Grant: Project Grant

Residents of the downtown east side (DTES) of Vancouver is heavily are more likely to suffer from homelessness, mental illnesses and substance use disorders, as well as other chronic medical conditions. However, they also struggle with access to primary health care. As a result, they often rely on the use of emergency departments or hospitals to access medical care and tend to have worse outcomes once discharged from hospital. In October 2019, the BC Centre for Excellence in HIV/AIDS with funding from the BC Ministry of Health and VCH opened a multidisciplinary primary health care service in the DTES, known as the Hope To Health (H2H) clinic. The clinic has been developed with a team-based approach to primary care. We designed a study to evaluate the effectiveness of the H2H service delivery model and to test further interventions to improve retention in primary care among residents of the DTES. We further wish to evaluate the effectiveness of such engagement in terms reducing acute care service utilization, hospitalizations and mortality. We plan to recruit 500 clients of the H2H Clinic who will be followed for one-year to measure health needs, facilitators and barriers to accessing primary care through the clinic and test the feasibility and acceptability of the a mobile health intervention with 50 of these participants. We will then offer mobile phones and data plans to all 1400 clients of the H2H Clinic and to see if this results in improved use of the clinic. Lastly, we will compare overall health service utilization and mortality between H2H Clinic clients and other DTES residents who attend community health clinics in the DTES of Vancouver.