Johnson, Luke and Gaber, Sophie Nadia and Langella, Rebecca and Turner-Moss, Eleanor and Weleff, Jeremy and Brothers, Thomas and Koay, Aaron and Hayward, Andrew C and Luchenski, Serena and Perri, Patrick and Story, Al and Sultan, Binta and Siersbaek, Rikke (2025) Outreach health-care services for people experiencing exclusion in high-income countries. The Lancet Public Health, Early online, DOI: 10.1016/S2468-2667(25)00144-6.
External website: https://www.thelancet.com/journals/lanpub/article/...
Inclusion health aims to prevent and address health and social inequalities for people experiencing exclusion, such as people experiencing homelessness, people who have a history of contact with the criminal justice system, people who use drugs, sex workers, vulnerable migrants, victims of modern slavery and human trafficking, and Romany Gypsy, Roma, and Travellers communities. These populations have poor health outcomes and disproportionate health inequities, partly resulting from inadequate health-care access. Outreach services can improve health-care access, but there is little evidence of how outreach operates successfully. We conducted a realist review of multicomponent outreach health-care services to understand the circumstances under which outreach works for people experiencing exclusion and why. Key components of effective outreach include person-centred services and appointments, staff expertise, high-quality communication, and close partnership with people experiencing exclusion and relevant organisations. Service users are likely to develop trust and further engage through positive experiences and regular interaction with the same staff.
G Health and disease > Substance use disorder (addiction)
J Health care, prevention, harm reduction and treatment > Harm reduction > Substance use harm reduction
J Health care, prevention, harm reduction and treatment > Type of care > Mental health care (Psychiatry / Psychology)
J Health care, prevention, harm reduction and treatment > Health care delivery
L Social psychology and related concepts > Interpersonal interaction and group dynamics > Social support > Peer support or coaching
L Social psychology and related concepts > Social inclusion and exclusion
MA-ML Social science, culture and community > Sociocultural distinctions > Minority group (racial / ethnic group, migrant, Traveller)
MA-ML Social science, culture and community > Social condition > Homelessness > Homeless services
MM-MO Crime and law > Public order offence / social code crime > Prostitution / sex-work
MM-MO Crime and law > Crime and violence > Crime against persons (assault / abuse) > Human exploitation
MP-MR Policy, planning, economics, work and social services > Social services > Outreach
T Demographic characteristics > Homeless person
T Demographic characteristics > Person who commits a criminal offence (offender)
VA Geographic area > International
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