomes measured decreased hospitalization rates, patient satisfaction, improved clinical skills, and improved self‐esteem of both patients and care providers.…”

“…Many partnerships discussed in the articles addressed social determinants of health (SDOH) for the homeless population at the intrapersonal, interpersonal, institutional, and community levels presented in the socioecological model by McLeroy et al (1988) (Table 1). Intrapersonal level factors, such as knowledge and access to health services, were provided through individual and group education sessions to guide and inform individual health behaviours (Arndell et al, 2014; Dahl et al, 1993; Gerberich 2000; Lashley, 2008; Omori et al, 2012; Owusu et al, 2012; Ragavan et al, 2016; Schick et al, 2020). Interpersonal level determinants of health addressed by partnerships mainly consisted of social support, although perceived social support did not have a significant increase following a diabetes self‐management program (Schick et al, 2020).…”

“…Intrapersonal level factors, such as knowledge and access to health services, were provided through individual and group education sessions to guide and inform individual health behaviours (Arndell et al, 2014; Dahl et al, 1993; Gerberich 2000; Lashley, 2008; Omori et al, 2012; Owusu et al, 2012; Ragavan et al, 2016; Schick et al, 2020). Interpersonal level determinants of health addressed by partnerships mainly consisted of social support, although perceived social support did not have a significant increase following a diabetes self‐management program (Schick et al, 2020). Several institutional‐level SDOHs, including limited access to health services, homelessness, economic instability, and barriers to transportation were mitigated by community partnerships through delivery of free services and provision of onsite services at temporary shelters (Mund et al, 2008).…”

“…Study settings were broad, including rural towns in the Midwest (Dahl et al, 1993) and North Carolina (Yaggy et al, 2006), as well as urban cities in Ohio, New York, Massachusetts, and Texas (Batra et al, 2009;Gerberich 2000;Lincoln et al, 2009;Owusu et al, 2012). The samples in the included studies were also diverse, ranging from health professional students involved in the partnerships rather than the patient population that was served (Arndell et al, 2014;Batra et al, 2009;Dahl et al, 1993;Gerberich 2000), people experiencing homelessness that were provided with health services (Corbin et al, 2000;Lashley, 2007;Ragavan et al, 2016;Schick et al, 2020;Yaggy et al, 2006), and both the health professionals involved and the people that received the health services (Lashley, 2008;Schoon et al, 2012). Two studies did not specify the number of people served, but provided overall patient encounters, program descriptions that did not discuss patient outcomes (Dahl et al, 1993;Mund et al, 2008).…”