Date of Award


Degree Type


Degree Name

Master of Clinical Science


Family Medicine


Dr. Judith Belle Brown

Second Advisor

Dr. Amardeep Thind


Aims: This thesis explored the experiences of vulnerable women using illicit drugs and inner-city family physicians in order to better understand the process of engagement.

Methods: This qualitative, phenomenological study used in-depth interviews with vulnerable, drug-using women and inner-city family physicians. An iterative and interpretive analysis was conducted.

Findings: All participants identified proximal and distal contexts that were barriers to engagement. Women and family physician participants took actions that served to both facilitate and hinder access to primary health care. Lastly, participants identified the central role of the patient-physician relationship in the process of engagement and maintenance.

Conclusions: Engagement is a two-step process characterized by engagement and maintenance phases. Strategies which enhance engagement include: 1) housing, 2) harm reduction programs 3) investing in peer programs, 4) concurrent social and medical services; and 5) patient-centered care.



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