IDEAS home Printed from https://ideas.repec.org/a/eee/cysrev/v115y2020ics019074091931480x.html
   My bibliography  Save this article

Access to healthcare among youth experiencing homelessness: Perspectives from healthcare and social service providers

Author

Listed:
  • Gallardo, Kathryn R.
  • Santa Maria, Diane
  • Narendorf, Sarah
  • Markham, Christine M.
  • Swartz, Michael D.
  • Batiste, Charles M.

Abstract

Access to healthcare services is critical for youth experiencing homelessness (YEH) given their high risk of experiencing adverse physical and mental health outcomes. Previous studies have identified factors that impact YEH’s access to healthcare services from the perspective of YEH, but less is known from the perspective of providers. The purpose of this study was to examine providers’ experiences and perceptions of the barriers and facilitators that impact YEH’s access to healthcare. Semi-structured interviews were conducted with 17 healthcare and social service providers in Houston, Texas. Drawing on constructs from healthcare access frameworks, findings were categorized into barrier-and facilitator-related themes that reflect five dimensions of healthcare access: approachability, acceptability, accommodation, affordability, and adequacy. The most commonly reported barrier was the high-barrier healthcare service delivery system (e.g., numerous documentation requirements, multi-step process) that YEH had to navigate in order to access healthcare services, followed by the limited availability of free and low-cost healthcare services. The most commonly reported facilitator was building interagency relationships that helped streamline the referral process and provided direct organizational contacts that could be called upon when YEH need assistance. This was followed by offering healthcare navigation assistance (e.g., teaching YEH how to identify healthcare services online) and accompanying YEH to appointments, which better ensured YEH’s access to care. Collectively, study findings indicate that the complex way in which healthcare services are currently organized and delivered fails to adequately accommodate YEH, who need low-threshold access to youth-centered healthcare services. Gaps in YEH’s access to healthcare services can be narrowed using a combination of administrative strategies and research efforts. These include implementing policies, programs, and practices that incorporate trauma-informed principles in YEH-serving organizations; establishing interagency collaborations to better facilitate the service connection process; and developing and evaluating patient navigator programs designed to increase YEH’s access to healthcare services.

Suggested Citation

  • Gallardo, Kathryn R. & Santa Maria, Diane & Narendorf, Sarah & Markham, Christine M. & Swartz, Michael D. & Batiste, Charles M., 2020. "Access to healthcare among youth experiencing homelessness: Perspectives from healthcare and social service providers," Children and Youth Services Review, Elsevier, vol. 115(C).
    • Handle: RePEc:eee:cysrev:v:115:y:2020:i:c:s019074091931480x
    DOI: 10.1016/j.childyouth.2020.105094
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S019074091931480X
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.childyouth.2020.105094?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Aykanian, Amanda, 2018. "Service and policy considerations when working with highly mobile homeless youth: Perspectives from the frontlines," Children and Youth Services Review, Elsevier, vol. 84(C), pages 9-16.
    2. Noble-Carr, Debbie & Barker, Justin & McArthur, Morag & Woodman, Elise, 2014. "Improving practice: The importance of connections in establishing positive identity and meaning in the lives of vulnerable young people," Children and Youth Services Review, Elsevier, vol. 47(P3), pages 389-396.
    3. Slesnick, Natasha & Dashora, Pushpanjali & Letcher, Amber & Erdem, Gizem & Serovich, Julianne, 2009. "A review of services and interventions for runaway and homeless youth: Moving forward," Children and Youth Services Review, Elsevier, vol. 31(7), pages 732-742, July.
    4. Kidd, Sean A. & Miner, Susan & Walker, Diana & Davidson, Larry, 2007. "Stories of working with homeless youth: On being "mind-boggling"," Children and Youth Services Review, Elsevier, vol. 29(1), pages 16-34, January.
    5. Esparza, Nicole, 2009. "Community factors influencing the prevalence of homeless youth services," Children and Youth Services Review, Elsevier, vol. 31(12), pages 1321-1329, December.
    6. Gharabaghi, Kiaras & Stuart, Carol, 2010. "Voices from the periphery: Prospects and challenges for the homeless youth service sector," Children and Youth Services Review, Elsevier, vol. 32(12), pages 1683-1689, December.
    7. Alex Abramovich, 2016. "Preventing, Reducing and Ending LGBTQ2S Youth Homelessness: The Need for Targeted Strategies," Social Inclusion, Cogitatio Press, vol. 4(4), pages 86-96.
    8. Abraído-Lanza, A.F. & Armbrister, A.N. & Flórez, K.R. & Aguirre, A.N., 2006. "Toward a theory-driven model of acculturation in public health research," American Journal of Public Health, American Public Health Association, vol. 96(8), pages 1342-1346.
    9. Black, Emma B. & Fedyszyn, Izabela E. & Mildred, Helen & Perkin, Rhianna & Lough, Richard & Brann, Peter & Ritter, Cheryl, 2018. "Homeless youth: Barriers and facilitators for service referrals," Evaluation and Program Planning, Elsevier, vol. 68(C), pages 7-12.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Damian, April Joy & Ponce, Delilah & Gonzalez, Melanie & Azevedo, Brandon & Kokan, Zeba & Ortiz-Siberon, Angel, 2023. "Barriers and opportunities to supporting youth of color and LGBTQ + youth experiencing homelessness during COVID: A qualitative assessment," Children and Youth Services Review, Elsevier, vol. 155(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daniela Lemmo & Maria Luisa Martino & Anna Rosa Donizzetti & Maria Francesca Freda & Daniela Caso, 2022. "The Relationship between Healthcare Providers and Preventive Practices: Narratives on Access to Cancer Screening," IJERPH, MDPI, vol. 19(17), pages 1-18, September.
    2. Prock, Kristen A. & Kennedy, Angie C., 2017. "Federally-funded transitional living programs and services for LGBTQ-identified homeless youth: A profile in unmet need," Children and Youth Services Review, Elsevier, vol. 83(C), pages 17-24.
    3. Vitopoulos, Nina A. & Frederick, Tyler J. & Leon, Scott & Daley, Mardi & McDonald, Carol & Morales, Shaniah & Cerswell Kielburger, Leysa & Cohen, Sue & Eacott, Karen & Howes, Carol & Gutierrez, Rose &, 2018. "Development of a complex tertiary prevention intervention for the transition out of youth homelessness," Children and Youth Services Review, Elsevier, vol. 94(C), pages 579-588.
    4. Gwadz, Marya Viorst & Cleland, Charles M. & Leonard, Noelle R. & Bolas, James & Ritchie, Amanda S. & Tabac, Lara & Freeman, Robert & Silverman, Elizabeth & Kutnick, Alexandra & Dickson, Victoria Vaugh, 2017. "Understanding organizations for runaway and homeless youth: A multi-setting quantitative study of their characteristics and effects," Children and Youth Services Review, Elsevier, vol. 73(C), pages 398-410.
    5. Bowen, Elizabeth A. & Miller, Berg & Barman-Adhikari, Anamika & Fallin, Kyla & Zuchlewski, Dale, 2017. "Emerging adult homelessness in geographic perspective: A view from the Rust Belt," Children and Youth Services Review, Elsevier, vol. 73(C), pages 213-219.
    6. Kennedy, Angie C. & Agbényiga, DeBrenna LaFa & Kasiborski, Natalie & Gladden, Jessica, 2010. "Risk chains over the life course among homeless urban adolescent mothers: Altering their trajectories through formal support," Children and Youth Services Review, Elsevier, vol. 32(12), pages 1740-1749, December.
    7. Axe, Jo & Childs, Elizabeth & Manion, Kathleen, 2020. "In search of employment: Tackling youth homelessness and unemployment," Children and Youth Services Review, Elsevier, vol. 113(C).
    8. Sulkowski, Michael L. & Michael, Kurt, 2014. "Meeting the mental health needs of homeless students in schools: A Multi-Tiered System of Support framework," Children and Youth Services Review, Elsevier, vol. 44(C), pages 145-151.
    9. Ullmann, S. Heidi & Goldman, Noreen & Pebley, Anne R., 2013. "Contextual factors and weight change over time: A comparison between U.S. Hispanics and other population sub-groups," Social Science & Medicine, Elsevier, vol. 90(C), pages 40-48.
    10. Neagu, Mariela & Sebba, Judy, 2019. "Who do they think they are: Making sense of self in residential care, foster care, and adoption," Children and Youth Services Review, Elsevier, vol. 105(C), pages 1-1.
    11. Lopez-Class, Maria & Castro, Felipe González & Ramirez, Amelie G., 2011. "Conceptions of acculturation: A review and statement of critical issues," Social Science & Medicine, Elsevier, vol. 72(9), pages 1555-1562, May.
    12. John, Dolly A. & de Castro, A.B. & Martin, Diane P. & Duran, Bonnie & Takeuchi, David T., 2012. "Does an immigrant health paradox exist among Asian Americans? Associations of nativity and occupational class with self-rated health and mental disorders," Social Science & Medicine, Elsevier, vol. 75(12), pages 2085-2098.
    13. Gurdak, Kristen & Bond, Lynden & Padgett, Deborah & Petering, Robin, 2022. "Transitioning to independent living: Experiences of homeless young adults in rapid rehousing," Evaluation and Program Planning, Elsevier, vol. 92(C).
    14. Halverson, McKenna & Hatchimonji, Danielle R. & Treglia, Dan & Flatley, Claire A. & Herbers, Janette E. & Cutuli, J.J., 2022. "Risky sexual behavior and STI testing among teens experiencing homelessness," Children and Youth Services Review, Elsevier, vol. 139(C).
    15. Côté, Philippe-Benoit & Blais, Martin, 2019. "Between resignation, resistance and recognition: A qualitative analysis of LGBTQ+ youth profiles of homelessness agencies utilization," Children and Youth Services Review, Elsevier, vol. 100(C), pages 437-443.
    16. Brodie Fraser & Nevil Pierse & Elinor Chisholm & Hera Cook, 2019. "LGBTIQ+ Homelessness: A Review of the Literature," IJERPH, MDPI, vol. 16(15), pages 1-13, July.
    17. Wusinich, Christina & Bond, Lynden & Nathanson, Anna & Padgett, Deborah K., 2019. "“If you’re gonna help me, help me”: Barriers to housing among unsheltered homeless adults," Evaluation and Program Planning, Elsevier, vol. 76(C), pages 1-1.
    18. Offiong, Asari & Powell, Terrinieka W. & Lewis, Quiana & Smith, Bianca & Prioleau, Morgan, 2020. "“I missed open arms”: The need for connectedness among Black youth affected by parental drug use," Children and Youth Services Review, Elsevier, vol. 114(C).
    19. Altena, Astrid M. & Boersma, Sandra N. & Beijersbergen, Mariëlle D. & Wolf, Judith R.L.M., 2018. "Cognitive coping in relation to self-determination and quality of life in homeless young adults," Children and Youth Services Review, Elsevier, vol. 94(C), pages 650-658.
    20. Schwan, Kaitlin J. & Fallon, Barbara & Milne, Betsy, 2018. "“The one thing that actually helps”: Art creation as a self-care and health-promoting practice amongst youth experiencing homelessness," Children and Youth Services Review, Elsevier, vol. 93(C), pages 355-364.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:cysrev:v:115:y:2020:i:c:s019074091931480x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/childyouth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.