26290 Skin care & emPowerment for All: Wellness for women experiencing homelessness

Abstract

Dermatologic conditions are highly prevalent among people experiencing homelessness due to overcrowded shelters, frequent malnutrition, and lack of accessible hygienic facilities. Complications of infection, infestation, and environmental exposures can be severe. Recognizing an unmet need, we developed the Skin care & emPowerment for All (SPA) initiative, a student-faculty collaborative to provide dermatologic support to women experiencing homelessness. This initiative takes place at a women’s only drop-in-space that Boston Health Care for the Homeless Program (BHCHP) provides weekly. The program was designed based on input from patients at BHCHP. Eight SPA sessions were conducted by medical students for 100 women between August 2017 and February 2018. In each session, a skin health educational workshop was paired with a relaxing dermatologic treatment. Educational topics focused on photoprotection, dry skin care, and foot hygiene. Original educational brochures were distributed during sessions. Anonymous pre- and postsession questionnaires were administered. Self-reported mean stress levels decreased significantly from 7.78 ± 2.47 to 5.77 ± 3.09 (P = .001) and self-reported mean confidence levels increased significantly from 5.84 ± 2.49 to 7.17 ± 2.38 (P = .013). Moreover, 88% of women (44/50) described at least one thing that they learned about maintaining healthy skin. Our novel program was successful in promoting psychological and dermatologic well-being among women experiencing homelessness. We have sustained these efforts in the belief that our program is helping foster participants’ trust in health care providers and encouraging medical students’ interest in serving vulnerable populations. We are eager to share our model so that it could be replicated in other communities.