Despite the large number of hepatitis C tests performed in Australia each year and the effort expended on developing and implementing policies to regulate this practice, very little research has been undertaken on the human factors associated with hepatitis C testing. This thesis aims to: 1) examine patterns (prevalence and incidence) of hepatitis C testing among young people who experience homelessness in Melbourne, Australia, and how they relate to behavioural and contextual factors, and 2) examine the contexts in which hepatitis C testing occurs for these young people. Two studies were undertaken to address these aims. The first employed longitudinal panel surveys collected from young people who had recently become homeless for the first time (N=165) over three waves: baseline, 12-month and 24-months. The second employed semi-structured qualitative interviews 24-months after baseline with 20 young people recruited from the longitudinal cohort.

The population of people experiencing homelessness has decreased less than 15% in the last ten years, but issues like mental illness and substance use are rising. There are many misconceptions about race, gender, location and age of people experiencing homelessness. Music therapy research about the homeless population is minimal and often focused on just one setting or treatment location. The purpose of this study was to better understand the relationship between music therapists and people experiencing homelessness. A survey of 365 music therapists in the United States revealed just under half of working clinicians provide services to people experiencing homelessness. Results from the survey revealed the most common settings where music therapists provided service to people experiencing homelessness were mental health, medical, and school systems. Additionally, the results discussed people experiencing homelessness’ demographic differences in clinician’s experiences versus annual reports. Results are not to be generalized but to be used as a tool to better understand people experiencing homelessness.

This study explores the implementation and impact of Supporting People, a policy of the New Labour and Coalition governments of 1997 to the present designed to provide housing related support to those considered vulnerable. The theoretical framework uses concepts from past studies of implementation, policy networks, governmentality, path dependency, other temporal concepts and a recent heuristic that provides an independent framework for analysing policy success. This conceptual framework was used in exploring the history of care and support services in the UK; assessing the successes and failures of the past. The study then looks at the drivers and policy goals for Supporting People and at some of the key reviews and studies of it thus far. The fieldwork uses a “mixed methods” approach utilising both quantitative and qualitative methods. An initial survey gathered views from a range of supported housing professionals, followed by a series of in-depth interviews with management practitioners from Supporting People funded organisations. Both stages utilised ideas from the conceptual framework in asking about implementation processes and successes and failures of the programme. This section also explores the use of evidence, dissemination and impact. In terms of the Supporting People policy, the study found a number of areas of strengths on which to build e.g. increased funding and improved strategic frameworks, but also many areas of weakness that require improvement. These include protection for funding, consistency across local authorities, fragmented structures of related policy networks and the top-down implementation style of the policy – there were lessons from No Second Night Out (NSNO) – Leicester in this regard. This was a piece of evaluative research carried out in tandem with the main study and integrated into it. The study found a consistent failure to provide adequate services for vulnerable people; services had failed to build up sufficient path dependent processes to protect them from funding and other resources being diverted to other priorities. The lack of a legislative and conceptual consensus around what it means to be “well housed” was key.

Trata-se de análise a respeito do Consultório na Rua, estratégia de atenção básica às pessoas em situação de rua. Foram utilizados três métodos para compreender este serviço: análise comparada das propostas legais das unidades móveis de Portugal, Estados Unidos da América e Brasil; estudo sócio-histórico, por meio da sociogênese proposta por Pierre Bourdieu, com base em documentos oficiais, literatura indexada e entrevistas de agentes; e avaliação de implantação de uma equipe de Consultório na Rua da cidade de São Paulo, utilizando-se de observação participante, informações oriundas de relatórios e prontuários, entrevistas com trabalhadores e usuários do serviço, e apoiando-se em modelo lógico e matriz de avaliação de grau de implantação. A proposta brasileira de unidade móvel apresentou semelhanças no uso de equipes multiprofissionais e oferecimento de ações de redução de danos entre as demais analisadas, elementos que contribuem para o alcance da equidade. Sua gênese foi possível em contexto político favorável ao investimento de políticas sobre drogas e expansão da Política Nacional de Atenção Básica. Porém sofreu influências de conflitos entre agentes de diferentes polos do espaço social. A análise de implantação revelou adaptações da proposta federal oriundas de programas anteriores do município de São Paulo, de limitações da rede de serviços, e influências de conflitos identificados na gênese / This is an analysis of the Clinic on the Street, a strategy of basic care for people in homelessness. Three methods were used to understand this service: comparative analysis of the legal proposals of the mobile units of Portugal, the United States of America and Brazil; socio-historical study, through the sociogenesis proposed by Pierre Bourdieu, based on official documents, indexed literature and interviews of agents; and evaluation of the implantation of a \'Clinic on the Street\' team from São Paulo, using participant observation, information from reports and records, interviews with workers and users of the service, and based on a logistic model and evaluation matrix of degree of implantation. The Brazilian proposal of mobile unit showed similarities in the use of multiprofessional teams and offering harm reduction actions among the others analyzed, elements that contribute to equity. Its genesis was possible in a political context favorable to the investment of policies on drugs and expansion of the National Policy of Basic Attention. However, it was influenced by conflicts between agents from different poles of the social space. The implementation analysis revealed adaptations of the federal proposal from previous programs in the city of São Paulo, limitations of the service network, and influences of conflicts identified in the genesis

Trata-se de análise a respeito do Consultório na Rua, estratégia de atenção básica às pessoas em situação de rua. Foram utilizados três métodos para compreender este serviço: análise comparada das propostas legais das unidades móveis de Portugal, Estados Unidos da América e Brasil; estudo sócio-histórico, por meio da sociogênese proposta por Pierre Bourdieu, com base em documentos oficiais, literatura indexada e entrevistas de agentes; e avaliação de implantação de uma equipe de Consultório na Rua da cidade de São Paulo, utilizando-se de observação participante, informações oriundas de relatórios e prontuários, entrevistas com trabalhadores e usuários do serviço, e apoiando-se em modelo lógico e matriz de avaliação de grau de implantação. A proposta brasileira de unidade móvel apresentou semelhanças no uso de equipes multiprofissionais e oferecimento de ações de redução de danos entre as demais analisadas, elementos que contribuem para o alcance da equidade. Sua gênese foi possível em contexto político favorável ao investimento de políticas sobre drogas e expansão da Política Nacional de Atenção Básica. Porém sofreu influências de conflitos entre agentes de diferentes polos do espaço social. A análise de implantação revelou adaptações da proposta federal oriundas de programas anteriores do município de São Paulo, de limitações da rede de serviços, e influências de conflitos identificados na gênese / This is an analysis of the Clinic on the Street, a strategy of basic care for people in homelessness. Three methods were used to understand this service: comparative analysis of the legal proposals of the mobile units of Portugal, the United States of America and Brazil; socio-historical study, through the sociogenesis proposed by Pierre Bourdieu, based on official documents, indexed literature and interviews of agents; and evaluation of the implantation of a \'Clinic on the Street\' team from São Paulo, using participant observation, information from reports and records, interviews with workers and users of the service, and based on a logistic model and evaluation matrix of degree of implantation. The Brazilian proposal of mobile unit showed similarities in the use of multiprofessional teams and offering harm reduction actions among the others analyzed, elements that contribute to equity. Its genesis was possible in a political context favorable to the investment of policies on drugs and expansion of the National Policy of Basic Attention. However, it was influenced by conflicts between agents from different poles of the social space. The implementation analysis revealed adaptations of the federal proposal from previous programs in the city of São Paulo, limitations of the service network, and influences of conflicts identified in the genesis

[pt] Os estudos da prática de assistência social têm tido como foco a ação dos profissionais da área de Serviço Social. No entanto, especialmente a partir da segunda metade dos anos 70, com a entrada do terceiro setor, a luta para diminuir as desigualdades sociais abriu espaço para o trabalho voluntário do/a cidadão/ã no atendimento àqueles que vivem em condições de vulnerabilidade social. No intuito de preencher essa lacuna, este estudo tem por objetivo contribuir para o entendimento das práticas de ofertas de ajuda, realizadas por voluntários. Para tanto, são analisadas, à luz do aparato teórico-metodológico da Análise da Conversa (Sacks, 1992; Sacks; Schegloff; Jefferson, 1974), as interações entre voluntários/as da Equipe de Abordagem Social da Turma da Sopa de Niterói, que tem como objetivo institucional tentar contribuir para o processo de reinserção/reintegração social de pessoas em situação de rua ou vulnerabilidade social, atendidas por eles/elas. Os resultados revelam a organização estrutural global das interações que constituem a abordagem social, identificando as etapas desse trabalho (início da abordagem, escuta e/ou sondagem, condução propositiva e fechamento), bem como as (micro) ações que ocorrem em cada fase. A pesquisa aponta também para a centralidade das ofertas nas conduções propositivas, diferenciando as ofertas delicadas, que apresentam formato despreferido, das não-deliciadas, realizadas em formato preferido. Com base nas análises, é possível identificar que práticas se mostraram mais ou menos eficazes para o atingimento dos objetivos institucionais. / [en] The study of professional practice in the field of social work focuses on the action of those trained in social services. However, particularly from the second half of the 1970s, along side the emergence of the third sector, the struggle for social care provision has opened up the possibility for citizens to engage in community service projects by supporting those who are socially vulnerable. Intending to fulfill this gap, this study focus is contributing to improving the comprehension of social reintegration practices performed by volunteers. In order to do so, the interaction between volunteers from the Social Approach Group of the Soup Group of Niterói and people experiencing homelessness was analyzed through the theoretical-methodological approach of Conversation Analysis. The results reveal the overall structural organization of the interaction, identifying the steps of this work (beginning of the approach, probing, propositional conduction, and closure) as well as the (micro) actions that occur in each step. The research also points to the centralization of the offers in propositional conductions, separating the delicate offers, which present unpreferred format, from the non-delicate ones, which are performed in a preferred format. Based on the analysis, it is possible to identify some practices that are more or less effective to achieve the interactional goals.