Access to Diabetes Care for Populations Experiencing Homelessness: an Integrated Review.
Populations experiencing homelessness with diabetes may encounter barriers to accessing comprehensive diabetes care to manage the condition, yet it is unclear to what extent this population is able to access care. We reviewed the literature to identify and describe the barriers and facilitators to accessing diabetes care and managing diabetes for homeless populations using the Equity of Access to Medical Care Framework. An integrated review of the literature was conducted and yielded 10 articles that met inclusion criteria. Integrated reviews search, summarize, and critique the state of the research evidence. Findings were organized using the dimensions of a comprehensive conceptual framework, the Equity of Access to Medical Care Framework, to identify barriers and facilitators to accessing care and managing diabetes. Barriers included competing priorities, limited access to healthy food, and inadequate healthcare resources. Facilitators to care included integrated delivery systems that provided both social and health-related services, and increased patient knowledge. Recommendations are provided for healthcare providers and public health practitioners to optimize diabetes outcomes for this population.
Division of Healthcare Studies, College of Health Professions, Medical University of South Carolina, 151B Rutledge Avenue, MSC 962, Charleston, SC, 29425-1600, USA. whitbm@musc.edu.
Brandi M
BM
White
Department of Library Science and Informatics, Medical University of South Carolina, 171 Ashley Avenue, PO Box 250403, Charleston, SC, 29425-1600, USA.
Ayaba
A
Logan
College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St., MSC 160, Charleston, SC, 29425-1600, USA.
Gayenell S
GS
Magwood
D000328:Adult; D003920:Diabetes Mellitus / Q000628:therapy*; D006297:Health Services Accessibility; D006703:Ill-Housed Persons; D006801:Humans; D008875:Middle Aged
Access to care; Diabetes; Homeless
JAMA. 2001 Jan 10;285(2):200-6
11176814
J Health Care Poor Underserved. 2013 May;24(2):456-68
23728022
Am J Public Health. 2010 Dec;100(12):2493-9
20966377
Am J Public Health. 2013 Dec;103 Suppl 2:S374-9
24148042
J Community Health Nurs. 1996;13(3):167-77
8916606
Ann Fam Med. 2016 Jan-Feb;14(1):41-6
26755782
Am J Public Health. 2013 Dec;103 Suppl 2:S331-9
24148052
J Adv Nurs. 2005 Dec;52(5):546-53
16268861
Adm Policy Ment Health. 2009 Jul;36(4):255-64
19280333
J Gen Intern Med. 2008 Oct;23(10):1685-7
18661189
J Urban Health. 2012 Dec;89(6):952-64
22644329
CMAJ. 2000 Jul 25;163(2):161-5
10934977
J Am Acad Nurse Pract. 2002 Aug;14(8):372-9
12242854
Health Serv Res. 1974 Fall;9(3):208-20
4436074
Soc Work Public Health. 2014;29(3):220-31
24802217
Dis Manag. 2007 Dec;10(6):347-55
18163863
Health Serv Res. 2013 Jun;48(3):992-1017
23134588
Am J Manag Care. 2014 Feb;20(2):135-42
24738531
Am J Public Health. 2015 Feb;105(2):e46-60
25521899
J Gen Intern Med. 2011 Nov;26 Suppl 2:683-8
21989622
J Nutr Educ Behav. 2006 Sep-Oct;38(5):307-15
16966052