Engaging health professions students in community-based service learning through the design of a needs assessment survey

Abstract

Background: Interprofessional student participation in community-based service learning projects is critically important for the preparation of future health professionals to care for underserved and vulnerable populations. Oftentimes, there is a disconnect between existing community services and the actual needs of individuals being served, such as those experiencing homelessness. A best practice of launching a new service learning project is to begin with a needs assessment. This study describes the stepwise approach taken to guide students launching a new street medicine program in developing and administering a needs assessment survey and is generalizable to other student-led service learning outreaches. Methods: We conducted a needs assessment from April-June 2018 on 144 unsheltered homeless individuals in metro Phoenix, Arizona. The 16-question survey investigated perceptions of priority needs, sources of medical care, health literacy, and health status. Survey results were analyzed using Wilcoxon Rank Sum Test, chi-squared analysis, and multivariable logistic regression. Results: Most respondents (91.6%) identified food as a top need. The majority (64.1%) utilized emergency departments as their primary source of care, and 40.1% reported suboptimal health. Suboptimal health was more likely to be reported in those who expressed transportation (OR 3.03, 95% CI: 1.30-7.07) as a top priority need. Health illiteracy (OR 3.68, 95% CI: 0.76-17.9) was associated with suboptimal health, as was obtaining care at an Emergency Department (OR 2.05, 95% CI: 0.81-5.25). Conclusions: Pairing healthcare with meals and other primary needs may be an effective strategy to increase service utilization by this population. Future needs assessments should consider implementing open-ended questions to better assess the holistic needs of study populations and match community partner organization services with these needs. Needs assessments provide an opportunity for health professional students to learn about social needs and more effectively connect patients with services from community agencies and healthcare organizations.