Research

The negative impact of homelessness on health, and the barriers that homeless individuals must overcome to access healthcare are well-documented. Primary care physicians often express difficulty in maintaining stable relationships with homeless patients, and access to free care clinics alone does not predict successful adherence to medical treatment. Motivation to seek care is also often cited as a barrier to adequate care. The current study assesses the effects of a student-driven, decentralized primary care, and advocacy model on the chronic health conditions and task motivation of female patients. We do this through a pre/post model survey for women who present to student-driven primary care clinics in emergency housing shelters in Philadelphia. The two-part self-assessment survey is administered at the first clinic visit and again once the participant is placed in permanent housing. The survey questions determine the psychological needs of the homeless women population as well as their motivation to seek care, and identify service gaps in meeting these needs. We hypothesize that homeless women who are served through this clinic will report a change in at least one measured parameter of their health care challenges and will report a greater motivation to continue to address these challenges. To date, we have successfully administered the survey at one clinic event and have several more planned as part of this longitudinal study. The first follow-up is in four months. The method of administering the survey was adjusted according to the length initially being too burdensome for the participants. A model to increase health-oriented task motivation in difficult living environments would bolster current health strategies for underserved populations. This strategy may also have ancillary benefits through improvements in motivation to address chronic conditions that may not have been addressed previously and to enable the clinic to be a more evidenced-based practice.

Funding

• Lankenau Medical Center has granted us $4,000 to pursue our research. The rest of our funds come from fundraising!