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Gaining access to vulnerable populations and establishing a relationship can be difficult and time-consuming. Because nurses actively participate in episodic health screening, promotion and education for medically underserved populations, effective strategies for building instant rapport and trust need to be identified and described. Using an academic health services project as the basis for exploring effective but brief client contacts with the homeless and elderly provided a naturalistic setting for exploring this issue. Project staff and outreach workers, along with community agency staff and key community informants determined the best locations, times, and marketing strategies for health screening, promotion, and education activities. Faculty and nursing students provided the person power and time to provide the homeless and elderly with selected local health services. The health screening and education activities targeted three major chronic illnesses: cardiovascular disease, cancer, and diabetes. More than 1000 ethnically diverse client contacts were made at more than 20 sites. Participant demographics, satisfaction, anecdotal comments, and agency satisfaction were collected. Project staff also reported client interactions with qualitative description. The use of a simple blood pressure screening opened multiple avenues upon which to educate and intervene with high-risk clients. When services were provided that did not include blood pressure screening, project staff reported increased difficulty in building a quick rapport and inferred trust. Clients, students, and agency personnel reported greater than 95% satisfaction with the screenings and education programs. The simplicity of the findings indicates the extreme usefulness of a blood pressure screening to the client-staff relationship. The findings provide information about access to primary health services for elderly and homeless. (Funded by US PHS grant #1 D11 HP00239-01.)
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