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Evaluating Structural Barriers to Quality Care in the SHOW Free Clinic

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Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.

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2017-05

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Substance Use Disorder Stigma Reduction among Health Professional Students: Module Development and Implementation in the SHOW Interprofessional Experiential Learning Course

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This paper discusses the impact of substance use disorder (SUD) stigma on individuals with substance use disorders and details the development of a SUD Stigma Reduction pilot module for the Student Health Outreach for Wellness (SHOW) affiliated course (HCR 494

This paper discusses the impact of substance use disorder (SUD) stigma on individuals with substance use disorders and details the development of a SUD Stigma Reduction pilot module for the Student Health Outreach for Wellness (SHOW) affiliated course (HCR 494 Complex Health - Immersion) offered at Arizona State University. This course was designed to educate pre-health professional and health professional students on complex health topics in an interprofessional, experiential-learning environment. The SUD and Stigma module developed in this thesis project provided students with information on SUDs and the opportunity to confront stigma, improving their perceptions on individuals with SUD.

The pilot module on SUD Stigma Reduction was researched, designed, and implemented in the HCR 494 course. After students completed the module, a retrospective pre-post survey was administered to evaluate the effectiveness of the module in two areas: content knowledge and personal perceptions. Only one student responded to the survey, placing limitations on analysis. The student’s response showed a general increase in understanding of the module material, matching the stated objectives, and positive changes in perceptions on people with SUDs. Due to the positive evaluation of the course, the pilot module was deemed successful and has been integrated into the HCR 494 course. Further research is necessary to determine the long term impact of stigma reduction modules in experiential learning courses.

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2020-05