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Advancing Public Health Through Cutting-Edge Research and Insightful Publications

At Zeihan Prohealth, we harness the transformative power of data to catalyze positive change in public health. Our pledge to research is to drive scientific progress and advance public health by collecting and publishing impactful data that addresses critical challenges, with a dedicated focus on the social determinants of health across diverse landscapes.

We are unwavering in our commitment to support our clients in achieving their project goals and enhancing the health and well-being of their communities through our peer-reviewed research and unparalleled expertise. Our goal is not only to lead, but also to inspire others to implement our findings, thereby advancing population health and education on a global scale.

Through our relentless efforts, we strive to create a healthier, more connected world, where our innovative solutions and data-driven insights lead to sustainable improvements in public health. Join us in our mission for a brighter, more health-conscious world.

Publication Year: 2023
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Utilization of street-based COVID-19 vaccination clinics in Phoenix’s homeless population

Abstract

The novel Coronavirus (COVID-19) is a highly contagious viral illness that has caused the most significant global health crisis in recent human history. Individuals experiencing homelessness represent one of the more vulnerable populations for COVID-19 infection and morbidity. Amongst individuals experiencing homelessness in Phoenix, a student-led interprofessional organization called Street Medicine Phoenix (SMP) sought to both reduce the risk of COVID-19 transmission and morbidity/mortality related to infection. Through collaborations with the Maricopa County Department of Public Health and various community organizations, SMP developed a format for street-based vaccination clinics. SMP deployed these clinics on numerous occasions to the streets directly surrounding the community homeless shelter, allowing SMP to vaccinate individuals directly in their encampments. Through SMP’s efforts starting in February 2021, 400 individuals experiencing homelessness have received at least one COVID-19 vaccine. Challenges encountered included low health literacy, lack of established rapport and trust, low vaccine confidence, difficulty verifying patients’ vaccination status, difficulty obtaining sufficient information from patients to create a record in the Arizona State Immunization Information System (ASIIS), monitoring patients post-vaccination, transporting vaccine supplies from encampment to encampment, and lack of patient awareness of the mobile vaccine clinic services. Despite challenges, SMP’s outreach efforts have demonstrated the feasibility and importance of mobile public health services to reach homeless encampments, particularly mobile vaccination clinics in response to disease outbreaks, and the necessity of strategic partnerships with community agencies to effectively meet the needs of underserved populations.
Publication Year: 2023
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Mpox Case Reports in an Urban Homeless Population and a Proof of Concept for a Street-Based Mobile Mpox Vaccination Clinic

Abstract

Mpox is a new public health outbreak that particularly threatens the homeless population. Street Medicine Phoenix (SMP) is a student-led interprofessional volunteer organization that provides medical care and other essential services to individuals experiencing homelessness in Phoenix, Arizona. In addition to core services such as wound care; health screenings (blood pressure and blood glucose.); vision screenings; HIV testing; naloxone education and distribution; flu, COVID-19, and Hepatitis A vaccinations; and community resource referrals, SMP began offering mpox education and vaccination at outreach events. During an outreach event shortly after the onset of the mpox outbreak, SMP identified 2 suspected mpox cases. Accordingly, SMP has partnered with the Maricopa County Public Health Department to set up mobile mpox vaccination clinics on the streets outside of Phoenix Arizona’s largest homeless shelter. We share the details of these 2 cases along with our early efforts vaccinating individuals experiencing homelessness for mpox via our mobile vaccination clinic. Our experiences demonstrate the importance of community agencies providing direct outreach to underserved populations where they are at, particularly the homeless population, to address public health concerns such as emerging disease outbreaks like mpox. In addition, these cases highlight the potential significant impact that street medicine programs can have on their respective homeless communities in the context of infectious disease mitigation and emphasize the importance of partnerships with local health departments.
Publication Year: 2022
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Education without walls: Using a street medicine program to provide real-world interprofessional learning

Abstract

Interprofessional education (IPE) is a core component of the curricula for many healthcare and social work training programs and has been shown to increase student self-efficacy, communication skills, and attitudes toward other professions. Street medicine programs expand options for teaching interprofessional, team-based care of vulnerable populations, such as those experiencing homelessness. Street Medicine Phoenix is an interprofessional team of health professions students and faculty that provides outreach to Phoenix’s homeless population. This study demonstrates the impact of volunteering in our street medicine program on the perceived development of interprofessional skills and behaviors. Volunteer teams, with representatives from medicine, nursing, social work, physical therapy, occupational therapy, public health, and undergraduate studies, completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) before and after semester-long, monthly outreach events. Results demonstrate statistically significant improvements in overall ICCAS scores for all volunteers, but there was no relationship between number of shifts completed and ICCAS score improvement. Based on these findings, street medicine programs could be considered as an option for providing interprofessional learning to students in healthcare and social work degree programs. Street medicine outreach can supplement didactic and simulation skill-building activities in the IPE curricula with point of care, real-world experiential learning.
Publication Year: 2022
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Engaging health professions students in community-based service learning through the design of a needs assessment survey

Abstract

Background: Interprofessional student participation in communitybased service learning projects is critically important for the preparation of future health professionals to care for underserved and vulnerable populations. Oftentimes, there is a disconnect between existing community services and the actual needs of individuals being served, such as those experiencing homelessness. A best practice of launching a new service learning project is to begin with a needs assessment. This study describes the stepwise approach taken to guide students launching a new street medicine program in developing and administering a needs assessment survey and is generalizable to other student-led service learning outreaches.

Methods: We conducted a needs assessment from April-June 2018 on 144 unsheltered homeless individuals in metro Phoenix, Arizona. The 16-question survey investigated perceptions of priority needs, sources of medical care, health literacy, and health status. Survey results were analyzed using Wilcoxon Rank Sum Test, chi-squared analysis, and multivariable logistic regression.

Results: Most respondents (91.6%) identified food as a top need. The majority (64.1%) utilized emergency departments as their primary source of care, and 40.1% reported suboptimal health. Suboptimal health was more likely to be reported in those who expressed transportation (OR 3.03, 95% CI: 1.30-7.07) as a top priority need. Health illiteracy (OR 3.68, 95% CI: 0.76-17.9) was associated with suboptimal health, as was obtaining care at an Emergency Department (OR 2.05, 95% CI: 0.81-5.25).

Conclusions: Pairing healthcare with meals and other primary needs may be an effective strategy to increase service utilization by this population. Future needs assessments should consider implementing open-ended.

Publication Year: 2021
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Improving health professionals’ and learners’ attitudes towards homeless individuals through street-based outreach

Abstract

Objective: To identify the impact of volunteering in a street medicine programme on perceptions of and attitudes towards individuals experiencing homelessness.

Design: Prospective pre- and post-analysis using involvement in a street medicine programme as the intervention. Attitudes towards and perceptions of individuals experiencing homelessness were measured using the Health Professional Attitude Towards the Homeless Inventory (HPATHI).

Setting: Participants provided outreach to individuals experiencing homelessness across metro Phoenix in parks and in homeless encampments along the streets.

Method: Students and preceptors from numerous professions, including medicine, nursing, social work, physical therapy, occupational therapy, public health and undergraduate students, who volunteered for the street medicine programme were organised into small outreach teams. All volunteers were emailed the HPATHI to complete before and after semester-long, monthly outreach events.

Results: Volunteering in our street medicine programme demonstrated statistically significant improvements in perceptions of and attitudes towards individuals experiencing homelessness for all volunteers, regardless of profession.

Conclusion: Our findings suggest that integrating street medicine programmes into curricula for health and social care programmes can reduce the stigma towards individuals experiencing homelessness, inspire increased commitment to practising in underserved communities and meet the unmet health and social needs of the homeless population.