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PhD candidate Rikke Siersbaek is researching the delivery of equitable healthcare access for homeless adults with complex needs

Rikke is a PhD scholar in the SPHeRE programme, which is the Structured Population and Health-services Research Education programme, and is funded by the Health Research Board, Ireland. Having originally completed a BA in English and an MA in American Studies, Rikke completed a master’s degree in Public Health at the Colorado School of Public Health. In the US, Rikke worked as a Programme Manager in a small NGO called Kids First Health Care, and before that, as a Programme Manager for Mental Health First Aid Colorado. Rikke’s research is supervised by Professor Steve Thomas (TCD), Dr Sara Burke (TCD), Dr Clíona Ní Cheallaigh (TCD) and Dr John Ford (Cambridge UIniversity). She is also supported by members of the All-Ireland Inclusion Health Forum. We spoke to Rikke about her research, its potential impact on health services policy, and how she has found her right fit in health services research.

Can you describe your research topic?
As a student in the SPHeRE programme, my broad area of research has the goal of understanding how health services are funded, organised, accessed, and delivered from a population health perspective. Within that that broader area, I am interested in health inequalities and how health systems facilitate or impede healthcare delivery for vulnerable populations. In particular, my PhD study asks how, why, for whom and to what extent health systems factors, such as funding, planning, performance management, service design and culture, impact on healthcare access for populations with complex needs experiencing homelessness. 

How do you see your work impacting healthcare in the future?
My goal, based on my PhD research, is to influence policy makers who plan and design health services by demonstrating the upstream factors that impact healthcare accessibility for vulnerable populations. Health services can be funded, organised and delivered in ways that make access easier. And healthcare practitioners can be trained to work in ways that promote accessibility and create the right culture in which services can be equitably accessed.

Did you always want to pursue a research career?
I did not always want to be a researcher, but I always wanted to do work that was meaningful, and which would have a positive impact on the world around me. I enjoy research and think it is a wonderful, engaging and challenging career choice. But it is a means to an end – providing evidence to policy makers, practitioners, and managers is crucial.

What do you enjoy most about your studies, and would you recommend the academic life to young student and undergraduates?
I enjoy the freedom of research and the ability to learn in-depth about things that interest me. In particular, the PhD process is great as it is allowing me the time and space to learn the right approaches to do rigorous work and to immerse myself both in methods and topics. I also enjoy the apprenticeship aspect of the PhD process whereby you get to learn with your supervisors as you get ongoing feedback and support throughout. And I really enjoy the camaraderie with other PhD students, particularly those of my cohort in the SPHeRE programme which has enhanced my PhD experience tremendously. I would encourage any PhD student to look for supervisors they like as people and can see themselves learning from and with, and to engage with peer communities as it can get lonely otherwise.

I would recommend doing a PhD to anyone who is interested in learning in-depth and who likes (or can tolerate at least) complexity and messiness. The PhD is a long process, and you have to trust that you will come to the end with a useful outcome and have to be able to go through periods where everything is confusing and unclear. Being part of structured programme has really helped me to trust the process and I would recommend that approach to anyone with the option.   

What are your plans for the future?
I hope to continue to work as a researcher and to produce research findings that are meaningful and useful to healthcare policy makers, planners and practitioners, and which promote more equitable health services.

When you are not working on your PhD studies, where could we find you?
I love to bake, knit and do jigsaws. I also love walking in nature and will often be in the park with my kids!

You can learn more about the SPHeRE Programme here:
A poster presentation given at the International Realist Conference in February 2021 can be accessed here: