Faculty of Health Sciences, Department of Global Health, McMaster University, Hamilton, Ontario, Canada.
Harm Reduction Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
BMJ Open. 2022 Aug 1;12(8):e058233. doi: 10.1136/bmjopen-2021-058233.
In Canada, individuals experiencing homelessness (IEH) rely on public health and social services for healthcare, food and basic necessities. The COVID-19 pandemic has disproportionately affected marginalised populations, in part by impacting their access to such services. We performed a scoping review to identify from the published literature how access to services has changed for Canadian IEH during the pandemic.
OVID Medline, Web of Science, Sociological Abstracts, CINAHL and OVID EmCare databases, and websites for the Salvation Army, Homeless Hub, Canadian Alliance to End Homelessness, Canadian Network for the Health and Housing of People Experiencing Homelessness and BC Centre for Disease Control.
We used the scoping review methodology developed by the Joanna Briggs Institute framework and defined access to healthcare and social services using the 10-component Levesque framework. Academic databases and grey literature searches were used, with the final searches for each taking place 24 May and 1 June 2021, respectively. Data were compiled into an Excel spreadsheet. Title and abstract screening and full-text review were completed by two independent reviewers (RG and MM). Data extraction was completed by MM and cross checked by RG.
In total, 17 academic and grey literature articles were included. Positive and negative changes in service access were reported in the literature. During the COVID-19 pandemic, access to social and healthcare resources was generally reduced for Canadian IEH. A new component of access, digital connectivity, was identified. Unexpectedly, coordination and collaboration of services improved, as did the number of outreach services.
Positive changes to service access such as improved coordination of services should be scaled up. Further work should be done to improve access to digital technologies for IEH.
在加拿大，无家可归者（IEH）依靠公共卫生和社会服务来获得医疗、食品和基本必需品。COVID-19 大流行对边缘化人群产生了不成比例的影响，部分原因是影响了他们获得这些服务的机会。我们进行了范围界定审查，以从已发表的文献中确定在大流行期间加拿大 IEH 获得服务的情况发生了怎样的变化。
OVID Medline、Web of Science、Sociological Abstracts、CINAHL 和 OVID EmCare 数据库，以及救世军、无家可归者中心、加拿大消除无家可归联盟、加拿大体验无家可归者健康和住房网络以及卑诗省疾病控制中心的网站。
我们使用了由 Joanna Briggs 研究所框架制定的范围界定审查方法，并使用 10 个组成部分的 Levesque 框架来定义获得医疗保健和社会服务的机会。使用了学术数据库和灰色文献搜索，最后一次搜索分别于 2021 年 5 月 24 日和 6 月 1 日进行。数据被汇编到 Excel 电子表格中。标题和摘要筛选以及全文审查由两名独立审查员（RG 和 MM）完成。数据提取由 MM 完成，由 RG 交叉检查。
共有 17 篇学术和灰色文献文章被纳入。文献中报告了服务获得的积极和消极变化。在 COVID-19 大流行期间，加拿大 IEH 获得社会和医疗资源的机会普遍减少。确定了一个新的获取途径组成部分，即数字连接。出乎意料的是，服务的协调和合作得到了改善，外展服务的数量也有所增加。
应扩大服务获取方面的积极变化，例如改善服务协调。应进一步努力改善 IEH 获取数字技术的机会。
