Research and practice development projects
The Lived Experience of Adherence to HIV medication in the context of addiction and homelessness; a qualitative study of a Blood Borne Virus Unit in Dublin City
In 2017 The Global Health Observatory estimated that there are 36.9 million people worldwide living with HIV/AIDS (WHO 2017). The rates in Ireland are increasing and people who Inject drugs account for 5% of the total diagnoses in Ireland. Research studies and health strategies emphasize the importance of adherence to HAART (HIV Medication) to avoid viral replication and personal/public health consequences. However, it is evident that addiction and homelessness can contribute to non-adherence to medical and pharmacological treatment for a range of diseases (Hinkin 2007). Explanations have been put forward in the research including, lack of structure/routine, cognitive impairment caused by drug use, lack of motivation/worth, lack of facilities to store and take medication. While research studies have been carried out regarding clinical manifestations and prevalence of co-morbidity as well as rates of HIV medication adherence, there are few qualitative studies containing more in depth explorations which capture the voices and perspectives of those encountering complexities and challenges. There is little exploration concerning the effects of homelessness/addiction on adherence to ART’ in the literature.
Currently there are calls for public and patient involvement/engagement in research in this area in order to fully understand lived experience and develop innovative person centred approaches to support HIV treatment adherence in this challenging context. The proposed research, using IPA methodology with 12 participants receiving services at Dublin Simon Community Blood Borne Virus Unit, aims to fill this gap in the literature and to contribute the voices, knowledge and expertise of persons directly affected to service planning and support initiatives. Research on adherence to Blood Borne Virus medication and treatment is essential for gaining knowledge and insight which in turn can be used to improve treatments aimed at suppressing viral loads. This knowledge also has benefits for healthcare professionals as they engage with clients in the context of homelessness and addiction to support them to achieve adherence. It is anticipated that the findings, discussion and recommendations from the study will contribute to Improved understanding of the needs of this population and more sensitive client centred approaches
Dates: September 2019 - September 2021 (2 year Research MSc)
Researcher: Eavanna Maloney
Funding: Irish Research Council /Dublin Simon Community Employment Based Programme.
Nursing Now campaign
Nursing Now, a three-year global campaign, aims to improve health by raising the profile and status of nursing worldwide. Run in collaboration with the World Health Organization and the International Council of Nurses, Nursing Now seeks to empower nurses to take their place at the heart of tackling 21st Century health challenges and maximize their contribution to achieving Universal Health Coverage
The campaign will focus on five core areas:
- Ensuring that nurses and midwives have a more prominent voice in health policy-making
- Encouraging greater investment in the nursing workforce
- Recruiting more nurses into leadership positions
- Conducting research that helps determine where nurses can have the greatest impact
- Sharing of best nursing practices.
Nursing Now Ireland was launched in 2019 at an event hosted by the Irish Nurses and Midwives Organisation (INMO) at the Richmond Education and Event Centre in Dublin. Nursing leaders and other high-level stakeholders from the world of public health gathered to present Nursing Now Ireland and discuss the importance of nursing.
Dates: 2018 - 2020
Organisers: WHO and International Council of Nurses
Local engagement: Dr Daniela Lewaldt, SNHS DCU
Premature ageing in long-term homeless adults (PAth Study)
In partnership with Dr. Cliona Ni Cheallaigh and St. James’s Hospital Inclusion Health services, preliminary data demonstrating premature onset of chronic age-associated conditions such as multimorbidity, frailty, COPD and dementia in homeless people in Depaul services.
We are now undertaking an extension of the internationally renowned Irish Longitudinal Study on Ageing (TILDA) to homeless people in partnership with Dr. Ni Cheallaigh.
The proposed study will characterise physical and cognitive frailty in homeless people, measure the prevalence and incidence of functional impairment and care needs, and inform the development of integrated health and social care to meet the needs of homeless people in Dublin .Finally, homelessness provides a clear human model of health inequities and premature ageing associated with psychological and socioeconomic stress throughout the life course. Understanding the premature ageing seen in homelessness will give us insight into the pathways, processes and mechanisms via which social exclusion gets “under the skin” to precipitate earlier ageing and will inform policies to deliver improved health equity
Organisers: DEPAUL & St. James’s Hospital Inclusion Health services
Local engagement: Jess Sears, Depaul
Depaul HHPA programme
Depaul’s Homeless Health Peer Advocacy (HHPA) works to reduce unplanned use of health services and missed appointments by people experiencing homelessness. This programme empowers people experiencing homelessness to overcome the barriers to accessing care through the provision of intensively trained HHPAs, all of whom have experience of homelessness. The complex nature of homelessness presents multiple inter-related, physical, personal and systemic barriers to accessing healthcare. This service takes a targeted approach to addressing the systemic and personal barriers faced by this group in accessing health care and facilitating safe discharge, improve attendance rates and health outcomes by supporting clients to better understand their health needs.
As part of the HSE Homeless Hospital Discharge protocol, this programme take a participatory and co-production approach to involve peers in:
- Informing the design and ongoing improvement of the Inclusion Health services
- Identifying research priorities and carrying out peer-led research
Organisers: Depaul’s Homeless Health Peer Advocacy (HHPA)
Local engagement: Jess Sears, Depaul
Adult autism in homelessness: prevalence, experiences and support needs in an Irish context – a mixed methods study
Dr Briege Casey and Dr Mary Rose Sweeney have been awarded funding from the National Disability Authority.
The relationships between mental health problems, intellectual disability and homelessness are well recognised, yet there is little empirical research concerning the prevalence, experiences and needs of people with autism who are homeless. This study, the first of its kind in Ireland, will research these areas and will also examine the self-perceived knowledge and skills levels of staff working with people who have autistic traits and are homeless.
We are delighted to be collaborating with the following agencies/ individuals regarding this project: Dublin Simon Community, ASIAM, Alasdair Churchard, Psychologist, University College London, DCU PPI Ignite, Dublin Region Homeless Executive.
Dates: 2019 - 2020
Funding: National Disability Authority.