Conceptual framework and item selection. 2004;12(3):221–32. Asia Pac J Clin Nutr. Identifying nutritionally vulnerable groups in case of emergencies: experience from the Athens 1999 earthquake. We thank the adults with intellectual disability, their families, carers and GPs, and the Endeavour Foundation. 2016;35(1):28–41. Physical activity programming for individuals experiencing homelessness. AB, TD, SG, NB, MK, TB, CH, MS, TM were responsible for dual critical appraisal and data extraction. Of the residential staff, 26% (intervention) and 36% (control) were male, with mean ages of 47 and 50 years. No validated tools were identified that assessed oral health, chronic conditions, anthropometry, demography, nutrition, continence, functional decline and frailty, or vision and hearing. https://doi.org/10.7416/ai.2017.2132. Consequently, many people experiencing homelessness also present with age-related declining physical and cognitive functions [4, 9, 10]. Census of population and housing: estimating homelessness, 2016. http://www.abs.gov.au/ausstats/abs@.nsf/mf/2049.0. J Epidemiol Community Health. bPerformed by the GP, audiologist or ENT surgeon. Levorato S, Bocci G, Troiano G, Messina G, Nante N. Health status of homeless persons: a pilot study in the Padua municipal dorm. It is based on the CEBM hierarchy model in which the hierarchy of evidence for diverse research questions contains different types of research designs (fit for purpose). Prim Dent Care. Clinically significant excesses in activities related to weight and women's health were also apparent in the CHAP arm (Table 2), with Papanicolau smears almost eight times more common. Also, an enhanced focus on qualitative benefits for all concerned in the clinical interaction will be highly desirable. BMC Med Ethics. After the CHAP assessment, the carer retained a copy of the action sheet, and the CHAP tool was returned to the research team. 2006;26(4):150–4. Google Scholar. Available at: https://www.who.int/ageing/events/world-report-2015-launch/en/. User’s manual and interpretation guide for the United States version of the World Health Organization quality of life (WHOQOL) tools. There is an urgent need to develop consistent and comprehensive health assessment and screening tools specific to the needs and concerns of subgroups of people experiencing homelessness. Br J Nutr. 2014;36(26):2210–5. Seven individuals conducted paired appraisals (AB, TD, SG, NB, MK, TB, CH). This is a structured checklist of psychometric properties and utility of application, developed for assessment and outcome measures [21]. Without evidence of validity, self-report tools of most concern regarding applicability to homeless populations include those measuring health domains such as chronic conditions, functional decline and frailty, cognitive function, continence and nutrition. Of the 13 studies that used validated tools for the target population, three were classified as NHMRC III-1 [34, 35, 44] (prospective observational cohort studies). 2012;40(2):115–25. J Gen Intern Med. WHO. Collins J, Freeman R. Homeless in north and West Belfast: an oral health needs assessment. Gregg MJ, Bedard A. Screening for traumatic brain injury: findings and public health implications. The identification of valid and reliable tools is the first step towards developing proactive health assessments that will be relevant and acceptable to people experiencing homelessness. 2001;62(3-B):1586. Holistic health assessments are integral components of patient care under this model. This comprehensive health assessment revealed severe problems in several health domains in a substantial number of ex-COVID-19 patients. Fifty-five other assessment and screening tools were potentially-relevant to persons experiencing homelessness, but no evidence was found that validity had been established with this target population. Most notable clinically were four cases of reflux disease in the intervention group compared with one, and the two cases of epilepsy and one case of diabetes, all found in the intervention group. However, the overall trend to improved healthcare suggests likely real benefit given to their substantial unmet health needs, lack of viable alternative strategies, and the support of a large proportion of carers and GPs. Prim Health Care Res Dev. 1990;90(10):1387–92. 2014;71(2):167–74. Lo PC. These were then screened according to the review method. 2006;21(1):61–4. Both tools captured information leading to homelessness, employment options, education, children, housing options, and access to benefits. J Nerv Ment Dis. PubMed  It did not include articles about assessment of the specific diseases which may occur in people experiencing homelessness (for instance cardiac or respiratory diseases, mental illnesses or infectious diseases). Int J Public Health. Staff and guardians discussed the project with those in their care before consent was given formally by the adults themselves (via their guardian) and by their main residential carer and their general practitioner (GP) (Figure 1). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 2010;38(2):136–44. Seattle: WHOQOL Center; 1997. 2012;27(1):16–22. Health Soc Care Community. Composed of physical examinations and a series of well-designed questions, these assessments are used by nurses to evaluate how each area — body, mind and spirit — is affecting the patient’s overall health. Reilly S. Addressing the health problems of the homeless: a systematic review and a controlled trial. McLellan AT, Luborsky L, O’Brien CP, Woody GE. PubMed  Health, homelessness, and poverty. Soc Indic Res. The individual quality appraisal items for each potentially-relevant article are provided in Additional file 3. Am J Prev Med. There is some support for this approach from a pilot study among older US adults with intellectual disability.23. 2010;99(2):333–40. J R Coll Gen Pract. 2009;16(3):94–8. Effects on assessing sensory impairment were especially striking (e.g. Approximately 40% adults experiencing homelessness report having at least one chronic health condition, which is often poorly controlled [7, 12]. A 12 item short form health survey: construction of scales and preliminary tests of reliability and validity. Google Scholar. Ware JE Jr, Kosinski M, Keller SD. Hwang SW, Wilkins E, Chambers C, Estrabillo E, Berends J, MacDonald A. Follow-up was for 1 year post intervention, with outcomes extracted from GPs’ clinical records. While the findings of this study suggest that implementation of such a process may have real value it may need adaptation for different models of healthcare. 2012;18(2):95–100. Potential relevance was assessed in terms of generalizability or transferrable constructs between the population with which they had been developed and tested, and people experiencing homelessness. J Med Life. Gordon, S.J., Grimmer, K., Bradley, A. et al. Disabil Rehabil. This systematic review is the first that we know of, that has collated information on the validity of health screening and assessment tools used for people experiencing homelessness. Google Scholar, European Comission. The health assessment includes an evaluation of social and cultural needs, preferences, strengths and limitations. Interventions to improve the health of the homeless: a systematic review. Background People with intellectual disability constitute ∼ 2% of the population. Interviews and data extraction were performed by T Rey-Conde, S Faint, J Brown, T Barnes and C Phillips. Luo Y, McGrath C. Oral health and its impact on the life quality of homeless people in Hong Kong. Two tools were identified which had been developed directly for, and with input from, homeless people [34, 35]. The implementation of the trial was performed by T Rey-Conde and D Rice, and overseen by the trial Steering Committee of N Lennox, C Bain, R Bush and D Purdie. Neuropsychological functioning of homeless men. A complete health assessment is a detailed examination that typically includes a thorough health history and comprehensive head-to-toe physical exam. Search across a wide variety of disciplines and sources: articles, theses, books, abstracts and court opinions. Hanover project team. These studies reported on 73 health screening or health assessment tools, across 11 domains: oral health [22,23,24,25,26,27,28,29,30,31,32]; health related quality of life, and health status [9, 33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48]; nutrition [49,50,51,52,53,54,55,56]; psychological and cognitive function [9, 22, 34, 35, 41, 42, 44, 56,57,58,59]; substance use [28, 33,34,35,36, 51, 57]; injury [29, 30, 36, 58]; chronic conditions [33, 44, 45, 60, 57]; demography and anthropometry [34,35,36,37,38,39,40, 44, 49, 51,52,53,54,55, 60]; functional decline and frailty [9, 37, 38, 54]; hearing and vision [9, 36, 61]; and pelvic floor health [9]. This left 34 clusters (17 pairs) with 234 intervention adults and 219 control adults of whom 430 participants (95% of those recruited) were successfully followed up at 1-year. private residential or institutional settings. Am J Public Health. Potentially-relevant articles were also identified through hand-searching of references cited in the reviewed articles. Community assessment is a core function of public health. Other aspects which assessors may need to consider are whether the tool is freely available and whether there are population norms for comparison. Comprehensive nursing assessment, as the first step in the nursing process, involves the systematic and constant data gathering to facilitate the development of the patient-specific nursing process. Article  We can also see that among those receiving the CHAP, rates of testing increased substantially above their pre-CHAP values (Table 1), with 20-fold more testing of visual acuity and 10-fold more hearing tests (annualized). Community Dent Health. High staff turnover is characteristic of disability services, and in this study only 65 of the original 118 residential care staff could be contacted at its conclusion. The intervention took place between August 1999 and March 2000. Food, health and eating among single homeless and marginalized people in London. 2015;128:126–33. GPs (63%) and carers (80%) identified personal gains through provision of better care and/or increased knowledge. Full details of participant flow are shown in Figure 1. The findings of this review confirm the complexities of assessing, accurately representing and addressing the potentially poor health of homeless populations. PLoS Med. Exit interviews found 24 of 48 GPs considered the health of their patients had improved as a result of the CHAP, as did 14 of 35 carers; the remainder were unsure or thought the adult's health was already optimal. Moreover, as values are often dependent on sampling strategies, sample size and comparison instruments, it generally requires a great deal more information to interpret a value, thus reporting a value on its own can be misinterpreted. Concerns in the elderly such as poor balance, falls, vision loss, incontinence, arthritis, chronic pain and poor skin health may also be relevant to younger homeless people [2, 10]. Model School-District Wellness Policies Warrant Improvements in Comprehensiveness and Strength. Human health research must align with the ethical principles of beneficence, non-maleficence, health maximization, efficiency, and respect for autonomy, justice and proportionality [72]. https://doi.org/10.1186/s12889-019-7234-y, DOI: https://doi.org/10.1186/s12889-019-7234-y. The values themselves are not reported in the Reckoner, as the Reckoner is simply a way of summarising the amount and type of testing to which an instrument has been subjected during developmental phases. These tools often have questions worded in a manner that assume that respondents sleep in a bed, and have access to food preparation and storage services, as well as bathroom and toilet facilities. Homelessness is increasing globally. No adverse effects from the CHAP were found. College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, 5042, S. J. Gordon, K. Grimmer, A. Bradley, T. Direen, N. Baker & T. Marin, Division of Physiotherapy, Faculty of Medicine and Health Science, Stellenbosch Uni, Cape Town, South Africa, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, 5000, School of Public Health, University of Adelaide, Adelaide, South Australia, 5000, School of Nursing, University of British Columbia, Vancouver, Canada, You can also search for this author in For example, based on the CHAP booklet data vision and hearing assessments were seen to have been performed in 68.7 and 83.4% of adults respectively, three to six times the rates recorded in the GP notes (on which our effect estimates are based). The disability services that have implemented it plan to use it yearly, largely because this fits organizational patterns; it is yet to be established if this is optimal. 2000;22(8):863–78. Data coding and entry was performed by T Rey-Conde, M Davis, R Murrell, D Hele, N Pandeya and D Purdie performed the analysis. We estimated the power of the study for primary outcomes where data on prevalence were available. And sources: articles, theses, books, abstracts and court opinions of funded! Wales: an oral health status: a new tool for substance abuse patients: the addiction index... Professionals other than pediatricians goal in health care is to attain a comprehensive history and head-to-toe. The study design Cisler RA disability performed by their general practitioner of 2122 identified studies, 37 identified! The Endeavour Foundation including demographic data, IQ, aetiology of disability and GP consultation were... 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