Improving the Overall Health of Vulnerable Population: Hope House Residents

Introduction: Problem Statement

Homeless persons:

Health disparities, vulnerable, uninsured, use emergency departments (Grabovschi, Loignon, & Fortin, 2013; Lin, Bharel, Zhang, O’Connell, & Clark, 2015; Zlotnick, Zerger, & Wolfe, 2013)

Project Description and Overall Goal(s)

• Participants, 45 homeless male residents
• Aged 18-75 years
• Long-term, sustainable life transformation at Hope House Mission
• The practicum conducted for about 24 weeks

Rationale

Health topics empower residents with knowledge

Objectives

The objectives included:

• Increase health and well-being awareness
• Increase acceptance and usability of preventive interventions
• Promote educational interventions to lessen healthcare problems
• Enhance the capacity of homeless shelter programs

Expected outcomes:

• Changes in knowledge, awareness, and practices

Review

• Current literature on homelessness, vulnerability, use of EDs (Grabovschi et al., 2013; Culo, 2011; Knowlton, Nguyen, Robinson, Harrell, & Mitchell, 2015)
• Common chronic conditions – diabetes, hepatitis C (Ba-Essa, Mobarak, & Al-Daghri, 2016)
• Self-neglect (Culo, 2011)
• Eye conditions (Noel et al., 2015)
• Poor oral health (Costa et al., 2012)

Competencies

Competencies addressing public health issue

Methods

• A holistic approach to public health
• Data collected from 45 participants
• The number differed for each class
• Data analysis – pre-test and post-test scores’ variations

Results

Discussion

• The findings support similar studies (May & Evans, 1994)
• Useful classes, desires for future studies

Strengths and Limitations

• Learning in normal setting/no external influences
• Small sample size, no generalization

Conclusion

• Results – increased knowledge gain
• Learning desires, possibilities of more lessons
• Further studies on health education

References

Ba-Essa, E. M., Mobarak, E. I., & Al-Daghri, N. M. (2016). Hepatitis C virus infection among patients with diabetes mellitus in Dammam, Saudi Arabia. BMC Health Services Research, 16, 313. Web.

Costa, S. M., Martins, C. C., de Lourdes, C. B., Zina, L. G., Paiva, S. M., Pordeus, I. A., & Abreu, M. H. (2012). A systematic review of socioeconomic indicators and dental caries in adults. International Journal of Environmental Research and Public Health, 9(10), 3540–3574. Web.

Culo, S. (2011). Risk assessment and intervention for vulnerable older adults. British Columbia Medical Journal, 53(8), 421-425.

Grabovschi, C., Loignon, C., & Fortin, M. (2013). Mapping the concept of vulnerability related to health care disparities: A scoping review. BMC Health Services Research, 13, 94. Web.

Knowlton, A. R., Nguyen, T. Q., Robinson, A. C., Harrell, P. T., & Mitchell, M. M. (2015). Pain symptoms associated with opioid use among vulnerable persons with HIV: An exploratory study with implications for palliative care and opioid abuse prevention. Journal of Palliative Care, 31(4), 228–233.

Lin, W.-C., Bharel, M., Zhang, J., O’Connell, E., & Clark, R. E. (2015). Frequent emergency department visits and hospitalizations among homeless people with Medicaid: Implications for Medicaid expansion. American Journal of Public Health, 105(S5), S716-S722. Web.

May, K. M., & Evans, G. G. (1994). Health education for homeless populations. Journal of Community Health Nursing, 11(4), 229-37. Web.

Noel, C. W., Fung, H., Srivastava, R., Lebovic, G., Hwang, S. W., Berger, A., & Lichter, M. (2015). Visual impairment and unmet eye care needs among homeless adults in a Canadian City. JAMA Ophthalmology, 133(4), 455-460. Web.

Zlotnick, C., Zerger, S., & Wolfe, P. B. (2013). Health care for the homeless: What we have learned in the past 30 years and what’s next. American Journal of Public Health, 103(Suppl 2), S199–S205. Web.