Attitudes of Physiotherapy Students toward People Experiencing Homelessness through a Musculoskeletal Health Program

Abstract Introduction: People experiencing homelessness (PEH) are more susceptible to developing musculoskeletal (MSK) conditions. However, they often lack access to adequate healthcare due to factors such as stigmatization and discrimination by healthcare professionals, which impacts their social integration. This study aimed to improve the attitudes of physiotherapy students toward PEH through a program focused on enhancing MSK health among PEH, implemented in homeless shelters. Methods: The project involved PEH from (shelter name) and undergraduate physiotherapy students from (institution name). MSK health in PEH was assessed using the Musculoskeletal Health Questionnaire and the Work Ability Index. Students’ attitudes were measured using the Escala de Atitudes Face à População em Situação de Sem-Abrigo (EAFPSSA) and a survey with six open-ended questions subjected to thematic analysis. Intervention: The program consisted of 20 sessions led by the students and defined by the coordinator, combining MSK health education with strength and aerobic training. Prior to this, students participated in sessions on education about homelessness, the program's presentation, and a simulation of a session. Results: None of the PEH met the criteria for project completion. All students demonstrated positive attitudes in 11 of the 17 ATHS items, but no significant improvements were observed in any domain. By the end of the project, students perceived PEH as individuals and reported enhanced interaction, which was shaped throughout the project. Students recognized the role of physiotherapy in social inclusion, education, and promoting self-efficacy among PEH. Participation impacted students as citizens, enhancing their appreciation for the psychosocial domain and improving skills such as communication and flexibility. Conclusion: Given the students’ perceptions, the implementation of projects aimed at bringing healthcare professionals closer to PEH is considered beneficial. It is recommended that PEH be involved in the design and implementation of such projects to increase their engagement.