Date of Award

Summer 8-11-2015

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Emily Graybill, PhD

Second Advisor

Monique Carry, PhD

Abstract

INTRODUCTION: Healthcare needs among homeless populations are difficult to meet within the scope of a standard healthcare model. A street medicine model addresses the specific needs of those experiencing homelessness; healthcare professionals seek to build trust and rapport with people who are living unsheltered by taking their clinical practice to the streets. The street medicine program evaluated in this study provides primary and behavioral care in a metropolitan area in the Southeastern United States. AIM: This program evaluation aimed to answer the following questions: how has the street medicine program affected the perceptions of ill-health and access to healthcare among its current patients? Further, how would the current patients of the street medicine program rate their satisfaction with the program and are they aware of all available services? METHODS: Using a mixed methods approach, 40 semi-structured interviews and participant observations were conducted with patients of the street medicine program. Participants were asked to rate their satisfaction with the program and their overall health status on a 5 point Likert scale. Informed by Consensual Qualitative Research (CQR) analysis methods, the qualitative data were transcribed and coded. All quantitative analyses were done using SPSS. RESULTS: Overall, 70% of participants rated their satisfaction with the street medicine program as excellent (n=28). For self-rated health status, there was a normal distribution across the Likert scale with 43% reporting their overall health status as moderate (n=17). Using CQR, four key domains emerged from the qualitative data: community trust, rapport building, needs addressed, and needs not addressed. These domains encompassed specific participant responses. Examples include: heard about the street medicine program through word of mouth (community trust), team showed kindness (rapport building), received diagnosis and treatment (needs addressed), and needing help getting into housing (needs not addressed). CONCLUSION: Overall, this study validated the effectiveness of the street medicine program in building trust and rapport with its patients. Satisfaction with the street medicine was high across patients. This study contributes information regarding patient experiences within an alternate healthcare model serving a highly vulnerable population.

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