Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness
Introduction: Health care providers face a multitude of challenges in providing care to patients with diabetes who are experiencing homelessness. Considering the unique circumstance faced by this population, mainstream services must be adapted and tailored to meet patients’ needs. The objective of t...
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| Format: | Article |
| Language: | English |
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Western Libraries, The University of Western Ontario
2021-11-01
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| Series: | International Journal on Homelessness |
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| Online Access: | https://ojs.lib.uwo.ca/index.php/ijoh/article/view/13643 |
| _version_ | 1828065513945694208 |
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| author | Nicole Mancini Rachel Campbell Hannah Yaphe Tadios Tibebu Eshleen Grewal Terry Saunders-Smith Kerry McBrien David Campbell |
| author_facet | Nicole Mancini Rachel Campbell Hannah Yaphe Tadios Tibebu Eshleen Grewal Terry Saunders-Smith Kerry McBrien David Campbell |
| author_sort | Nicole Mancini |
| collection | DOAJ |
| description | Introduction: Health care providers face a multitude of challenges in providing care to patients with diabetes who are experiencing homelessness. Considering the unique circumstance faced by this population, mainstream services must be adapted and tailored to meet patients’ needs. The objective of this study was to explore both the barriers faced by providers and programs in offering comprehensive diabetes care to these patients, and their suggested areas for improvement.
Methods: We conducted semi-structured interviews with providers who care for patients who have diabetes and/or who experience homelessness. Participants included primary care providers, specialist physicians, dietitians, shelter staff, outreach workers, and diabetes educators in five Canadian centres (n=96). Responses were analyzed using qualitative thematic analysis.
Results: Barriers most frequently cited by providers were a lack of resources for staff. Other challenges included policy barriers (restrictions on billing codes, care professionals’ scope of practice, and the structure of financial support for this population), duplication of services, and alternative priorities of care. Participants identified several strategies to improve care, which targeted the following spheres: location of service provision and coordination of care, policy changes, and extending funding and resources for staff, such as augmented funding to hire allied health professionals in outpatient settings and increasing outreach capabilities.
Conclusion: Programs that strive to address the unique needs of clients experiencing homelessness face numerous challenges. Unique potential solutions to these barriers, such as service provision in a convenient location involving social and health services, incorporating allied health care providers in care to a greater extent, and updating policies to reflect the social complexity of the population can improve diabetes care. |
| first_indexed | 2024-04-10T23:15:21Z |
| format | Article |
| id | doaj.art-41f8509441a14df5a06250baa09be60b |
| institution | Directory Open Access Journal |
| issn | 2564-310X |
| language | English |
| last_indexed | 2024-04-10T23:15:21Z |
| publishDate | 2021-11-01 |
| publisher | Western Libraries, The University of Western Ontario |
| record_format | Article |
| series | International Journal on Homelessness |
| spelling | doaj.art-41f8509441a14df5a06250baa09be60b2023-01-12T20:47:40ZengWestern Libraries, The University of Western OntarioInternational Journal on Homelessness2564-310X2021-11-0121486710.5206/ijoh.2022.1.136437585Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing HomelessnessNicole Mancini0Rachel Campbell1Hannah Yaphe2Tadios Tibebu3https://orcid.org/0000-0002-5956-7437Eshleen GrewalTerry Saunders-Smith4https://orcid.org/0000-0002-5008-6450Kerry McBrien5https://orcid.org/0000-0002-6024-7828David Campbell6https://orcid.org/0000-0002-5570-3630University of Calgary, Cumming School of Medicine, Undergraduate Medical Education, Department of Physiology & PharmacologyUniversity of Calgary, Cumming School of Medicine, Department of MedicineUniversity of Calgary, Cumming School of Medicine, Undergraduate Medical EducationMAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health TorontoUniversity of Calgary, Cumming School of Medicine, Department of MedicineUniversity of Calgary, Cumming School of Medicine, Department of Community Health Sciences, Department of Family MedicineUniversity of Calgary, Cumming School of Medicine, Department of Medicine, Department of Community Health Sciences, Department of Cardiac SciencesIntroduction: Health care providers face a multitude of challenges in providing care to patients with diabetes who are experiencing homelessness. Considering the unique circumstance faced by this population, mainstream services must be adapted and tailored to meet patients’ needs. The objective of this study was to explore both the barriers faced by providers and programs in offering comprehensive diabetes care to these patients, and their suggested areas for improvement. Methods: We conducted semi-structured interviews with providers who care for patients who have diabetes and/or who experience homelessness. Participants included primary care providers, specialist physicians, dietitians, shelter staff, outreach workers, and diabetes educators in five Canadian centres (n=96). Responses were analyzed using qualitative thematic analysis. Results: Barriers most frequently cited by providers were a lack of resources for staff. Other challenges included policy barriers (restrictions on billing codes, care professionals’ scope of practice, and the structure of financial support for this population), duplication of services, and alternative priorities of care. Participants identified several strategies to improve care, which targeted the following spheres: location of service provision and coordination of care, policy changes, and extending funding and resources for staff, such as augmented funding to hire allied health professionals in outpatient settings and increasing outreach capabilities. Conclusion: Programs that strive to address the unique needs of clients experiencing homelessness face numerous challenges. Unique potential solutions to these barriers, such as service provision in a convenient location involving social and health services, incorporating allied health care providers in care to a greater extent, and updating policies to reflect the social complexity of the population can improve diabetes care.https://ojs.lib.uwo.ca/index.php/ijoh/article/view/13643qualitative researchdiabetesdiabetes mellitushomelessnessbarriers to careallied healthcare professionalscoordination of care |
| spellingShingle | Nicole Mancini Rachel Campbell Hannah Yaphe Tadios Tibebu Eshleen Grewal Terry Saunders-Smith Kerry McBrien David Campbell Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness International Journal on Homelessness qualitative research diabetes diabetes mellitus homelessness barriers to care allied healthcare professionals coordination of care |
| title | Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness |
| title_full | Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness |
| title_fullStr | Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness |
| title_full_unstemmed | Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness |
| title_short | Identifying Challenges and Solutions to Providing Diabetes Care for Those Experiencing Homelessness |
| title_sort | identifying challenges and solutions to providing diabetes care for those experiencing homelessness |
| topic | qualitative research diabetes diabetes mellitus homelessness barriers to care allied healthcare professionals coordination of care |
| url | https://ojs.lib.uwo.ca/index.php/ijoh/article/view/13643 |
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