{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T03:18:41Z","timestamp":1768274321388,"version":"3.49.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although homelessness is a much-studied phenomenon today, statistics indicate a steady increase in homelessness globally. UN General Assembly itself recommends implementing strategies through the commitment of the various stakeholders involved, among which health services are at the forefront. This current community case study details a specific research-practice partnership strategy\u2014led in Brescia (Italy) in 2023 by the Association of volunteer doctors \u201cUn Medico x Te\u201d (A doctor for you) and the Research Center on Family and Childhood Education (CESPEFI) of the Universit\u00e0 Cattolica del Sacro Cuore\u2014as an attempt to deepen the evaluation of peoples experiencing homelessness' health conditions in Brescia urban area and to promote best practices in granting population experiencing homelessness sustainable health-care approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In phase 1, since chronic liver diseases are very common in people experiencing homelessness, to investigate the presence of these pathologies, the Association \u201cUn Medico x Te\u201d carried out a preliminary observational retrospective echocardiographic cohort study in the population experiencing homelessness hosted in Brescia's housing services. In phase 2, CESPEFI led a research project to investigate the way health and healthcare is conceived by the homeless population living in Brescia urban area, according to the ethnographic methodological framework. Qualitative data were coded to explore emerging themes concerning the best practices to approach the population experiencing homelessness and to grant them appropriate care. At the end of the process internal guidelines were drawn up, based on greater attention to the relationship between doctors and patients experiencing homelessness and to the sustainability of the care-process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Chronic hepatic diseases were more common and severe in people experiencing homelessness than general population and it was related to the duration of the homeless condition. Taking care of the particular aspects of the relationships between doctors and patients experiencing homelessness made clinical research and health care more effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study demonstrates that a multi-disciplinary approach is strategic in order to respond to such a complex phenomenon as homelessness is; not-adopting a multidisciplinary approach may itself represent an additional mechanism of exclusion. Further studies are needed to explore innovative strategies to better face the problem of how: 1) to approach patients experiencing homelessness and 2) to implement appropriate medical assistance.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1611410","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T05:29:22Z","timestamp":1756186162000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Taking care of people experiencing homelessness: a community case study on the practice of the Volunteer Association \u201cA doctor for you\u201d in Brescia, Italy"],"prefix":"10.3389","volume":"13","author":[{"given":"A.","family":"Pasini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Pasini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Puccio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Seddio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Bocci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Lovati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Amadini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"B1","unstructured":"Researching homelessness in Europe: theoretical perspectives\n          \n          19\n          44\n          \n            \n              Pleace\n              N\n            \n          \n          Eur J Homelessness.\n          10\n          2016"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14036090510034563","article-title":"Explaining homelessness: a critical realist perspective","volume":"22","author":"Fitzpatrick","year":"2005","journal-title":"Hous Theory Soc."},{"key":"B3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/B978-0-08-047163-1.00347-7","article-title":"Homelessness: causation","volume-title":"International Encyclopedia of Housing and Home","author":"Fitzpatrick","year":"2012"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14036096.2017.1408678","article-title":"Defining \u201cat-risk of experiencing homelessness\u201d: re-connecting causes, mechanisms and risk","volume":"36","author":"Batterham","year":"2017","journal-title":"Hous Theory Soc."},{"key":"B5","volume-title":"Homelessness in Italia. Biografie, Territori, Politiche","author":"Consoli","year":"2020"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e342","DOI":"10.1016\/S2468-2667(20)30055-4","article-title":"Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review","volume":"5","author":"Aubry","year":"2020","journal-title":"Lancet Public Health."},{"key":"B7","first-page":"37","article-title":"Housing First: ending homelessness, promoting recovery, and reducing costs","volume-title":"How to House the Homeless.","author":"Tsemberis","year":"2010"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780199989805.001.0001","author":"Padgett","year":"2016","journal-title":"Housing First: Ending Homelessness, Transforming Systems, and Changing Lives"},{"key":"B9","article-title":"The problem of definitions: points of similarity and difference","volume-title":"Presented at: CUHP Thematic Network Conference","author":"Marpsat","year":"2005"},{"key":"B10","unstructured":"Indicator HM1\n          \n          \n          \n          2024"},{"key":"B11","unstructured":""},{"key":"B12","volume-title":"Inclusive Policies and Programmes to Address Homelessness","author":"UN","year":"2023"},{"key":"B13","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1080\/10530789.2020.1763573","article-title":"Unhealthy by design: health and safety consequences of the criminalization of homelessness","volume":"30","author":"Westbrook","year":"2021","journal-title":"J Soc Distress Homelessness."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1353\/hpu.2021.0153","article-title":"Health status and chronic disease burden of the homeless population: an analysis of two decades of multi-institutional electronic medical records","volume":"32","author":"Bensken","year":"2021","journal-title":"J Health Care Poor Underserved."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e304","DOI":"10.1016\/S2468-2667(20)30120-1","article-title":"Effective interventions for experiencing homelessness populations: the evidence remains unclear","volume":"5","author":"Wickham","year":"2020","journal-title":"Lancet Public Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1177\/08445621211032136","article-title":"Towards equitable health care access: community participatory research exploring unmet health care needs of homeless individuals","volume":"54","author":"D'Souza","year":"2022","journal-title":"Can J Nurs Res."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e000065","DOI":"10.1136\/ihj-2020-000065","article-title":"Integrating healthcare services for people experiencing homelessness in Australia: key issues and research principles","volume":"4","author":"Clifford","year":"2022","journal-title":"Integr Healthc J."},{"key":"B18","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1177\/2158244018789750","article-title":"Addressing health care needs in the homeless population: a new approach using participatory action research","author":"Kiser","year":"2018","journal-title":"Sage Open."},{"key":"B19","unstructured":"Popolazione residente per genere \n          \n          \n            \n              Comune\n              di Brescia\n            \n          \n          \n          2024"},{"key":"B20","unstructured":"Piano di zona 2021\u20132023\n          \n          \n            \n              Comune di\n              Brescia\n            \n            \n              Ambito 1 Brescia e\n              Collebeato\n            \n          \n          \n          2022"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1401662","DOI":"10.3389\/fpubh.2024.1401662","article-title":"Disparities in all-cause mortality among people experiencing homelessness in Toronto, Canada during the COVID-19 pandemic: a cohort study","volume":"12","author":"Richard","year":"2024","journal-title":"Front Public Health."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0281912","DOI":"10.1371\/journal.pone.0281912","article-title":"Deaths of profound despair: a retrospective cohort study of mortality among people experiencing homelessness","volume":"18","author":"Chang","year":"2023","journal-title":"PLoS ONE."},{"key":"B23","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1001\/jamainternmed.2013.1604","article-title":"Mortality among homeless adults in Boston","volume":"173","author":"Baggett","year":"2013","journal-title":"JAMA Intern Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s13244-014-0336-2","article-title":"Ultrasound in chronic liver disease","volume":"5","author":"Gerstenmaier","year":"2014","journal-title":"Insights Imaging."},{"key":"B25","volume-title":"Epidemiology in Medicine","author":"Hennekens","year":"1987"},{"key":"B26","volume-title":"Modern Epidemiology","author":"Rothman","year":"2008"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World medical association declaration of Helsinki: ethical principles for medical research involving human subjects","volume":"310","year":"2013","journal-title":"JAMA"},{"key":"B28","unstructured":"ICH Harmonised Guideline\n          \n          \n          \n          1996"},{"key":"B29","doi-asserted-by":"publisher","first-page":"237","DOI":"10.3390\/nu13010237","article-title":"Management of anaemia of chronic disease: beyond iron-only supplementation","volume":"13","author":"Pasini","year":"2021","journal-title":"Nutrients."},{"key":"B30","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1002\/cld.1061","article-title":"Global epidemiology of chronic liver disease","volume":"17","author":"Cheemerla","year":"2021","journal-title":"Clin Liver Dis."},{"key":"B31","doi-asserted-by":"publisher","first-page":"55","DOI":"10.14658\/pupj-jhcep-2020-2-5","article-title":"Salute e malattia AI margini della societ\u00e0: uno studio qualitativo sui Senza Dimora","volume":"2","author":"Callegarin","year":"2020","journal-title":"J Health Care Educ Pract"},{"key":"B32","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1111\/j.1745-7599.2008.00371.x","article-title":"Healthcare experiences of the homeless","volume":"21","author":"Nickasch","year":"2009","journal-title":"J Am Assoc Nurse Pract."},{"key":"B33","first-page":"101","article-title":"Il metodo etnografico","volume-title":"Metodi Per la Ricerca Educativa.","author":"Bove","year":"2019"},{"key":"B34","volume-title":"Cultura Della Ricerca E Pedagogia","author":"Mortari","year":"2007"},{"key":"B35","volume-title":"Descrivere il mondo. Teoria e pratica del mondo etnografico in sociologia","author":"Gobo","year":"2001"},{"key":"B36","volume-title":"Doing Qualitative Research","author":"Silverman","year":"2000"},{"key":"B37","doi-asserted-by":"crossref","DOI":"10.4135\/9781848608337","volume-title":"Handbook of Ethnography","author":"Atkinson","year":"2001"},{"key":"B38","doi-asserted-by":"publisher","first-page":"113","DOI":"10.14672\/ada20181390113-132","article-title":"Diventare \u201csenza dimora\u201d. Politiche e pratiche del welfare alla lente dell'etnografia","volume":"5","author":"Porcellana","year":"2018","journal-title":"Antropologia"},{"key":"B39","volume-title":"Punire I Poveri: Il Nuovo Governo Dell'insicurezza Sociale","author":"Wacquant","year":"2006"},{"key":"B40","volume-title":"Experiencing Homelessness: A Critical Introduction","author":"Parsell","year":"2023"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5206\/ijoh.2023.3.22263","article-title":"From roots to home: visualizing the journey from experiencing homelessness to housing","volume":"5","author":"Hill","year":"2025","journal-title":"Int J Homelessness"},{"key":"B42","volume-title":"La Struttura Maieutica E L'evolverci","author":"Dolci","year":"1996"},{"key":"B43","volume-title":"Homelessness e Dialogo Interdisciplinare. Analisi e Confronto tra Modelli Diversi","author":"Gnocchi","year":"2009"},{"key":"B44","doi-asserted-by":"publisher","first-page":"139","DOI":"10.5206\/ijoh.2023.3.16655","article-title":"Excellence in homelessness services: evidence-based frontline practices","volume":"4","author":"McDonald","year":"2024","journal-title":"Int J Homelessness"},{"key":"B45","first-page":"185","article-title":"Reflexivity","volume-title":"Intercultural Issues and Concepts. A Multi-Disciplinary Glossary","author":"Amadini","year":"2021"},{"key":"B46","first-page":"85","article-title":"How can educational research assume an intersectional approach? A case study on experiencing homelessness in Brescia","volume-title":"Proceedings of the Third International Conference of the journal Scuola Democratica. Education and\/for Social Justice. Vol. 1: Inequality, Inclusion, and Governance. Associazione \u201cPer Scuola Democratica\u201d","author":"Amadini","year":"2025"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1611410\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T05:29:28Z","timestamp":1756186168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1611410\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":46,"alternative-id":["10.3389\/fpubh.2025.1611410"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1611410","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,26]]},"article-number":"1611410"}}