The Health Bus, an innovative outreach program, serves the marginalized population of a large Canadian city. In this article, a needs assessment/evaluation study of its services is discussed. Barriers to mainstream healthcare and solutions are examined. This study was qualitative, descriptive, and exploratory and surveyed 58 client volunteers of the program through semistructured interviews and focus groups. Thematic analysis of data was carried out. The Health Bus was found to provide basic healthcare and supplies effectively. Clients value respectful treatment, competency of healthcare professionals, and accessibility, whereas disrespectful treatments and lack of transportation are barriers to mainstream healthcare. A conclusion of this study is that Health Bus services should be expanded with clients’ input. Mainstream institutions need flexibility and a change in attitudes toward the marginalized.
Bryant, T. (2004). Housing and health in Canada. In D. Raphael (Ed.), Social determinants of health: Canadian perspectives (pp. 217-238). Toronto: Canadian Scholars Press.
2.
Bunkers, S. S. (2004). The lived experience of feeling cared for: A human becoming perspective. Nursing Science Quarterly, 17(1), 63-71.
3.
Cheung, A. M., & Hwang, S. W. (2004). Risk of death among homeless women: A cohort study and review of the literature. Canadian Medical Association Journal, 170(8), 1243-1249.
4.
Drevdahl, D., Kneipp, S. M., Canales, M. K., & Dorcy, K. S. (2001). Reinvesting in social justice: A capital idea for public health nursing?Advances in Nursing Science, 24(2), 19-31.
5.
Gillis, L. M., & Singer, J. (1997). Breaking through the barriers: Healthcare for the Homeless, Inc., Baltimore, Maryland. Journal of Nursing Administration, 27(6), 30-34.
6.
Hagedorn, S. (2002). The advocate: Caring for street youth. A nursing challenge. Journal for Specialists in Pediatric Nursing, 7(1), 34-37.
7.
Hargrave, C. (2004). Homelessness in Canada: From housing to shelters to blankets. Share International, Archives. Retrieved November 18, 2004, from http://www.share-international.org/archives/homelessness/hl-ch_Canada.htm%23top
8.
Harris, S. N., Mowbray, C. T., & Solarz, A. (1994). Physical health, mental health, and substance abuse problems of shelter users. Health & Social Work, 19(1), 37-46.
9.
Hwang, S. W. (2000). Mortality among men using homeless shelters in Toronto, Ontario. Journal of the American Medical Association, 283(16), 2152-2157.
10.
Hwang, S. W., Martin, R. E., Tolomiczenko, G. S., & Hulchanski, J. D. (2003). The relationship between housing conditions and health status of rooming house residents in Toronto. Canadian Journal of Public Health, 94(6), 436.
11.
Josephson, D. K. (2000). Women of hope—Tiospaye. Nursing Science Quarterly, 13(4), 300-302.
12.
Josephson, D. K., & Bunkers, S. S. (2004). Eighth Street Bridge: A dream of human becoming. Nursing Science Quarterly, 17(2), 122-127.
13.
McGee, P., & Barnard, A. M. (1999). Meeting the needs of homeless people: The St. John Ambulance mobile service. Nursing Standard, 13(42), 38-40.
14.
Morris, R. I., & Butt, R. A. (2003). Parents’ perspectives on homelessness and its effects on the educational development of their children. Journal of School Nursing, 19(1), 43-50.
15.
O’Connell, J. (2004). Dying in the shadows: The challenge of providing health care for homeless people. Canadian Medical Association Journal, 170(8), 1251-1252.
16.
Power, R., French, R., Connelly, J., George, S., et al. (1999). Education and debate: Health, health promotion, and homelessness. British Medical Journal, 318(7183), 590-592.
17.
Raeburn, J., & Rootman, I. (1998). People-centred health promotion. Chichester, NY: John Wiley.
18.
Raphael, D. (2003a). Addressing the social determinants of health in Canada: Bridging the gap between research findings and public policy. Policy Options, 24(3), 35-40.
19.
Raphael, D. (2003b, November 13). A prescription for poor health: Poverty, health and public policy. Presentation made at the annual meeting of the Metro Association of Family Resource Programs, Toronto, Ontario.
20.
Raphael, D. (Ed.). (2004). Social determinants of health: Canadian perspectives. Toronto: Canadian Scholars Press.
21.
Rasmusson, D. L. (1999). True presence with homeless persons. In R. R. Parse (Ed.), Illuminations: The human becoming theory in practice and research (pp. 105-113). Sudbury, MA: Jones and Bartlett.
22.
Registered Nurses Association of Ontario. (2002). Best practice guideline: Client centred care. Toronto: Author.
23.
Sawyer, L. (1995). Community participation: Lip service?Nursing Outlook, 43(1), 17-22.
24.
Sunnak, A. (2004). Homes first: Hope and housing for the homeless. Registered Nurse Journal, 16(3), 10-13.
25.
Trevena, L. D., Nutbeam, D., & Simpson, J. S. (2001). Asking the right questions of disadvantaged and homeless communities: The role of housing, patterns of illness and reporting behaviours in the measurement of health status. Australian and New Zealand Journal of Public Health, 25(4), 298-304.
26.
Zerwekh, J. (2000). Caring on the rugged edge: Nursing persons who are disenfranchised. Advances in Nursing Science, 22(4), 47-61.
