Evidence map›Paper›PMID 35853663›Full record

ArticleCMAJ open

Challenges faced by people experiencing homelessness and their providers during the COVID-19 pandemic: a qualitative study.

Kathryn Hodwitz, Janet Parsons, Clara Juando-Pratts, Esther Rosenthal, Amy Craig-Neil, Stephen W Hwang, Joel Lockwood, Paul Das, Tara Kiran

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PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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  7. Article
  8. Wastewater surveillance for COVID-19 in shelters: A creative strategy for a complex setting.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2024
    Article
  9. Family physicians' moral distress when caring for patients experiencing social inequities: a critical narrative inquiry in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024
    Article
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Kathryn HodwitzApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Janet ParsonsApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Clara Juando-PrattsApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Esther RosenthalApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Amy Craig-NeilApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Stephen W HwangApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Joel LockwoodApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Paul DasApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.
Tara KiranApplied Health Research Centre (Hodwitz, Parsons, Juando-Pratts), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto; Institute of Health Policy, Management and Evaluation (Parsons, Kiran), University of Toronto; Department of Physical Therapy and Rehabilitation Sciences Institute (Parsons), University of Toronto; Dalla Lana School of Public Health (Juando-Pratts), University of Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), St. Michael's Hospital, Unity Health Toronto; Department of Family and Community Medicine (Rosenthal, Das, Kiran), Faculty of Medicine, University of Toronto; MAP Centre for Urban Health Solutions (Craig-Neil, Hwang, Kiran), St. Michael's Hospital, Unity Health Toronto; Division of General Internal Medicine (Hwang), Department of Medicine, Faculty of Medicine, University of Toronto; Division of Emergency Medicine (Lockwood), Faculty of Medicine, University of Toronto; Department of Emergency Medicine (Lockwood), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont. tara.kiran@utoronto.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople experiencing homelessness are vulnerable to SARS-CoV-2 infection and its consequences. We aimed to understand the perspectives of people experiencing homelessness, and of the health care and shelter workers who cared for them, during the COVID-19 pandemic.

methodsWe conducted an interpretivist qualitative study in Toronto, Canada, from December 2020 to June 2021. Participants were people experiencing homelessness who received SARS-CoV-2 testing, health care workers and homeless shelter staff. We recruited participants via email, telephone or recruitment flyers. Using individual interviews conducted via telephone or video call, we explored the experiences of people who were homeless during the pandemic, their interaction with shelter and health care settings, and related system challenges. We analyzed the data using reflexive thematic analysis.

resultsAmong 26 participants were 11 men experiencing homelessness (aged 28-68 yr), 9 health care workers (aged 33-59 yr), 4 health care leaders (aged 37-60 yr) and 2 shelter managers (aged 47-57 yr). We generated 3 main themes: navigating the unknown, wherein participants grappled with evolving public health guidelines that did not adequately account for homeless individuals; confronting placelessness, as people experiencing homelessness often had nowhere to go owing to public closures and lack of isolation options; and struggling with powerlessness, since people experiencing homelessness lacked agency in their placelessness, and health care and shelter workers lacked control in the care they could provide.

interpretationReduced shelter capacity, public closures and lack of isolation options during the COVID-19 pandemic exacerbated the displacement of people experiencing homelessness and led to moral distress among providers. Planning for future pandemics must account for the unique needs of those experiencing homelessness.

Indexed as

COVID-19Ill-Housed PersonsCOVID-19 TestingHumansMalePandemicsSARS-CoV-2

Identifiers

PMID35853663
PMCPMC9312992

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.