INTRODUCTION: Healthcare needs among homeless populations are difficult to meet within the scope of a standard healthcare model. A street medicine model addresses the specific needs of those experiencing homelessness; healthcare professionals seek to build trust and rapport with people who are living unsheltered by taking their clinical practice to the streets. The street medicine program evaluated in this study provides primary and behavioral care in a metropolitan area in the Southeastern United States. AIM: This program evaluation aimed to answer the following questions: how has the street medicine program affected the perceptions of ill-health and access to healthcare among its current patients? Further, how would the current patients of the street medicine program rate their satisfaction with the program and are they aware of all available services? METHODS: Using a mixed methods approach, 40 semi-structured interviews and participant observations were conducted with patients of the street medicine program. Participants were asked to rate their satisfaction with the program and their overall health status on a 5 point Likert scale. Informed by Consensual Qualitative Research (CQR) analysis methods, the qualitative data were transcribed and coded. All quantitative analyses were done using SPSS. RESULTS: Overall, 70% of participants rated their satisfaction with the street medicine program as excellent (n=28). For self-rated health status, there was a normal distribution across the Likert scale with 43% reporting their overall health status as moderate (n=17). Using CQR, four key domains emerged from the qualitative data: community trust, rapport building, needs addressed, and needs not addressed. These domains encompassed specific participant responses. Examples include: heard about the street medicine program through word of mouth (community trust), team showed kindness (rapport building), received diagnosis and treatment (needs addressed), and needing help getting into housing (needs not addressed). CONCLUSION: Overall, this study validated the effectiveness of the street medicine program in building trust and rapport with its patients. Satisfaction with the street medicine was high across patients. This study contributes information regarding patient experiences within an alternate healthcare model serving a highly vulnerable population.

A partir da formulação do panorama sócio-econômico no Brasil e, em especial de São Paulo, é investigada a precariedade da habitação onde grande parte da população vive: as favelas, loteamentos irregulares e os cortiços. Essas formas precárias de moradias conformam situações de risco e vulnerabilidade, onde a ocorrência de um fenômeno natural, como a chuva, pode provocar um desastre. Invariavelmente, as pessoas atingidas por um \"desastre natural\" são obrigadas a procurar abrigos temporários; em muitos casos são utilizadas estruturas transportáveis e desmontáveis como abrigos emergenciais. Por meio do levantamento do estado da arte dos abrigos emergenciais, é sugerida uma série de recomendações que visa orientar o desenvolvimento de um abrigo emergencial adequado às características sociais, culturais e econômicas dos usuários. / After the establishment of the social-economic scenario in Brazil and specifically in São Paulo, the precarious habitation conditions where a great part of the population lives is investigated: the slum quarters, irregular land divisions and tenement houses. These precarious forms of housings create situations of risk and vulnerability, where the occurrence of natural phenomena, such as rain, may cause disasters. Invariably, people affected by \"natural disasters\" have to seek acommodations in temporary shelters; in many cases, transportable structures or structures that can be dismounted are used as emergency shelters. By means of the survey of the state of the art of the existing emergency shelters, a series of recommendations is suggested, aiming to guide the development of an appropriate emergency shelter that fits the social, cultural and economic characteristics of its users.

In the United States, it is estimated that millions of adults are homeless. Some individuals choose not to use homeless shelters or are ineligible for their use. Researchers have indicated that many unsheltered homeless are men over the age of 45 years. The purpose of this phenomenological study was to examine the experiences with social services providers among unsheltered men. Understanding the social networks of unsheltered homeless and the use of spirituality or faith as a resource for coping was also examined, as a significant gap exists in the research on unsheltered homeless. Face-to-face, in-depth interviews were conducted with 8 men age 45 years and older to explore the lived experience of being unsheltered. A social constructivism framework and the theory of social capital were used to guide the data interpretation. Using the Giorgi data analysis method for inductive data analysis, 4 themes emerged from the data. The themes were difficulties and complexities of being unsheltered, barriers to becoming sheltered, specific needs of unsheltered homeless men, and the way in which faith sustains the unsheltered. The results of the study can promote positive social change by helping policy makers understand the unique needs of unsheltered men. As such, a reduction in the number of homeless living on the street can occur by reallocating funding to programs that address the unmet needs of unsheltered individuals.

A partir da formulação do panorama sócio-econômico no Brasil e, em especial de São Paulo, é investigada a precariedade da habitação onde grande parte da população vive: as favelas, loteamentos irregulares e os cortiços. Essas formas precárias de moradias conformam situações de risco e vulnerabilidade, onde a ocorrência de um fenômeno natural, como a chuva, pode provocar um desastre. Invariavelmente, as pessoas atingidas por um \"desastre natural\" são obrigadas a procurar abrigos temporários; em muitos casos são utilizadas estruturas transportáveis e desmontáveis como abrigos emergenciais. Por meio do levantamento do estado da arte dos abrigos emergenciais, é sugerida uma série de recomendações que visa orientar o desenvolvimento de um abrigo emergencial adequado às características sociais, culturais e econômicas dos usuários. / After the establishment of the social-economic scenario in Brazil and specifically in São Paulo, the precarious habitation conditions where a great part of the population lives is investigated: the slum quarters, irregular land divisions and tenement houses. These precarious forms of housings create situations of risk and vulnerability, where the occurrence of natural phenomena, such as rain, may cause disasters. Invariably, people affected by \"natural disasters\" have to seek acommodations in temporary shelters; in many cases, transportable structures or structures that can be dismounted are used as emergency shelters. By means of the survey of the state of the art of the existing emergency shelters, a series of recommendations is suggested, aiming to guide the development of an appropriate emergency shelter that fits the social, cultural and economic characteristics of its users.

Through natural and constructed elements, landscape architects design public landscapes to engage the public in the great outdoors. While many local governments and designers actively create landscapes to keep the unsheltered and homeless out of public spaces, keep water in storm drains, and keep native plants on the periphery of the public landscape, my project, Safe Haven, is about creating an inclusive public landscape for people, water, and native plants. Preliminary research into the history of property ownership, discrimination, economic inequality, and government programs for the unsheltered created a picture of why certain demographics struggle with housing. Case studies of homeless encampments in the Washington DC area of NOMA, Abbot's Camp in Austin, Texas, and car camping in San Diego, California, and Seattle, Washington, gave insight into the current landscape needs of unsheltered people. Studies of the watershed and plants native to the site inspired a water retention system and a seasonal pallet of plants. The design incorporates existing infrastructure, new buildings, a natural playground, wilderness camping, a Mount Vernon-inspired vegetable garden, and a sunken garden designed to retain water while showcasing native plants. Describing the design are narratives sharing the perspective of water, native plants, the unsheltered, and the homeless. Lady Landscape guides the stories and offers her views on the responsibilities of a landscape architect. / Master of Landscape Architecture / Inclusive landscapes create a vision of places where children, older adults, people with and without disabilities enjoy the beauty of Mother Nature. There are ADA regulations that ensure everyone can be accommodated within a public landscape, but those regulations don't extend to the needs of unsheltered or homeless people. Their needs to enjoy public parks and recreation areas are different from housed people. They're looking for a home, and many public spaces are built to deter them from living on public lands. My project is a landscape designed with the unsheltered and homeless as the primary client. My project is about creating room for people without homes in the landscape - offering them dignity and meeting them where they are. Researching the needs of the homeless and what is presently available helped guide my design. After choosing an appropriate site in Fairfax City, Virginia, it became apparent that water and native plants would also need a home in this project. A thorough study of the water pattern over the area informed design elements that gave water a home through a Vegetative Swale and Sunken Garden while native plants found space in garden rooms. The thesis is presented as a narrative with Lady Landscape guiding the reader through the design by introducing them to the people and natural elements the landscape offers refuge to.