Addressing health disparities of individuals experiencing homelessness in the U.S. with community institutional partnerships: An integrative review.
Jennifer J Lee, Emma Jagasia, Patty R Wilson
PMID 36882981WHAT IT FOUND
Community partnerships delivering care in shelters increased health service use and screenings while decreasing hospitalizations.
Nurses often led these teams. However, evidence relies on short-term outcomes and program descriptions, so long-term health impacts remain unproven.
Key findings
01Partnerships improved health by increasing utilization of services and screenings while decreasing hospitalization rates.
02Most included studies were low-evidence program evaluations or case reports rather than controlled trials.
03No included study assessed social determinants of health at the policy or societal level.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence base is weak: 12 of the 16 included studies were low-level program evaluations or case reports rather than controlled trials. All outcomes were measured immediately after service provision; there is no data on long-term health effects or sustainability. The review is limited to U.S. contexts, which may not apply to other healthcare systems. Several studies focused on student learning outcomes rather than patient health outcomes, potentially biasing the reported benefits toward educational goals.
Declared interests
No conflict of interest declared by the authors.
The easy way to misread this
Do not interpret the reported improvements in health service use as proof of long-term clinical efficacy. The review explicitly states that strategies for measuring partnership impact are premature, and most studies lacked control groups or long-term follow-up.