Summaries of Independent Scientist (K) Awards

Ensign, Josephine

Institution: University of Washington, Seattle
Grant Title: Measuring Quality of Care for Homeless Adolescents
Grant Number:  K08 HS011414
Duration: 4 years (2001-2005)
Total Award: $405,500

Project Description: This research examined factors necessary for monitoring access and quality of primary health care for homeless youth.  A qualitative component of the study included narrative interviews and focus groups with homeless youth.  This was complemented by the development of process and outcome measures of quality health care using a modified Delphi technique.  The project also included a pilot study of existing youth health-related quality of life instruments that were deemed appropriate to this population based on results of the previous research components.

Career Goals: Dr. Ensign is an Associate Professor in the Department of Psychosocial and Community Health in the School of Nursing at the University of Washington. She earned her PhD in International Public Health. Her research is practice-based and she has a special interest in applying practices and approaches from international health to US underserved populations.

Progress to Date: This grant has been completed.  Dr. Ensign found youth most often stated cultural and interpersonal aspects of quality of care were important to them.  Outcomes of health care included survival of homelessness, functional and disease state improvement, and having increase trust and connections with adults and the wider community.  Most youth under age 18 said they were often denied health care at hospitals because of their underage status and youth over 18 years stated that health care bills contributed to their inability to obtain and maintain stable housing.

Highlights and Specific Accomplishments:

• Work with University of Washington's Carlson Leadership Center to develop a new interdisciplinary and service learning course entitled "Homeless Youth: Critical and International Perspectives," and will teach in Spring Quarter with Director of the Seattle Youth Children's Home SafeLinks and StreetLinks program, one of the research sites for this grant.
• Serve as a faculty preceptor on the SafeLinks medical van, supervising medical, physician assistant and nurse practitioner students providing street-based health care to Seattle homeless youth.
• Served as expert advisory panel committee member for National Health Care for the Homeless Council to develop a monograph on health care for homeless young adults ages 18-24, sponsored by the Bureau of Primary Health Care, for publication and distribution at the national meeting, June 2004.

K-Generated Publications:

Ammerman S, Ensign J, Rew L, et al. Society of Adolescent Medicine position paper on homeless youth. Society of Adolescent Medicine 2006.

Ammerman S, Ensign J, Kirzner R, et al. Homeless young adultsa Ages 18-24: Examining service delivery adaptation. Nashville: National Health Care for the Homeless Council. 2004.

Ensign BJ. Perspectives and experiences of homeless young people. Journal of Advanced Nursing 2006. 54(6):647-52.

Ensign, J. Health care for homeless youth. Washington Family Physician: The Journal of the Washington Academy of Family Physicians 2006. 32(3):8-11.

Ensign J. Ethical issues in qualitative health research with homeless youth. Journal of Advanced Nursing 2003 Jul. 43(1):45-50.

Ensign J, Bell M. Illness experiences of homeless youth. Qualitative Health Research 2004. Nov 14(9):1239-54.

Ensign J. Quality of health care: The views of homeless youth. Health Services Research 2004 Aug. 39(4 Pt 1):695-707.

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