Using Peer Health Education to Decrease Barriers to Care for Homeless Youth S/A

The health and personal risks endured by homeless youth are distinct from those experienced by housed youth and homeless adults, requiring innovative and tailored health interventions. Increased transience, unstable housing, exposure to violence, substance abuse, engagement in survival sex work, and decreased access to health care contribute to high health risks and poor health outcomes among street youth. In June 2009, Sidney Borum Jr., Health Center and Youth On Fire (YOF) homeless youth drop-in center collaborated to address barriers to care experienced by homeless youth and initiated the Peer Health Education (PHE) Outreach Project. The PHE project is a harm reduction, youth-centered program that aims to decrease barriers to care, empower youth regarding their health, and increase homeless youth primary care and health insurance coverage. As street-identified youth and lay health workers, PHEs help eliminate barriers to care by bringing the medical home to the patient, on the patient's terms. PHEs act as health navigators, able to recognize and respond to acute and chronic health care needs, triaging peers to appropriate sites of care, and facilitating health insurance and primary care enrollment. The project is embedded at YOF and connected to primary care provision through the Borum, effectively decreasing travel barriers to care and improving continuity of care that can withstand patient transience, contributing to overall better health outcomes for this community. Project design utilized existing models and evidence-based interventions, but was also innovative, tailored to the needs of members of YOF whom it serves.