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探索社区式中途宿舍为无家可归者提供健康和福利服务的有效和低效之处:服务协调的参与式行动评估。

Exploring what works well and less well in a community-based drop-in hub providing health and wellbeing services for people experiencing homelessness: a participatory action evaluation of service coordination.

机构信息

Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE2 4AX, UK.

出版信息

BMC Health Serv Res. 2024 Nov 18;24(1):1423. doi: 10.1186/s12913-024-11897-x.

Abstract

BACKGROUND

People experiencing homelessness often face obstacles accessing health and social care support. Challenges are further exacerbated when support provision for multiple unmet needs are not integrated or coordinated. To overcome these challenges, there has been growing attention on integrating and co-locating health and wellbeing services for people experiencing homelessness. In an urban area of North East England, a long-standing Hub or 'drop-in centre' offers a range of health and wellbeing support by bringing together the different health and care system agencies in one space. However, little is known about the perspectives of providers on what works well and less well in how the different services are coordinated.

METHODS

Using a participatory action research approach, a qualitative service evaluation was undertaken between June and September 2023. Fourteen interviews were conducted with providers who work in a paid or voluntary capacity operating some of their service offerings or support in the Hub. Interview transcripts were analysed using inductive reflexive thematic analysis.

RESULTS

Three themes were evident from the evaluation: 1) location and space matter, 2) co-location and relationships make a difference, and 3) service consistency and flexibility are paramount.

CONCLUSION

Co-locating support to cover the breadth of health and care needs has the potential to increase engagement and access for people experiencing homelessness, and to enhance trust with service users and between agencies. This model provides a unique example of co-location and integration of support, particularly with it being operated by a community housing organisation.

摘要

背景

无家可归者在获取健康和社会关怀支持方面常常面临障碍。当多个未满足的需求的支持提供没有整合或协调时,挑战会进一步加剧。为了克服这些挑战,越来越多的人关注为无家可归者整合和集中提供健康和福利服务。在英格兰东北部的一个城市地区,一个历史悠久的中心(或“中途停留中心”)通过将不同的卫生和保健系统机构集中在一个空间内,提供了一系列健康和福利支持。然而,对于提供者在协调不同服务方面哪些方面做得好,哪些方面做得不好的看法知之甚少。

方法

采用参与式行动研究方法,于 2023 年 6 月至 9 月进行了定性服务评估。对在中心提供部分服务或支持的 14 名付费或志愿提供者进行了访谈。使用归纳性反思主题分析方法对访谈记录进行了分析。

结果

评估结果显示出三个主题:1)地点和空间很重要,2)集中办公和关系有影响,3)服务一致性和灵活性至关重要。

结论

集中支持以满足广泛的健康和保健需求,有可能增加无家可归者的参与度和获得服务的机会,并增强与服务使用者和机构之间的信任。这种模式提供了支持集中和整合的独特范例,特别是由社区住房组织运营。

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More than a house: Women's recovery from homelessness in Australia.超越住所:澳大利亚女性摆脱无家可归状态的历程
Health Soc Care Community. 2022 Jul;30(4):e1427-e1437. doi: 10.1111/hsc.13550. Epub 2021 Aug 19.

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