Order #: 14519

Authors:

Altice, F.L., Bruce, R.D., Walton, M.R., Buitrago, M.I.

Title:

Adherence to Hepatitis B Virus Vaccination at Syringe Exchange Sites.

Source:

Journal of Urban Health : Bulletin of the New York Academy of Medicine 82(1): 151-161, 2005. (Journal Article: 11 Pages)

Abstract:

This article looks at injection drug users (IDUs), who are at high risk for hepatitis B virus (HBV), yet often do not receive preventive vaccinations. IDUs who use mobile health care services linked to a syringe exchange program in New Haven were routinely screened for HBV, hepatitis C virus, and syphilis. Individuals without prior exposure to HBV were offered three-part vaccination series. Of the 212 IDUs screened for HBV infection, 134 were eligible (negative for HBV surface and core anti-bodies) for vaccination and 10 had evidence of chronic HBV infection. Compared to those with previous exposure to HBV, vaccine-eligible patients were significantly more likely to be younger and use heroin and less likely to be black, home-less, daily injectors, and cocaine users. Of the 134 vaccine-eligible subjects, 103 and 89 completed two and three vaccinations, respectively. Correlates of completing all three vaccinations included older age, injecting daily, and being homeless. These results suggest that IDUs remain at high risk for acquiring HBV infection. Programs that link health care to a syringe exchange program are effective ways to provide preventive health care services to IDUs, particularly HBV vaccination. Trust engendered by and mutual respect afforded by such programs result in repeated encounters by active IDUs over time (authors). 

Order #: 15043

Authors:

Buck, D.S., Rochon, D., Turley, J.P.

Title:

Taking It to the Streets: Recording Medical Outreach Data on Personal Digital Assistants.

Source:

Computers, Informatics, Nursing 23(5): 250-255, 2005. (Journal Article: 6 Pages)

Abstract:

This article talks about how carrying hundreds of patient files in a suitcase makes medical street outreach to the homeless clumsy and difficult.  Healthcare for the Homeless- Houston (HHH) began a case study under the assumption that tracking patient information with a personal digital assistant (PDA) would greatly simplify the process.  Equipping clinicians with custom-designed software loaded onto Palm V Handheld Computers (palmOne, Inc, Milpitas, CA), Healthcare for the Homeless- Houston assessed how this type of technology augmented medical care during street outreach to the homeless in a major metropolitan area.  Preliminary evidence suggests that personal digital assistants free clinicians to focus on building relationships instead of recreating documentation during patient encounters.  However, the limits of the PDA for storing and retrieving data made it impractical long-term.  This outcome precipitated a new study to test the feasibility of tablet personal computers loaded with a custom-designed software application specific to the needs of homeless street patients (authors). 

Order #: 14517

Authors:

Cunningham, C.O., Shapiro, S., Berg, K.M., Sacajiu, G., Paccione, G., Goulet, J.L.

Title:

An Evaluation of a Medical Outreach Program Targeting Unstably Housed HIV-Infected Individuals.

Source:

Journal of Health Care for the Poor and Underserved 16(1): 127-138, 2005. (Journal Article: 12 pages)

Abstract:

This study's objective was to evaluate a medical outreach program that targets unstably housed individuals infected with human immunodeficiency virus (HIV). One hundred sixty-one cross-sectional interviews were conducted prior to and after establishing a medical outreach program in single room occupancy hotels. Participants' mean age was 42 years; 58% were men, 95% minority, and 59% active substance users. The postintervention group was more likely to have a regular health care provider, and take Pneumocystis carinii pneumonia prophylaxis and antiretroviral medication than the pre-intervention group. Quality of care was more positively perceived in the postintervention group. On multivariate analysis the postintervention group remained more likely to have a regular provider, take antiretroviral medication, and have a better perception of quality of care. A medical outreach program targeting unstably housed individuals infected with HIV was associated with increased use of regular medical care and improved perceived quality of care (authors). 

Order #: 14411

Authors:

Nakonezny, P.A., Ojeda, M.

Title:

Health Services Utilization Between Older and Younger Homeless Adults.

Source:

Gerontologist 45(2): 249-254, 2005. (Journal Article: 5 Pages)

Abstract:

The purpose of this study was to examine the relationship between health services utilization delivered by means of the Homeless Outreach Medical Services (HOMES) program and health services utilization delivered by means of the Parkland emergency room and inpatient units among a sample of older and younger homeless adults being served by the Parkland Health and Hospital System. Older homeless individuals utilized the HOMES more than inpatient services for substance abuse and musculoskeletal conditions, but they utilized inpatient services the most for psychiatric-related conditions. This level of inpatient utilization is perhaps a result of greater severity or progression of mental illness among older homeless adults. The level of outpatient utilization is probably because the HOMES program mitigates many of the barriers that prevent homeless individuals from obtaining primary medical care (authors).