Barriers to reducing health disparities in a primary care curriculum for the underserved

As the need for medical education programs devoting time and resources to care for the underserved becomes more apparent, the need for effective programs and accurate measures of that effectiveness is being realized. Attitudes of health professionals and medical students have been shown to affect the decision of pursuing careers in care for the underserved. These attitudes have changed over the course of medical school sometime for the positive and sometimes for the negative. Tools such as the Attitudes Towards the Homeless Questionnaire (ATHQ) and the Health Professionals Attitudes Towards Homeless Inventory (HPATHI) have been created to assess these changes over time. Through the use of these tools medical students' attitudes have shown to both become more positive and more negative throughout their training. Based on prior comparisons, the HPATHI was chosen to represent the attitudes of the medical students in an assessment of medical student attitudes. An addendum was then created in an effort better understand the variability in outcomes that have previously been documented. This addendum utilizes both proximity of experience to the homeless in the following four categories of: Awareness, Personal Experience, Volunteer Experience and Direct Care Experience. Additionally, the frequency of those experiences through a five-point Likert scale from ‘Never' to ‘Very Often' was determined. Comparative data from this tool will be reported on medical students across four years of their training and implications of proximity and frequency of experience with homeless individuals towards medical student attitudes discussed for further research opportunities.