Dataset Information

Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago.

ABSTRACT:

Background

Community violence is an important social determinant of health in many high-poverty, urban communities.

Objective

The purpose of this study was to explore and characterize self-described experiences of community violence among adults with chronic health conditions.

Design

Qualitative study design was implemented in 2017 using in-depth, semi-structured focus groups and interviews; data were collected from two clinical sites located in geographic epicenters of high violent crime in Chicago.

Participants

Adult patients, ages 35 years and older, who had at least one chronic condition.

Approach

Data were analyzed using grounded theory and the constant comparison method.

Key results

The overall sample (N?=?51) was predominantly female (67%) and black non-Hispanic (75%); a large proportion had hypertension (65%), arthritis (55%), obesity (53%), and/or diabetes (45%). The majority reported that a close friend or family member was seriously injured or killed due to community violence (71%); a similar proportion had never discussed their experiences of community violence with a healthcare provider (73%). Several major themes emerged: (1) perceived risk of being targeted, (2) chronic stress and worry, (3) hypervigilance, (4) social breakdown, (5) chronic isolation, (6) constrained choice (loss of freedom), (7) limited access to material resources, and (8) inadequate healthcare responses.

Conclusions

Patients often struggled to balance the challenges imposed by community violence with the demands of living with and managing their chronic conditions. Emergent themes may inform practical targets for addressing community violence as a social determinant of health in vulnerable populations.

SUBMITTER: Tung EL

PROVIDER: S-EPMC6206331 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago.

Tung Elizabeth L EL Johnson Tyrone A TA O'Neal Yolanda Y Steenes Althera M AM Caraballo Graciela G Peek Monica E ME

Journal of general internal medicine 20180803 11

<h4>Background</h4>Community violence is an important social determinant of health in many high-poverty, urban communities.<h4>Objective</h4>The purpose of this study was to explore and characterize self-described experiences of community violence among adults with chronic health conditions.<h4>Design</h4>Qualitative study design was implemented in 2017 using in-depth, semi-structured focus groups and interviews; data were collected from two clinical sites located in geographic epicenters of hig ...[more]

PMID: 30076574

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Project description:BACKGROUND:Approximately one-third of all adults worldwide are diagnosed with multiple chronic conditions (MCCs). The literature has identified several challenges facing providers and patients coping with managing MCCs in the community, yet few studies have considered their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore. METHODS:This study involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provide subsidised primary care services. Topic guides were developed with reference to the literature review, Chronic Care Model (CCM) and framework for patient-centred access to healthcare. RESULTS:Despite the perceived affordability and availability of the support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those who did not visit the clinics might not receive timely care. Furthermore, patients reported long consultation waiting time. Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges to delivering safe and quality care with limited consultation duration due to the need to manage high patient load and waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients. Although providers could equip patients with self-management and lifestyle-related guidelines, patients' actions are influenced by multiple factors, including work requirements, beliefs and environment. CONCLUSIONS:There were barriers on care access, delivery and self-management. It is crucial to adopt a whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCC management. This study has also highlighted the importance of considering the different viewpoints of healthcare providers and users in policy formulation and community care planning.

Dataset Information

Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago.

Background

Objective

Design

Participants

Approach

Key results

Conclusions

Publications

Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago.

Similar Datasets

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