Need for Communication

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Homeless people also need to communicate.

How to make communication for and by homeless people easier.

Reasons why communication is important

Homeless people seek information in a variety of ways and being able to contact them directly is important for events such as vaccine recalls, public health issues, and tainted food at a particular shelter or changes in government programmes. Therefore, being able to identify and categorize information-seeking behaviours of homeless populations is an important step in changing the way information is collected from and disseminated to this population.

In the event of a public health crisis receiving information is paramount.

Homeless individuals who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization

Technology could also be used for prevention, intervention, and aftercare services with the homeless.

Why mobile phone communication:

To enhance communication between homeless clients and their health care providers

In the event of a public health crisis, the use of mobile phones to contact the homeless would provide a simple way to disseminate information, perhaps through an automated system.

Safety. “Cell phones are good especially if the person has health problems” – “In times of emergency like when you got attacked”.

Responsibility. Follow up on employment applications by placing calls to potential employers. Even more important is the ability to receive calls from potential or current employers.

Social Connectedness. Speak with family members to “check in,” “let them know I’m still alive,” and “catch up”.

When searching for jobs, rooms but also when trying to maintain sobriety and clean time, a mobile phone allows instant access to one’s support system.

Organize around a common cause: the homeless community could use mobile phones to organize and publically demand safe and affordable housing, jobs, adequate health care that includes prescription coverage, and other such measures that exemplify dignity, respect, and full membership in society.

Text messages could be sent to homeless people about locations at which they can eat sleep, and acquire necessities during extreme weather conditions—emergencies unique to the street homeless. Information about influenza vaccinations and other infectious disease outbreaks could also be disseminated in this manner with obvious public health ramifications

Prevention and intervention programs delivered through mobile phones for human immunodeficiency virus, tobacco use and medication adherence have been developed and found to be feasible and effective in various populations. If tailored appropriately, these programs may work with homeless people

Why computer use:

Computer use can increase homeless people self-esteem and help them begin to feel a part of society

Social connectedness – important for remaining socially connected with others

Business purposes – information on employment, weather forecasts, affordable housing, medical conditions and medications, research studies in which to enroll, maps, scholarships for educational programs, locations of recovery meetings.

Leisure – surf the internet, playing games, learning the latest news, listening to music, watching videos and movies, locating free stuff, reading books, comics and so forth.

Online peer communication—support groups, discussion boards, and other knowledge resources—is another manner in which computer technology could be used to enhance health outcomes of the homeless. In this model, peers share information, provide reciprocal emotional support, link others to material aid, and establish positive, healthy group norms. Other computer-mediated support groups combine online prevention and intervention programs delivered by health care providers with online peer communication in the form of discussion forums. This ‘hybrid’ model has been used to intervene with individuals who have breast cancer, chronic pain, depression, diabetes, eating disorders, heart transplants, HIV/AIDS, obesity, and nicotine dependence. A meta-analysis found that these computer-mediated support groups led to increased social support, decreased depression, increased quality-of-life, and increased self-efficacy to manage one’s health condition – all of great importance to those experiencing homelessness.

Challenges

Contacting friends, family members, and health care providers can be difficult for the homeless who generally have limited access to telephone landlines, no permanent mailing address, little money for pay phones and public transportation, and in some cases, difficulty walking long distances because of physical ailments and safety concerns

The reliability of each individual’s mobile phone service: lack of funding; fear of mobile phone loss or theft.

Recommendations

The city should use technology to disseminate information across the homeless community

The success of a telephone network to disseminate information to homeless people would probably be dramatically increased if a reverse system was instituted, so that participants who voluntary enrolled in a telephone network could receive automated emergency notifications regardless of whether or not they had paid for their mobile phone service.

Find ways to offer free internet access and email accounts – Efforts should be made to encourage them to obtain email addresses. This would provide healthcare workers with a means to contact homeless people that would not impose a cost on anyone involved.

In order to encourage homeless people to check their email addresses regularly, perhaps city or regional health directors might be willing to offer incentives such as food vouchers. If a city was able to build a database containing the email addresses of all of its homeless, monthly notices that require a reply could be sent in order to receive such incentives.

In the event of a public health crisis, the use of mobile phones to contact the homeless would provide a simple way to disseminate information, perhaps through an automated system. This theoretical system could be constructed and maintained by a charity organization, rather than a law enforcement or government agency, to maximize participation in the programme.

Computers could be located in facilities that focus on treating the homeless, mentally ill, such as drop-in centers, clubhouses, and Housing First programs

Information could be posted online to inform homeless individuals about places at which they can eat, sleep, and acquire necessities in extremis. Information dissemination does not have to focus only on emergent situations: people who are newly homeless are unaware of the city’s shelter, food, clothing, personal hygiene, mail, and other resources for the population. A list of such resources could be posted online.

Providers could post educational health information online about the most common conditions homeless individuals contract, including physical (pneumonia, skin infections, diabetes) and mental health (depression, anxiety, psychosis) conditions.

Data on substance use, service use, new problems, and positive gains could be collected electronically from homeless individuals. Allowing people to enter their data at their convenience (i.e., time and place of their choice) has the potential to yield better and longer-term follow-up data in a transient population.


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