Evaluating knowledge and utilization of community health resources to promote autonomous decision-making among people experiencing homelessness in New Orleans

ABSTRACT

People experiencing homelessness encounter barriers to self-directed community health resource use that may limit autonomous decision-making. Tailored educational material is needed to increase knowledge, promote well-informed resource access, and improve community health system navigability. This study aimed to 1) assess homeless individuals' baseline knowledge and utilization of community health resources and 2) evaluate use of a pocket-sized resource guide. Participants (N = 103) were recruited at a no-cost medical clinic in New Orleans to complete pre- and post-surveys assessing knowledge and utilization of community health resources listed on the guide. Over a third (38.8%) of participants indicated having low knowledge of resources at baseline. Utilization of resources varied substantially, ranging from a majority (66.7%) to a select few (6.9%) participants reporting attendance at sites. Among participants who completed the follow-up survey, self-rated knowledge of resources significantly increased (p = 0.029); however, the number of resources used in the past month slightly declined. These results may speak to participants who used the resource guides having an improved ability to selectively access resources for their specific needs. Interventions to improve health resource knowledge can, thus, aid more efficient and autonomous decision-making and are needed to improve community health system accessibility for populations experiencing homelessness.

KEYWORDS:

• Homelessness
• knowledge
• decision-making
• community health
• utilization

Acknowledgements

We would like to acknowledge the Albert Schweitzer Fellowship for the full funding of this project and express our sincere gratitude for their continuous support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Albert Schweitzer Fellowship at Louisiana State University Health Sciences Center in New Orleans, Louisiana.

Notes on contributors

Olivia E. Gilbert

Olivia E. Gilbert is an MD candidate at Louisiana State University Health Sciences Center in New Orleans and an incoming Neurosurgery resident physician at University of North Carolina Chapel Hill. She serves as the Director of the Student Run Community Clinics at the Ozanam Inn, a homeless shelter in New Orleans, Louisiana.

Nicole A. Dominique-Branley

Nicole Dominique-Branley, MD, MPH is a Stanford Pediatrics resident physician at Lucile Packard Children's Hospital in Palo Alto, California.

Abrania Marrero

Abrania Marrero is a PhD candidate in Population Health Sciences, Nutritional Epidemiology at Harvard T.H. Chan School of Public Health. Her research investigates human and global environmental changes in small island food systems, including the impacts of dietary colonialism and climatic shocks on human health, nutrition security, and chronic disease risk.

Melinda S. Sothern

Melinda S. Sothern, PhD, CEP is a licensed clinical exercise physiologist and currently serves as Professor Emerita at the Louisiana State University Health Sciences Center, Schools of Medicine and Public Health in New Orleans, Louisiana. Her research focuses on pediatric exercise physiology, nutritional genomics, social determinants of health and behavioral counseling as it relates to the screening, diagnosis, design, implementation and evaluation of interventions to prevent and treat chronic diseases in childhood such as obesity, type 2 diabetes, asthma, musculoskeletal and emotional disorders.

Stephen Phillippi

Stephen Phillippi, PhD is the Chair of Behavioral & Community Health Sciences at the Louisiana State University Health Sciences Center's School of Public Health. As a full professor, with tenure, he is also the Director of the Institute for Public Health & Justice and Founding Director of the Center for Evidence to Practice, both working to bring evidence-based practices and supportive policies to states and local communities.