{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:27:16Z","timestamp":1793658436265,"version":"4.5.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":46,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":46,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>People experiencing homelessness are known to suffer from poor health and can be reluctant to seek healthcare except in crisis. Foot and ankle problems are a concern; as well as causing discomfort and pain, they may escalate from a minor problem to a very serious one without timely and appropriate treatment. Little is known about the foot and ankle problems of people experiencing homelessness.<\/jats:p><jats:p>This paper describes a podiatric service specifically for people experiencing homelessness, which includes a fixed site as well as outreach services. The service operates as part of the Homelessness Team program at Cohealth, a large community health service in Melbourne.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study used routinely collected data. Every person who was seen by the podiatrist in the Cohealth Homelessness Team in 2019, whether on site or on outreach, was included in the study (<jats:italic>n<\/jats:italic> =\u2009295). Of these, 156 were attending for the first time and 139 were returning clients. People who used the service were predominantly rough sleeping (45.2%), with 32.2% in unstable or insecure housing and 22.6% recently housed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Skin and nail pathologies (68.1%), inadequate footwear (51.9%) and biomechanical issues (44.1%) were the most common presentations. People sleeping rough were particularly likely to present with biomechanical issues (50.8%), acute wound care needs (17.4%) or traumatic injury (10.6%). Most people presented with more than one issue (mean\u2009=\u20092.4), and new clients (mean\u2009=\u20092.53) and those rough sleeping (mean\u2009=\u20092.69) had more issues than others.<\/jats:p><jats:p>Outreach was the most effective way to reach clients in the most difficult circumstances (48.9% of those in unstable housing, 34.8% of rough sleepers). Most of the clients (81.4%) had connections with other services offered by Cohealth, such as social work or physiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrated that reaching and intervening on foot and ankle problems of people experiencing homelessness who may not seek care on their own could be achieved through a publicly funded health service, using simplified pathways to care including outreach. In addition to the long\u2010 and short\u2010 term benefits of the immediate podiatric treatment, building trust and connections through footcare may provide an entry point into accepting other health and welfare services.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13047-022-00518-7","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T06:03:57Z","timestamp":1644991437000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Responding to foot health needs of people experiencing homelessness: the role of a publicly funded community\u2010based podiatry service"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-719X","authenticated-orcid":false,"given":"Robyn M.","family":"Mullins","sequence":"first","affiliation":[{"name":"Centre for Health Systems Development Australian Institute for Primary Care and Ageing La Trobe University Plenty Rd &amp; Kingsbury Dr 3086 Bundoora VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E.","family":"Mannix","sequence":"additional","affiliation":[{"name":"cohealth Melbourne 53 Victoria St 3055 Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Marshall","sequence":"additional","affiliation":[{"name":"cohealth Kensington 12 Gower St 3031 Kensington VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7802-625X","authenticated-orcid":false,"given":"Virginia J.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Centre for Health Systems Development Australian Institute for Primary Care and Ageing La Trobe University Plenty Rd &amp; Kingsbury Dr 3086 Bundoora VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)61132\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.01264"},{"key":"e_1_2_12_4_1","unstructured":"Australian Bureau of Statistics.Discussion Paper: Methodological Review of Counting the Homeless.2006."},{"key":"e_1_2_12_5_1","volume-title":"2049.0 \u2010 Census of Population and Housing: Estimating homelessness, 2016","author":"Australian Bureau of Statistics","year":"2018"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1839\u20104655.1992.tb00911.x"},{"key":"e_1_2_12_7_1","unstructured":"Australian Commission on Safety and Quality in Health Care.https:\/\/www.safetyandquality.gov.au\/sites\/default\/files\/migrated\/1.3\u2010Cellulitis.pdfAccessed 12 August 2021."},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0167463"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-018-0284-z"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2011.04.030"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.12604"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2020.08.009"},{"key":"e_1_2_12_13_1","unstructured":"International Working Group on the Diabetic Foot.https:\/\/iwgdfguidelines.org\/guidelines\/guidelines\/Accessed 12 August 21."},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2016.02.001"},{"key":"e_1_2_12_15_1","volume-title":"Allied health and dental services","author":"Australian Institute of Health and Welfare","year":"2020"},{"key":"e_1_2_12_16_1","volume-title":"Primary health care","author":"Australian Institute of Health and Welfare","year":"2020"},{"key":"e_1_2_12_17_1","unstructured":"Australian Podiatry Association.2020Foot Health Survey.https:\/\/www.podiatry.org.au\/documents\/item\/2319."},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757\u20101146\u20101\u20108"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010017\u20100188\u20103"},{"key":"e_1_2_12_20_1","unstructured":"cohealthhttps:\/\/www.cohealth.org.au\/Accessed 12 August 2021."},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030982"},{"key":"e_1_2_12_22_1","unstructured":"Bolton Clarke.https:\/\/www.boltonclarke.com.au\/additional\u2010services\/homeless\u2010person\u2010programAccessed 12 August 2021."},{"key":"e_1_2_12_23_1","unstructured":"Footscapehttp:\/\/www.footscape.com.au\/. 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Consent was waived as the analysis used routinely collected data which was anonymised.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15"}}