{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:25:39Z","timestamp":1783340739671,"version":"3.54.6"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.19460.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000}}],"reference-count":33,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["23501\/Z\/21\/Z"],"award-info":[{"award-number":["23501\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Introduction:<\/ns4:bold>\n                    Despite having high unmet health need, people with severe and multiple disadvantage (SMD, including combinations of homelessness, substance misuse, poor mental health and domestic violence and abuse) have poor access to general practice. This realist review will examine the existing evidence on interventions or aspects of routine care in general practice that are likely to increase or decrease access to general practice for people with SMD.\n                    <ns4:bold>Methods and analysis:<\/ns4:bold>\n                    he aim of this review is to identify how these interventions or aspects of routine care increase or decrease access to general practice for people with SMD, in which contexts and for which patients. This review will involve a process comprising five sequential phases: (1) identifying established theories, (2) conducting an extensive search for proof, (3) selecting appropriate articles, (4) gathering and organising relevant data, and (5) utilising a realist analytical approach to synthesise evidence and make conclusions. Local implementation documents, in addition to published research studies, will be incorporated to enrich the analysis. We will collaborate with a stakeholder group consisting of people with lived experience of SMD and those who support them to advise us throughout.\n                    <ns4:bold>Ethics and dissemination:<\/ns4:bold>\n                    Ethical approval is not required. Our findings will be disseminated through peer-reviewed publications, conference presentations and lay summaries and will be used to develop a complex intervention for improving access to general practice for and with people with severe and multiple disadvantage.\n                    <ns4:bold>PROSPERO registration number:<\/ns4:bold>\n                    CRD42023390495\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.19460.2","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T11:50:05Z","timestamp":1697025005000},"page":"331","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Improving access to general practice for people with severe and multiple disadvantage: a realist review protocol (The Connection Study)"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5380-5361","authenticated-orcid":false,"given":"Lucy","family":"Potter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"McDonagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Horwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Farr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7890-3926","authenticated-orcid":false,"given":"Gene","family":"Feder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"ref-1","first-page":"162","article-title":"Gender Matters: Gendered patterns of severe and multiple disadvantage in England.","author":"F Sosenko","year":"2020"},{"key":"ref-2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgpopen17X100941","article-title":"Multimorbidity, disadvantage, and patient engagement within a specialist homeless health service in the UK: an in-depth study of general practice data.","volume":"1","author":"A Queen","year":"2017","journal-title":"BJGP Open."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"77-91","DOI":"10.1108\/HCS-05-2020-0007","article-title":"Premature frailty, geriatric conditions and multimorbidity among people experiencing homelessness: a cross-sectional observational study in a London hostel.","volume":"23","author":"R Rogans-Watson","year":"2020","journal-title":"Housing, Care and Support."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"241-250","DOI":"10.1016\/S0140-6736(17)31869-X","article-title":"Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis.","volume":"391","author":"R Aldridge","year":"2018","journal-title":"Lancet."},{"key":"ref-5","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-016-0487-5","article-title":"Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study.","volume":"15","author":"P O\u2019Donnell","year":"2016","journal-title":"Int J Equity Health."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"503-10","DOI":"10.1370\/afm.778","article-title":"The Inverse Care Law: Clinical Primary Care Encounters in Deprived and Affluent Areas of Scotland.","volume":"5","author":"S Mercer","year":"2007","journal-title":"Ann Fam Med."},{"key":"ref-7","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07581-7","article-title":"Access to healthcare for street sex workers in the UK: perspectives and best practice guidance from a national cross-sectional survey of frontline workers.","volume":"22","author":"L Potter","year":"2022","journal-title":"BMC Health Serv Res."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"1011-7","DOI":"10.1007\/s11606-007-0183-7","article-title":"Homeless People\u2019s Perceptions of Welcomeness and Unwelcomeness in Healthcare Encounters.","volume":"22","author":"C Wen","year":"2007","journal-title":"J Gen Intern Med."},{"key":"ref-9","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-015-0331-9","article-title":"Access to healthcare for long-term conditions in women involved in street-based prostitution: a qualitative study.","volume":"16","author":"E Mastrocola","year":"2015","journal-title":"BMC Fam Pract."},{"key":"ref-10","first-page":"245-7","article-title":"The Kirketon Road Centre - 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Blane, General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, 22 Nov 2023, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-331\/v2#referee-response-68437","order":1,"name":"referee-response-68437","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust grant number 23501\/Z\/21\/Z. \r\n\r\n(Lucy Potter, School for Primary Care Research PhD Programme for Primary Care Clinicians number 23501\/Z\/21\/Z) is funded in partnership by the National Institute for Health and Care Research (NIHR) School for Primary Care Research and the Wellcome Trust for this research project. This research was supported by the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) and the National Institute for Health and Care Research Bristol Biomedical Research Centre. GF's salary was supported by the UK Prevention Research Partnership (Violence, Health and Society; MR-VO49879\/1), an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}