Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1008, Kansas City, KS, 66160, USA.
Family Planning Clinical Consultant, Kansas Department of Environmental Health, KDHE Wichita District Office, Wichita, KS, USA.
J Community Health. 2020 Dec;45(6):1252-1258. doi: 10.1007/s10900-020-00894-w.
The community health delivery system (CHDS) are vital agencies to the success of integration and the provision of services to improve the health and well-being of justice-involved women. Many agencies face barriers and challenges in providing services to vulnerable populations, such as justice-involved women, and, as a result, often offer individual rather than coordinator care. Thus, it is necessary to explore CHDS systemic barriers and challenges to identify opportunities for coordinated care. We conducted semi-structured interviews with 26 CHDS directors or designees to identify systemic barriers and challenges, organizational processes, experiences with vulnerable populations, services and programs, and care coordination and perceived women's barriers and challenges to the provision of services including decision-making processes and access. Qualitative analyses were used to construct thematic descriptions in five areas: (1) mental health as an unmet need, (2) financial constraints, (3) limited organizational capacity, (4) implicit bias, and (5) minimal cultural support of vulnerable populations.
社区卫生服务体系（CHDS）是整合服务并提高参与司法活动的妇女健康和福祉的重要机构。许多机构在为弱势群体（如参与司法活动的妇女）提供服务方面面临障碍和挑战，因此通常提供个体护理而非协调护理。因此，有必要探讨 CHDS 的系统障碍和挑战，以确定协调护理的机会。我们对 26 名 CHDS 主任或指定人员进行了半结构化访谈，以确定系统障碍和挑战、组织流程、弱势群体的经验、服务和计划以及协调护理，并了解妇女在提供服务方面的障碍和挑战，包括决策过程和获取途径。定性分析用于构建五个领域的主题描述：（1）心理健康作为未满足的需求，（2）财务限制，（3）有限的组织能力，（4）隐性偏见，以及（5）弱势群体的文化支持不足。
