在无家可归者服务中支持月经健康：基于提供者信息的多层次变革策略。

Supporting menstrual health in homeless services: provider-informed strategies for multilevel change.

作者信息

Schnolis Emma, Hrubiak Sofia, Arora Anukriti, Gamaleldin Kinzie, Martinez Rebecca, Cromer Risa, Ruiz Yumary, Rodriguez Natalia M, DeMaria Andrea L

机构信息

Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, West Lafayette, IN, 47907, USA.

School of Health Sciences, Purdue University, West Lafayette, IN, USA.

出版信息

BMC Health Serv Res. 2025 May 30;25(1):778. doi: 10.1186/s12913-025-12932-1.

DOI:10.1186/s12913-025-12932-1

PMID:40448085

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12123704/

Abstract

BACKGROUND

People experiencing homelessness (PEH) face heightened barriers to menstrual health, including limited access to products, hygiene facilities, and consistent care. Social service providers (SSPs) and healthcare providers (HCPs) are critical in supporting PEH but often work within resource-constrained systems. This study explores SSP and HCP perspectives on the menstrual health needs of PEH in a rural-serving community in the U.S., using the Social-Ecological Model (SEM) to identify multilevel barriers and opportunities for intervention.

METHODS

We conducted semi-structured interviews with 12 SSPs and HCPs in Tippecanoe County, Indiana. Transcripts were analyzed using thematic analysis to identify key challenges and recommendations related to menstrual health support for PEH.

RESULTS

Our analysis revealed complex challenges providers faced in supporting the menstrual health of PEH, including emotional burden, resource scarcity, and limited organizational guidance. They described how stigma, provider discomfort, and systemic gaps in training and infrastructure hindered effective care. Providers also shared that menstrual health was often deprioritized due to competing health needs and structural barriers such as lack of housing, transportation, and product access. Despite these challenges, providers offered actionable recommendations to improve menstrual health support through education, policy change, and more equitable organizational practices.

CONCLUSIONS

This study highlights the multi-level barriers providers face when supporting the menstrual health needs of PEH. Our findings show that meaningful change requires coordinated efforts across all levels of the SEM. Actionable strategies include provider training, improved intake processes, expanded access to menstrual products and hygiene resources, and policy reforms to address housing and insurance gaps. These insights can inform training programs, shelter protocols, and advocacy efforts to promote menstrual health equity and provider sustainability.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12913-025-12932-1.

摘要

背景

无家可归者在经期健康方面面临更多障碍，包括难以获得经期用品、卫生设施以及持续护理。社会服务提供者和医疗保健提供者在支持无家可归者方面至关重要，但他们通常在资源有限的系统内工作。本研究利用社会生态模型（SEM）来识别多层次障碍和干预机会，探讨美国一个乡村服务社区中社会服务提供者和医疗保健提供者对无家可归者经期健康需求的看法。

方法

我们对印第安纳州蒂珀卡努县的12名社会服务提供者和医疗保健提供者进行了半结构化访谈。使用主题分析法对访谈记录进行分析，以确定与支持无家可归者经期健康相关的关键挑战和建议。

结果

我们的分析揭示了提供者在支持无家可归者经期健康方面面临的复杂挑战，包括情感负担、资源稀缺以及组织指导有限。他们描述了耻辱感、提供者的不适感以及培训和基础设施方面的系统性差距如何阻碍了有效的护理。提供者还表示，由于相互竞争的健康需求以及缺乏住房、交通和产品获取等结构性障碍，经期健康往往被置于次要地位。尽管存在这些挑战，提供者还是提出了可行的建议，通过教育、政策变革和更公平的组织实践来改善经期健康支持。

结论

本研究强调了提供者在满足无家可归者经期健康需求时面临的多层次障碍。我们的研究结果表明，有意义的变革需要社会生态模型各级的协调努力。可行的策略包括提供者培训、改进接纳流程、扩大经期用品和卫生资源的获取，以及进行政策改革以解决住房和保险差距。这些见解可为培训项目、收容所规程和宣传努力提供参考，以促进经期健康公平和提供者的可持续性。