Homelessness is a major problem for the United States today, and the fastest growing segment of this population is made up of women and young families. Research on the health needs of homeless women has suggested that they are unlikely to use birth control, and are likely to have limited gynecological care, unplanned pregnancies, inadequate prenatal care, and poor birth outcomes. However, to date this research has been limited, primarily focusing on women living in shelters or those who visit clinics.
The specific aims of the study are: 1. To assess homeless women's birth control status, use of women's health services (i.e., care related to their obstetrical and gynecological needs), and level of satisfaction with women's health services. 2. To assess the correlates of homeless women's use of, and satisfaction with contraception and women's health services. 3. To describe health care provider and facility characteristics of women's health services available to the homeless, and examine their potential influence on homeless women's use of such services. 4. To examine homeless women's perceptions of factors that would promote their use of birth control and women's health services, and their willingness to obtain care if desired facilitators were implanted. 5. To describe medical providers' views of factors that might improve access to women's health care for the homeless, and to determine how willing the providers are to implement new strategies of care. Toward these ends, a community based probability sample of 1200 homeless women of reproductive age in Los Angeles County's shelters and souplines will undergo a structured face-to-face interview. In addition, interviews will be conducted with 50 medical directors and 100 providers of women's health services, who the homeless women commonly mention as their sources of care, to understand more about provider characteristics and organizational factors that may facilitate or impede the use of women's health services. The data will be used to suggest interventions to enhance homeless women's ability to use birth control, family planning, general gynecology, and prenatal services. Study findings will also inform providers of women's health services and community groups to recognize how, based on homeless history, ethnicity, and other psychological and cultural factors, changes in both individual behavior, as well as in provider and organizational policies and practices, would allow them to care more effectively for our diverse and vulnerable populations.
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