Physicians in a rural community are working to ensure vulnerably housed people can safely and more easily access primary care.
In Squamish, the population of vulnerably housed people without a primary care physician has increased significantly over the past few years.
Noticing this trend, local family physicians, Dr. Melissa Aragon and Dr. Allan Bohn, decided to see how providing primary care within a shelter setting could potentially help.
However, they also wanted to evaluate the impact of the endeavor—so a research project was born.
In order to carry out the project, the pair decided to apply for a $10,000 grant available from the Rural Coordination Centre of BC (RCCbc) through the Rural Physician Research Grant Program (RPRGP).
It was a great decision, says Melissa.
“The research project started off as just a way for us to ensure we were on the right path. It was a way of being like, ‘well, if we’re going make this this work in the long run, we need to be able to prove that this is a valid, helpful thing for people’,” she says.
“I think what's been interesting, is just how keen both colleagues and patients have been on being involved with the study.”
Multiple existing studies show that marginalized populations, such as those who are vulnerably housed, have poorer health outcomes and increased morbidity and mortality compared to those in the general population.
Preventative and routine medical care is often difficult to obtain for patients with mental health, addictions and housing instability. This is due to many barriers (transport/missed appointments/stigma) and a mistrust of the healthcare system and health professionals.
Melissa and Allan’s study, which is still in the works, seeks to ascertain if the establishment of a low barrier primary care clinic located within a local shelter/food bank improves engagement, trust and subsequently health outcomes amongst a mid-size, rural community’s most marginalized population.
The primary care is being carried out in partnership with Under One Roof, operated by the not-for-profit Helping Hands Society. It is a centralized shelter, food bank, and housing complex that is located in downtown Squamish.
“I think what’s been interesting, is just how keen both colleagues and patients have been on being involved with the study,” said Melissa. “Our interviewer ended up being one of my nursing colleagues who was super keen, and she had such a positive experience, she really loved it.
“Then a lot of the patients expressed to her, and even to me, that they were really excited to be involved. So that was kind of cool.”
Melissa says she is grateful for the support she received from RCCbc from people who have expertise with research. She was able to work with the research team to answer any questions that she had. The grant money was also really useful.
“The grant has been huge. Being able to hire a research assistant to do the interviews and have the funding for that has been great. It would be possible without the grant, but it would have been really difficult.
The study is not yet complete, but Melissa is seeing the results in real-time.
“The biggest thing is in a rural area there’s a lot of barriers to specialist care, especially for more vulnerable populations. They don’t have access to transportation to the city. They don’t have a phone, or if they do have a phone, it’s out of battery or out of minutes. So they don’t have that follow-up with the specialists, and then they get no-show fees, and then just never follow up.
“So I think what’s been a huge benefit is helping to organize either transportation to the city, or even a specialist appointment over the phone. So sometimes I will be on a phone call with the specialist and the patient to coordinate things. So that’s been a huge benefit that I think, in rural care, patients usually end up missing out on,” she says.
“It’s super important. And I think for a lot of people who felt judged before, ostracized by the healthcare system, having their family doctor, or maybe it’s a nurse practitioner there at their side, it has really increased their comfort level.”
““It's super important. And I think for a lot of people who felt judged before, ostracized by the healthcare system, having their family doctor, or maybe it's a nurse practitioner there at their side, it has really increased their comfort level.””
Application deadline is April 30
Do you have an idea for a rural health research project?
Applications are now being accepted for the RPRGP. The RPRGP empowers rural physician researchers—especially new aspiring researchers—to pursue innovative rural research projects that advance rural health in British Columbia. The annual application deadline for RPRGP is April 30. More: https://rccbc.ca/initiatives/rprgp/
