Attitudes of homeless and drug-using youth regarding barriers and facilitators in delivery of quality and culturally sensitive health care.

PROBLEM Major barriers to care included a lack of culturally competent, accessible care despite the proximity of numerous health service agencies serving homeless youth. METHODS A qualitative approach using semistructured focus groups was used to assess the perspectives of 54 homeless and drug-using youth, aged 18-24 years, recruited from street- and shelter-based settings. FINDINGS Substance use was perceived as an adaptive response to psychological pain and survival on the streets as well as a health risk and barrier to care. CONCLUSIONS Facilitators to care and suggestions for improved health delivery and quality of care included utilization of health "mentors" to assist in navigating the medical system, cultural competency enhancements, improved amenities in clinic wait areas, and expanded pharmaceutical services.

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