Background:
Women make up the fastest-growing segment of the United States homeless population, and many homeless women either are pregnant or have been pregnant in the past year. Although homelessness affects birth outcomes and reproductive health, designing prenatal care that is appropriate for and accessible to homeless women is difficult. Travel difficulties and competing priorities create a barrier to keeping medical appointments and participating in routine prenatal care. Homeless women use inpatient and outpatient services at high rates, but use preventive services at low rates. However, homeless women in previous studies report that receiving all health care and social services at the same place makes it easier to obtain routine and preventive health care.
The Opportunity Center of the MidPensinsula is an example of a new approach to providing care for the hard-to-reach, underserved homeless population. The Center uses an integrated approach, combining housing for the homeless with rehabilitation, case management, and healthcare services. The onsite clinic provides routine medical services and preventive care. Half of the services are designed to serve homeless women and women with children. The recent opening of the Center (September 2006) allows us to investigate the effects of its integrated, onsite approach to addressing the special needs of homeless women.

Objectives:
To learn about the innovative integrated approach the Opportunity Center uses to care for homeless women and their children. Interview data will show how homeless women characterize the impact of having onsite medical services on how they seek medical care.

Methods:
Qualitative interviews with about 50 homeless clients of the Opportunity Center, including women of reproductive age, will be used to characterize their healthcare-seeking behaviors and the impact of the Center's onsite services on these behaviors. Interviews will also be conducted with local Emergency Room personnel to elicit their viewpoints.

Results:
This study, conducted during Summer 2007, will offer insight into the effect that the Opportunity Center's supportive housing and integrated onsite services have had on how the homeless seek healthcare.

Conclusion and implications for practice:
This study will describe the effects of the Opportunity Center's integrated approach to providing care for homeless women.