Describing the experiences of healthcare providers who supported an outreach program to deliver point-of-care screening in adults with Type 1 and Type 2 diabetes who are experiencing homelessness in Calgary, Canada: A qualitative analysis.
Hannah M Yaphe, Sara Scott, Huanghe Ding, Breanna McSweeney, Eshleen Grewal, David Jt Campbell
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引用次数: 0
Abstract
Objectives: Unstable housing and homelessness are associated with increased risks of diabetes-related morbidity and mortality. Concordantly, as few as 12-30% of people with lived experience of homelessness (PWLEH) complete recommended screening for microvascular complications of diabetes. Innovative models of care delivery are needed to address this disparity. We recently piloted a novel, community-based, point-of-care screening program for diabetes complications (the SAFER model of care, i.e. Screening for glycosylated hemoglobin (A1c), feet, eyes and renal function) in Calgary, Alberta. Herein, we describe the experiences of providers who supported the implementation of SAFER to explore factors which influenced the adoption and maintenance of this innovative model.
Methods: Complete details of the intervention are reported elsewhere. Semi-structured interviews were conducted with service providers and clinic managers at the sites which hosted the SAFER intervention. Transcribed data were analyzed through qualitative thematic analysis with NVivo software.
Results: Nine participants from two organizations were interviewed. Participants described four thematic messages regarding their experiences: 1) The intervention successfully addressed relevant barriers to enable clients to complete screening, 2) Generating and maintaining client engagement requires dedicated effort, 3) Competing priorities for providers and organizations can be a barrier to sustaining programs - even when effective, 4) Programs introduced through research studies are inherently dependent upon resources that are time-limited in nature which impacts the ability to maintain the program long-term.
Conclusion: Lessons learned from providers' experiences with SAFER can inform the planning and delivery of other programs like SAFER to address ongoing disparities in diabetes care for PWLEH.
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