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HCV infections in people experiencing homelessness and housing instability…
HCV infections in people experiencing homelessness and housing instability.
Health Belief Model
Perceived Barriers
Cost of care and preventative treatments/antivirals
Lack of clean resources and environment for treatment (ie. no regular pharmacy, water for pills, etc)
Conflicting advice from the medical community leads to mistrust
Access to care
Difficult to find primary care providers
Physical location of care
Lack of transportation
lack of resources offered within temporary housing
Perceived Susceptibility
Understanding of associated risk factors for disease transmission
Knowledge or lack of knowledge regarding pre-existing comorbidities
Understanding how HCV is transmitted
Less likely to think that they will get HCV
Needle use and transmission is not clearly identified
Cues to Action
Consideration of others and how health outcomes impacts them
Increased responsibility of care for children or parental figures
Personal stake in health outcomes
Feeling ill
Wanting to make a change
No longer using drugs
Affiliation with a health care provider
Encouragement to improve health
Symptomatic of HCV illness
Hospital referral for HCV treatment
Social Cognitive Theory
Behavioral factors
Health enhancing
Health compromising
Drug addiction can make identifying disease difficult.
Behavioral skills
Intentions
Reinforcements
Personal cognitive factors
Self efficacy
Poor self-confidence due to previous shortcomings (which may have contributed to housing hardships and/or HCV infection)
Outcome expectations
Socio-environmental factors
Observational learning
others around them may be getting HCV treatment
Normative beliefs
There is a stigma associated with being homeless
drug use and abuse is normalized around peers
Social support
victim of abuse
no support system
Opportunities and barriers
Barrier: curfews at shelters and people being asked to leave make it hard to complete a course of HCV treatment in the shelter
does the shelter offer primary care testing/treatment
Integrated behavior model
Theory of Planned behavior
Behavioral intentions
subjective norms
high probability of substance use
assumed risk of HCV
Attitudes
Confidence in adhering to medication regimen
perceived control
Fear of positive result, therefore don't want to get tested
Knowledge
Limited knowledge on how HCV is transmitted
Limited knowledge of HVC diagnosis
Motivational factors
Peer pressure
intentions
Not wanting to spread the disease to others
Theory of Reasoned Action