Multidisciplinary primary care outreach for women experiencing domestic and family violence and/or homelessness: a rapid evidence review

Background Women and children who experience domestic and family violence (DFV) have complex physical and mental health needs, may be at risk of homelessness, and face substantial barriers to accessing health care. The integration of outreach primary health care delivered by a multidisciplinary team (MDT) into shelters or mobile clinics may address these issues. This rapid review sought to identify and describe outreach programs for women and children affected by DFV and/or homelessness in middle- and high-income countries. Methods Seven bibliographic databases were searched in March 2024. Included studies described a primary care MDT outreach program that was delivered in a shelter, refuge, mobile clinic or drop-in centre; were written in English; and reported results separately for women. Results Twelve publications reporting on 11 programs were included. These identified four staffing models: (1) nurse-led MDT; (2) nurse-led MDT with physician available remotely; (3) MDT with on-site physician; and (4) student-led. Model 3 offered the greatest range of services (11.5 on average), and Model 4 the least (5.5 on average). Three publications reported on two quasi-experimental studies, whereas the remainder of the studies lacked a control group. All studies reported benefits to outreach service clients for one or more of the following outcomes: service acceptability, healthcare use, health outcomes and economic outcomes. Only two studies examined the impact on health outcomes. Conclusions Few studies evaluate primary care MDT outreach programs; however, those identified in this review indicate benefits for women and children experiencing DFV and/or homelessness.