Capacity Building for Participatory Health Services Research in Housing First

Background: Pathways to Housing ends chronic homelessness for individuals with serious mental illness (SMI) by providing housing first, and then combining that housing with supportive treatment services in the area of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This scattered site model fosters a sense of home and self-determination, and it helps speed client\u27s reintegration into the community. The Pathways model has been remarkable successful in addressing chronic homelessness. Research Question What are the chronic physical disease self management support needs of Pathways to Housing clients

Introduction to Community-Based Participatory Research

Objectives: Understand the core principles of CBPR Discuss one example of a CBPR project using Photovoice Describe the CBPR conceptual model Apply the CBPR conceptual model during a brief group thought projec

JFMA Street Outreach: A Resident-Run Street Medicine Program A retrospective chart review examining the needs of a vulnerable population and services provided

In Philadelphia it is estimated that over 12,000 people experience homelessness annually, and up to 500 individuals live on the street on any given day.1 Project HOME coordinates the City of Philadelphia’s outreach effort aimed at forming relationships with unsheltered individuals, identifying their barriers to entering permanent supportive housing and assisting them in overcoming these barriers. Having identified this population’s need for medical services, in 2007 faculty in Jefferson Family Medicine Associates (JFMA) reached out to Project HOME and extended an ongoing community-academic partnership. Since then Family Medicine residents and students have been traveling with the outreach team, meeting people identified by Project HOME as having an acute medical need. The medical street outreach program sees over 150 patient visits annually and is organized and operated entirely by residents in the Department of Family and Community Medicine

Baseline Monitoring of Standard Health Indicators in a Formerly Homeless Population

Research Question: What are the rates of baseline health status indicators recording at Pathways to Housing (PTH) using select recommended measures from the National Association of State Mental Health Program Directors (NASMHPD) and the Healthcare Effectiveness Data Information Set (HEDIS)? How do health indicators compare between clients receiving direct clinical care in the integrated care program vs non-integrated care clients

Moving From Street to Home: Health Status of Entrants to a Housing First Program

Housing First (HF) is an evidence-based practice that ends chronic homelessness for individuals with serious mental illness by providing immediate access to permanent independent housing and team-based community supports. Little is known about the health status of homeless individuals entering HF programs. Through a cross-sectional analysis, this paper reports on the chronic physical disease burden of people entering a newly established HF program and examines whether these individuals recognize and request support for ongoing health-related issues. The authors’ evaluation confirmed significantly higher rates of chronic disease (60%) and fair/poor self-reported health status (47%) than the general urban population of Philadelphia. The majority of clients reported they wanted to address both medical (67%) and mental health (68%) problems, but a much lower percentage reported wanting to reduce substance use (23%) or take psychiatric medications (25%). The authors conclude that formerly homeless entrants to HF programs have a high burden of chronic disease with complex health-related needs. Additionally, these individuals look to the program for health-related assistance. As the HF model is disseminated throughout the United States to end chronic homelessness, these findings support the development of flexible, integrated, person-centered health services within the HF service delivery system as a potentially effective method to address complex health needs

Individual agency, community capacity building, and chronic illness care: Using participatory methods to implement the Stanford Chronic Disease Self Management Program in a Housing First Program

Research questions: Is a standardized chronic disease self management program (CDSMP) experienced as a valuable intervention by Pathways\u27 consumers? What is the impact of collaborative inquiry into health program development on participant\u27s critical agency

A primary care-public health partnership addressing homelessness, serious mental illness, and health disparities.

BACKGROUND: People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports. METHODS: The Jefferson Department of Family and Community Medicine and a Housing First agency, Pathways to Housing-PA, has formed a partnership to address multiple levels of health care needs for this group. We present a preliminary program evaluation of this partnership using the framework of the patient-centered medical home and the 10 Essential Public Health Services. RESULTS: Preliminary program evaluation results suggest that this partnership is evolving to function as an integrated person-centered health home and an effective local public health monitoring system. CONCLUSION: The Pathways to Housing-PA/Jefferson Department of Family and Community Medicine partnership represents a community of solution, and multiple measures provide preliminary evidence that this model is feasible and can address the grand challenges of integrated community health services