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Hill C, Hsu H, Holguin M, Morton M, Winetrobe H, Rice E. An examination of housing interventions among youth experiencing homelessness: an investigation into racial/ethnic and sexual minority status. J Public Health (Oxf) 2022; 44:834-843. [PMID: 34355749 DOI: 10.1093/pubmed/fdab295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/28/2021] [Accepted: 07/02/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The purpose of this study is to explore main and interaction effects of minority and multiple minority statuses on exits from homelessness and the stability of homelessness exits overtime. METHODS This study utilized the Homeless Management Information System administrative data of 10 922 youth experiencing homelessness collected from a convenience sample of 16 geographically diverse communities across the USA between 2015-17. Using multinomial logistic regression analyses and logistic regression, main effects and interaction effects of racial/ethnic minority identity and sexual/gender minority identity were examined on various homelessness exits (n = 9957) and housing sustainability (n = 5836). RESULTS Black youth, relative to White youth, were disproportionately exiting homelessness through incarceration (P < 0.001). Black and Latinx youth were less likely to successfully self-resolve their homelessness (both P < 0.05). Black heterosexual and Black and Latinx non-heterosexual youth were most frequently lost to the homeless system (all P < 0.01). Black youth, relative to White youth, were approximately half as likely to remain stably housed after returning to family (P < 0.01). CONCLUSIONS With respect to housing exits and exit stability, Black and Latinx heterosexual youth are consistently at a disadvantage. Homelessness/housing systems and programs need to conduct a deeper investigation into how they implement and develop equitable outreach and engagement practices.
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Affiliation(s)
- C Hill
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - H Hsu
- School of Social Work, University of Missouri, Columbia, MO 65211, USA
| | - M Holguin
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - M Morton
- University of Chicago, Chicago, IL 60637
| | - H Winetrobe
- Center for Artificial Intelligence in Society Operations Coordinator, Suzanne Dworak Peck School of Social Work, University of Southern California, ,Los Angeles, CA 90089, USA
| | - E Rice
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
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Vázquez JJ, Cala-Montoya CA, Berríos A. The vulnerability of women living homeless in Nicaragua: A comparison between homeless women and men in a low-income country. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2314-2325. [PMID: 34913172 DOI: 10.1002/jcop.22777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
This article takes a gender perspective approach to a series of issues that may affect the vulnerability of people in a homeless situation in Nicaragua, focusing particularly on women. The study was completed using data obtained from two similarly-sized samples, one of homeless men (n = 32) and the other of homeless women (n = 30). The information was gathered using a structured interview. Results show that there are key similarities in the situation and characteristics of both men and women living homeless in Nicaragua. Results also support the thought that women living homeless - some with dependent children to care for - are in a situation of particular vulnerability, suffering violence, a greater need to find safe places to stay, greater "revolving door to homelessness," more barriers to finding work and more sex work. The analysis of the issues differentiating men from women may be of use in driving forward public policies and social care resources adapted to the specific characteristics and needs of these women and their children. As can be taken from this paper, people living homeless in low-income and high-income countries share a number of similar circumstances, which in turn could facilitate a global approach to the problem.
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Affiliation(s)
- José J Vázquez
- Department of Social Psychology, Instituto Universitaro de Investigación en Estudios Latinoamericanos (IELAT), Alcalá de Henares, Universidad de Alcalá, Madrid, Spain
| | | | - Alberto Berríos
- Department of Psychology, Universidad Nacional Autónoma de Nicaragua (UNAN-León), León, Nicaragua
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Cutuli JJ, Treglia D, Herbers JE. Adolescent Homelessness and Associated Features: Prevalence and Risk Across Eight States. Child Psychiatry Hum Dev 2020; 51:48-58. [PMID: 31270658 DOI: 10.1007/s10578-019-00909-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study utilizes data from the Youth Risk Behavior Survey to estimate the prevalence of adolescent homelessness and relations to five indicators of poor functioning among students attending public high school in eight states. About 3.27% of students experienced homelessness, and nearly 7% of teens who identified as lesbian, gay, or bisexual (LGB) experienced homelessness. Homelessness was related to higher rates of sexual/dating violence as well as having been bullied and feeling unsafe at school. Homelessness and LGB identification predicted higher rates of more-severe problems with alcohol, hard drug use, poor grades, suicidality, and risky sexual behavior, controlling for other factors. There was no interaction effect between homelessness and LGB status, suggesting that these risks are additive.
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Affiliation(s)
- J J Cutuli
- Department of Psychology, Rutgers University - Camden, 311 N Fifth Street, Rm 308, Camden, NJ, 08243, USA.
| | - Dan Treglia
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Janette E Herbers
- Department of Psychological and Brain Sciences, Villanova University, Villanova, PA, USA
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Gambon TB, Gewirtz O'Brien JR. Runaway Youth: Caring for the Nation's Largest Segment of Missing Children. Pediatrics 2020; 145:peds.2019-3752. [PMID: 31964756 DOI: 10.1542/peds.2019-3752] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The largest segment of missing children in the United States includes runaways, children who run away from home, and thrownaways, children who are told to leave or stay away from home by a household adult. Although estimates vary, as many as 1 in 20 youth run away from home annually. These unaccompanied youth have unique health needs, including high rates of trauma, mental illness, substance use, pregnancy, and sexually transmitted infections. While away, youth who run away are at high risk for additional trauma, victimization, and violence. Runaway and thrownaway youth have high unmet health care needs and limited access to care. Several populations are at particular high risk for runaway episodes, including victims of abuse and neglect; lesbian, gay, bisexual, transgender, and questioning youth; and youth in protective custody. Pediatricians and other health care professionals have a critical role to play in supporting runaway youth, addressing their unique health needs, fostering positive relationships within their families and with other supportive adults, and connecting them with available community resources. This report provides clinical guidance for pediatricians and other health care professionals regarding (1) the identification of adolescents who are at risk for running away or being thrown away and (2) the management of the unique medical, mental health, and social needs of these youth. In partnership with national, state, and local resources, pediatricians can significantly reduce risk and improve long-term outcomes for runaway youth.
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The Particularly Vulnerable Situation of Women Living Homeless in Madrid (Spain). SPANISH JOURNAL OF PSYCHOLOGY 2019; 22:E52. [PMID: 31787125 DOI: 10.1017/sjp.2019.58] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
People in homeless situation are one of the major embodiments of the phenomenon of social exclusion, and women living homeless are considered a particularly vulnerable group. This paper examines different variables that may affect the situation of vulnerability experienced by women living homeless in Madrid (Spain). The study was carried out using data obtained from a representative sample of homeless men in Madrid (n = 158) and a sample of homeless women in Madrid of a similar size (n = 138). The information was gathered using a structured interview in shelters or other facilities for people in a homeless situation, on the street and in other places not initially designed for sleeping. The results show that woman living homeless are highly vulnerable compared to the domiciled population and, in some respects, to homeless men as well, especially in the number of times homeless (χ2 = 10.314; p < .01), in the time working with a contract and/or self-employed (t = 5.754; p < .001), and in the use of sedatives (χ2= 14.741; p < .001). It is however noted that homeless women show in some aspects greater strengths than homeless men. Such strengths could serve as a supporting point for their social inclusion processes. The analysis of issues that differentiate women in a homeless situation from their male counterparts could be useful for developing public policies and care resources adapted to the specific characteristics and needs of women living homeless.
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Rothstein MA, Coughlin CN. Ensuring Compliance With Quarantine by Undocumented Immigrants and Other Vulnerable Groups: Public Health Versus Politics. Am J Public Health 2019; 109:1179-1183. [PMID: 31318598 DOI: 10.2105/ajph.2019.305201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A successful quarantine requires a high rate of compliance by individuals with potential exposure to a communicable disease.Many individuals would be reluctant to comply with a quarantine because they fear that contact with government officials will place them in legal, personal, or economic jeopardy. These include undocumented immigrants and individuals with a substance use disorder. For a quarantine to succeed, individuals must be granted temporary immunity from arrest, deportation, or similar adverse consequences, but doing so will be politically unpopular.We argue that public health considerations must take precedence over politics in protecting the health of the public.
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Affiliation(s)
- Mark A Rothstein
- Mark A. Rothstein is with the Institute for Bioethics, Health Policy and Law, University of Louisville School of Medicine, Louisville, KY, and is an AJPH associate editor. Christine N. Coughlin is with the Wake Forest University School of Law, Winston-Salem, NC
| | - Christine N Coughlin
- Mark A. Rothstein is with the Institute for Bioethics, Health Policy and Law, University of Louisville School of Medicine, Louisville, KY, and is an AJPH associate editor. Christine N. Coughlin is with the Wake Forest University School of Law, Winston-Salem, NC
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Malla A, Iyer S, Shah J, Joober R, Boksa P, Lal S, Fuhrer R, Andersson N, Abdel‐Baki A, Hutt‐MacLeod D, Beaton A, Reaume‐Zimmer P, Chisholm‐Nelson J, Rousseau C, Chandrasena R, Bourque J, Aubin D, Levasseur MA, Winkelmann I, Etter M, Kelland J, Tait C, Torrie J, Vallianatos H, the ACCESS Open Minds Youth Mental Health Network. Canadian response to need for transformation of youth mental health services: ACCESS Open Minds (Esprits ouverts). Early Interv Psychiatry 2019; 13:697-706. [PMID: 30556335 PMCID: PMC6563151 DOI: 10.1111/eip.12772] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/18/2018] [Accepted: 11/04/2018] [Indexed: 01/02/2023]
Abstract
AIM Youth mental health is of paramount significance to society globally. Given early onset of mental disorders and the inadequate access to appropriate services, a meaningful service transformation, based on globally recognized principles, is necessary. The aim of this paper is to describe a national Canadian project designed to achieve transformation of mental health services and to evaluate the impact of such transformation on individual and system related outcomes. METHOD We describe a model for transformation of services for youth with mental health and substance abuse problems across 14 geographically, linguistically and culturally diverse sites, including large and small urban, rural, First Nations and Inuit communities as well as homeless youth and a post-secondary educational setting. The principles guiding service transformation and objectives are identical across all sites but the method to achieve them varies depending on prevailing resources, culture, geography and the population to be served and how each community can best utilize the extra resources for transformation. RESULTS Each site is engaged in community mapping of services followed by training, active stakeholder engagement with youth and families, early case identification initiatives, providing rapid access (within 72 hours) to an assessment of the presenting problems, facilitating connection to an appropriate service within 30 days (if required) with no transition based on age within the 11 to 25 age group and a structured evaluation to track outcomes over the period of the study. CONCLUSIONS Service transformation that is likely to achieve substantial change involves very detailed and carefully orchestrated processes guided by a set of values, principles, clear objectives, training and evaluation. The evidence gathered from this project can form the basis for scaling up youth mental health services in Canada across a variety of environments.
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Affiliation(s)
- Ashok Malla
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Srividya Iyer
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Jai Shah
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Ridha Joober
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Patricia Boksa
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Shalini Lal
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
- School of Rehabilitation, Faculty of MedicineUniversité de MontréalMontréal, QuébecCanada
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM)Montréal, QuébecCanada
| | - Rebecca Fuhrer
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréal, QuébecCanada
| | - Neil Andersson
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of Family Medicine, Community Information and Epidemiological Technologies (CIET) Institute and Participatory Research at McGill (PRAM)McGill UniversityMontréal, QuébecCanada
- McGill University Institute for Human Development and Well‐beingMontréal, QuébecCanada
| | - Amal Abdel‐Baki
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of PsychiatryUniversité de MontréalMontréal, QuébecCanada
- Centre hospitalier de l'Université de Montréal (CHUM), CRCHUMMontréal, QuébecCanada
| | - Daphne Hutt‐MacLeod
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Eskasoni Mental Health ServicesEskasoni, Nova ScotiaCanada
| | - Ann Beaton
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- School of Psychology, Faculty of Health Sciences and Community ServicesUniversité de MonctonMonctonNew BrunswickCanada
| | - Paula Reaume‐Zimmer
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Mental Health and Addictions ServicesBluewater Health and Canadian Mental Health AssociationLambton Kent, OntarioCanada
| | - Jessica Chisholm‐Nelson
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Cécile Rousseau
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Centre de recherche SHERPA, Institut Universitaire au regard des communautés culturellesCentre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre‐Ouest‐de‐l'Île‐de‐MontréalMontréal, QuébecCanada
| | - Ranjith Chandrasena
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Schulich School of MedicineWestern UniversityLondonOntarioCanada
| | - Jimmy Bourque
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Faculty of EducationUniversité de MonctonMonctonNew BrunswickCanada
| | - Diane Aubin
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Dans La Rue and Réseau d'intervention de proximité auprès des jeunes de la rue (RIPAJ)‐Montréal/Homeless Youth NetworkMontréal, QuébecCanada
| | - Mary Anne Levasseur
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- ACCESS Open Minds Family and Carers Council, Douglas Mental Health University Institute, MontréalQuébecCanada
| | - Ina Winkelmann
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Meghan Etter
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Counselling ServicesInuvialuit Regional CorporationInuvik, Northwest TerritoriesCanada
| | - Jill Kelland
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Young Adult and Cross Level Services, Addiction and Mental Health, Edmonton Zone, Alberta Health ServicesEdmontonAlbertaCanada
| | - Caroline Tait
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of PsychiatryUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Jill Torrie
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Public Health DepartmentCree Board of Health and Social Services of James BayMistissini, QuébecCanada
| | - Helen Vallianatos
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of AnthropologyUniversity of AlbertaEdmontonAlbertaCanada
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VonHoltz LAH, Frasso R, Golinkoff JM, Lozano AJ, Hanlon A, Dowshen N. Internet and Social Media Access Among Youth Experiencing Homelessness: Mixed-Methods Study. J Med Internet Res 2018; 20:e184. [PMID: 29789281 PMCID: PMC5989062 DOI: 10.2196/jmir.9306] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/08/2018] [Accepted: 03/22/2018] [Indexed: 11/20/2022] Open
Abstract
Background Youth experiencing homelessness are at a risk for a variety of adverse outcomes. Given the widespread use of the internet and social media, these new technologies may be used to address their needs and for outreach purposes. However, little is known about how this group uses these resources. Objective This study investigated how homeless adolescents use these technologies for general and health-related purposes, whether the scope of their use changes with housing status, and their interest in a website dedicated to youth experiencing homelessness. Methods A convenience sample of youth aged 18 to 21 years was recruited from a youth-specific homeless shelter. All participants completed a 47-item survey, with 10 individuals completing a semistructured interview. Descriptive statistics, exact testing, logistic regression, and generalized estimating equation modeling was performed for quantitative data analysis. Interviews were transcribed verbatim, and NVivo 10 (QSR International) was employed to facilitate double coding and thematic analysis. Results A total of 87 participants completed the survey with a mean age of 19.4 (SD 1.1) years. While experiencing homelessness, 56% (49/87) accessed the internet at least once a day, with 86% (75/87) accessing once a week. Access to a smartphone was associated with a 3.03 greater odds of accessing the internet and was the most frequently used device (66% of participants, 57/87). While experiencing homelessness, subjects reported a 68% decreased odds in internet access frequency (odds ratio [OR] 0.32, P<.001), 75% decreased odds in spending greater amounts of time on the internet (OR 0.25, P<.001), and an 87% decreased odds of social media use (OR 0.13, P=.01). Ten participants completed the semistructured interview. Several themes were identified, including (1) changes in internet behaviors while experiencing homelessness, (2) health status as a major concern and reason for Internet use, and (3) interest in a website dedicated to youth experiencing homelessness. While experiencing homelessness, participants indicated their behaviors were more goal-oriented and less focused on leisure or entertainment activities. Conclusions While homeless youth experience changes in the frequency, amount of time, and specific uses of the internet and social media, study participants were able to access the internet regularly. The internet was used to search health-related topics. Given the importance of smartphones in accessing the internet, mobile-optimized websites may be an effective method for reaching this group.
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Affiliation(s)
| | - Rosemary Frasso
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jesse M Golinkoff
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Alicia J Lozano
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Alexandra Hanlon
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Nadia Dowshen
- Craig-Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Salhi BA, White MH, Pitts SR, Wright DW. Homelessness and Emergency Medicine: A Review of the Literature. Acad Emerg Med 2018; 25:577-593. [PMID: 29223132 DOI: 10.1111/acem.13358] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 11/24/2017] [Accepted: 12/04/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We aimed to synthesize the available evidence on the demographics, prevalence, clinical characteristics, and evidence-based management of homeless persons in the emergency department (ED). Where appropriate, we highlight knowledge gaps and suggest directions for future research. METHODS We conducted a systematic literature search following databases: PubMed, Ovid, and Google Scholar for articles published between January 1, 1990, and December 31, 2016. We supplemented this search by cross-referencing bibliographies of the retrieved publications. Peer-reviewed studies written in English and conducted in the United States that examined homelessness within the ED setting were included. We used a qualitative approach to synthesize the existing literature. RESULTS Twenty-eight studies were identified that met the inclusion criteria. Based on our study objectives and the available literature, we grouped articles examining homeless populations in the ED into four broad categories: 1) prevalence and sociodemographic characteristics of homeless ED visits, 2) ED utilization by homeless adults, 3) clinical characteristics of homeless ED visits, and 4) medical education and evidence-based management of homeless ED patients. CONCLUSION Homelessness may be underrecognized in the ED setting. Homeless ED patients have distinct care needs and patterns of ED utilization that are unmet by the current disease-oriented and episodic models of emergency medicine. More research is needed to determine the prevalence and characteristics of homelessness in the ED and to develop evidence-based treatment strategies in caring for this vulnerable population.
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Affiliation(s)
- Bisan A. Salhi
- Department of Emergency Medicine Emory University Atlanta GA
- Department of Anthropology Emory University Atlanta GA
| | | | | | - David W. Wright
- Department of Emergency Medicine Emory University Atlanta GA
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Bender K, Begun S, Durbahn R, Ferguson K, Schau N. My Own Best Friend: Homeless Youths' Hesitance to Seek Help and Strategies for Coping Independently after Distressing and Traumatic Experiences. SOCIAL WORK IN PUBLIC HEALTH 2018; 33:149-162. [PMID: 29377774 DOI: 10.1080/19371918.2018.1424062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although homeless youth face extreme adversities, they are often hesitant to seek help from formal and informal supports. The current study qualitatively explored homeless youths' reasons for coping independently and their strategies for doing so. Youth accessing services (N = 145) in three U.S. cities were interviewed about their rationales for not seeking help from others regarding distressing experiences. Analyses illustrated specific barriers to help seeking that prompted homeless youth to cope on their own by utilizing soothing, avoidant, aggressive, and introspective coping strategies. Implications for outreaching to those least likely to seek help are discussed.
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Affiliation(s)
- Kimberly Bender
- a Graduate School of Social Work , University of Denver , Denver , Colorado , USA
| | - Stephanie Begun
- b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Rebecca Durbahn
- a Graduate School of Social Work , University of Denver , Denver , Colorado , USA
| | - Kristin Ferguson
- c School of Social Work , Arizona State University , Phoenix , Arizona , USA
| | - Nick Schau
- a Graduate School of Social Work , University of Denver , Denver , Colorado , USA
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Prevalence and Correlates of Youth Homelessness in the United States. J Adolesc Health 2018; 62:14-21. [PMID: 29153445 PMCID: PMC5826721 DOI: 10.1016/j.jadohealth.2017.10.006] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/13/2017] [Accepted: 10/13/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. METHODS Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13-17 and young adults aged 18-25, as well as self-reports from young adults aged 18-25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. RESULTS Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. CONCLUSIONS The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations.
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Tsai J. Lifetime and 1-year prevalence of homelessness in the US population: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. J Public Health (Oxf) 2017; 40:65-74. [DOI: 10.1093/pubmed/fdx034] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 03/07/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jack Tsai
- Department of Psychiatry, Yale School of Medicine, New Haven, CT06510, USA
- Department of Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center, West Haven, CT06516, USA
- VA National Center on Homelessness Among Veterans, West Haven, CT06516, USA
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14
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Barman-Adhikari A, Begun S, Rice E, Yoshioka-Maxwell A, Perez-Portillo A. Sociometric network structure and its association with methamphetamine use norms among homeless youth. SOCIAL SCIENCE RESEARCH 2016; 58:292-308. [PMID: 27194667 PMCID: PMC4873723 DOI: 10.1016/j.ssresearch.2016.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 01/05/2016] [Accepted: 01/22/2016] [Indexed: 05/25/2023]
Abstract
Homeless youths' social networks are consistently linked with their substance use. Social networks influence behavior through several mechanisms, especially social norms. This study used sociometric analyses to understand whether social norms of drug use behaviors are clustered in network structures and whether these perceived norms (descriptive and injunctive) influence youths' drug use behaviors. An event-based approach was used to delineate boundaries of the two sociometric networks of homeless youth, one in Los Angeles, CA (n = 160) and the other in Santa Monica, CA (n = 130). Network characteristics included centrality (i.e., popularity) and cohesiveness (location in dense subnetworks). The primary outcome was recent methamphetamine use. Results revealed that both descriptive and injunctive norms influenced methamphetamine use. Network cohesion was found to be associated with perception of both descriptive and injunctive norms in both networks, however in opposite directions. Network interventions therefore might be effective if designed to capitalize on social influence that naturally occurs in cohesive parts of networks.
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Affiliation(s)
| | - Stephanie Begun
- School of Social Work, University of Denver, Denver, CO, USA.
| | - Eric Rice
- School of Social Work, University of Southern California, Los Angeles, CA, USA.
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15
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Abstract
Abstract. Background: Although the protective value of social connectedness is emphasized in suicide prevention programming, little is known about the relationship between connectedness in high-risk runaway and homeless youth (RHY) networks and suicidal ideation. Aims: The study examined how social connectedness, in the form of social network position and network exposures, was associated with suicidal ideation among RHY. Method: Using population-level social network data from 384 RHY, each youth’s network position and exposure to potentially suicidogenic peer attributes were calculated. Logistic regression analyses were used to examine associations between network position (core vs. periphery), peer exposures (e.g., depressed or suicidal peers), and suicidal ideation. Results: In univariable analyses, being in the core of the network and being connected to greater proportions of depressed and suicidal peers increased the likelihood of suicidal ideation. In the final multivariable model, higher exposure to depressed peers remained associated with suicidal ideation, and a marginal effect for network position was observed. Conclusion: The risk of suicidal ideation was linked to depression among peers and to a lesser extent being more integrated into the RHY network. Identifying and treating depression in naturally occurring friendship groups, particularly in the core of the network, represents a promising network-level intervention.
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Affiliation(s)
- Anthony Fulginiti
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Eric Rice
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, Columbia, MO, USA
| | - Harmony Rhoades
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Hailey Winetrobe
- School of Social Work, University of Southern California, Los Angeles, CA, USA
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16
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Petering R. Sexual risk, substance use, mental health, and trauma experiences of gang-involved homeless youth. J Adolesc 2016; 48:73-81. [PMID: 26897432 DOI: 10.1016/j.adolescence.2016.01.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 11/27/2022]
Abstract
This study examined the associations of sexual risk behaviors, substance use, mental health, and trauma with varying levels of gang involvement in a sample of Los Angeles-based homeless youths. Data were collected from 505 homeless youths who self-reported various health information and whether they have ever identified as or been closely affiliated with a gang member. Multivariable logistic regression assessed associations of lifetime gang involvement with risk taking behaviors and negative health outcomes. Results revealed seventeen percent of youths have ever identified as a gang member and 46% as gang affiliated. Both gang members and affiliates were at greater risk of many negative behaviors than non-gang involved youths. Gang members and affiliates were more likely to report recent methamphetamine use, cocaine use, chronic marijuana use, having sex while intoxicated, and symptoms of depression, symptoms of posttraumatic stress disorder. They were also more likely to have experienced childhood sexual abuse and witnessing family violence. Gang members were more likely to ever attempt suicide, experience recent partner violence, and report physical abuse during childhood. Results suggest that lifetime gang involvement is related to a trajectory of negative outcomes and amplified risk for youths experiencing homelessness. Additionally, being closely connected to a gang member appears to have just as much as an impact on risk as personally identifying as a gang member. Given the lack of knowledge regarding the intersection between youth homelessness and gang involvement, future research is needed to inform policies and programs that can address the specific needs of this population.
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Affiliation(s)
- Robin Petering
- School of Social Work, University of Southern California, Los Angeles, CA, USA.
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17
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Rice E, Petering R, Rhoades H, Barman-Adhikari A, Winetrobe H, Plant A, Montoya J, Kordic T. Homelessness and Sexual Identity Among Middle School Students. THE JOURNAL OF SCHOOL HEALTH 2015; 85:552-557. [PMID: 26149311 DOI: 10.1111/josh.12280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, or questioning (LGBQ) high school students experience higher rates of homelessness than their heterosexual peers. Moreover, LGBQ high school students are more likely to stay in riskier locations (eg, with a stranger) and less likely to stay in a shelter. This study tested whether these trends also apply to middle school students. METHODS Using representative data, we examined sexual identity and homelessness among Los Angeles Unified School District middle school students. RESULTS Nearly 10% of middle school students identified as LGBQ and 23.5% experienced at least 1 night of homelessness during the previous year. Contrary to high school data, LGBQ students did not experience higher rates of homelessness overall. However, when limiting the sample to students who had experienced homelessness, LGBQ students were more than 5 times as likely as heterosexual students to have stayed in a public place and 63% as likely to have stayed in a shelter. CONCLUSIONS Lesbian, gay, bisexual, or questioning students are more likely to experience public homelessness. Schools must implement homelessness surveillance systems to assist in identifying early episodes of homelessness, thereby reducing the likelihood of poor physical and mental health outcomes associated with chronic homelessness.
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Affiliation(s)
- Eric Rice
- School of Social Work, University of Southern California, 1150 S. Olive Street, 14th floor, Los Angeles, CA 90015.
| | - Robin Petering
- School of Social Work, University of Southern California, 1150 S. Olive Street, 14th floor, Los Angeles, CA 90015.
| | - Harmony Rhoades
- School of Social Work, University of Southern California, 1149 S. Hill Street, Suite 360, Los Angeles, CA 90015.
| | - Anamika Barman-Adhikari
- Department of Social Work Education, Fresno State University, 5310 N. Campus Drive, M/S PHS 144, Fresno, CA 93710-8019.
| | - Hailey Winetrobe
- School of Social Work, University of Southern California, 1149 S. Hill Street, Suite 360, Los Angeles, CA 90015.
| | - Aaron Plant
- Program Planning and Evaluation, Sentient Research, 231 N. Walnuthaven Drive, West Covina, CA 91790.
| | - Jorge Montoya
- Sentient Research, 231 N. Walnuthaven Drive, West Covina, CA 91790.
| | - Timothy Kordic
- LAUSD Health Education Programs, HIV/AIDS Prevention Unit, 333 S. Beaudry Avenue, 29th floor, Los Angeles, CA 90017.
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18
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Mastropieri B, Schussel L, Forbes D, Miller L. Inner resources for survival: integrating interpersonal psychotherapy with spiritual visualization with homeless youth. JOURNAL OF RELIGION AND HEALTH 2015; 54:903-921. [PMID: 25862338 DOI: 10.1007/s10943-015-0044-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Homeless youth have particular need to develop inner resources to confront the stress, abusive environment of street life, and the paucity of external resources. Research suggests that treatment supporting spiritual awareness and growth may create a foundation for coping, relationships, and negotiating styles to mitigate distress. The current pilot study tests the feasibility, acceptability, and helpfulness of an interpersonal spiritual group psychotherapy, interpersonal psychotherapy (IPT) integrated with spiritual visualization (SV), offered through a homeless shelter, toward improving interpersonal coping and ameliorating symptoms of depression, distress, and anxiety in homeless youth. An exploratory pilot of integrative group psychotherapy (IPT + SV) for homeless young adults was conducted in a New York City on the residential floor of a shelter-based transitional living program. Thirteen young adult men (mean age 20.3 years, SD = 1.06) participated in a weekly evening psychotherapy group (55 % African-American, 18 % biracial, 18 % Hispanic, 9 % Caucasian). Measures of psychological functioning were assessed at pre-intervention and post-intervention using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ-9, GAD-7), and the Inventory of Interpersonal Problems (IIP-32). A semi-structured exit interview and a treatment satisfaction questionnaire were also employed to assess acceptability following treatment. Among homeless young adults to participate in the group treatment, significant decreases in symptoms of general distress and depression were found between baseline and termination of treatment, and at the level of a trend, improvement in overall interpersonal functioning and levels of general anxiety. High utilization and treatment satisfaction showed the intervention to be both feasible and acceptable. Offered as an adjunct to the services-as-usual model at homeless shelters serving young adults, interpersonal psychotherapy with spiritual visualization (IPT + SV) in group appears to be a feasible and potentially useful treatment option for promoting improved mental health.
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19
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Kennedy DP, Brown RA, Morrison P, Vie L, Ryan GW, Tucker JS. Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation. BMC Public Health 2015; 15:62. [PMID: 25636862 PMCID: PMC4324882 DOI: 10.1186/s12889-015-1419-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 01/14/2015] [Indexed: 11/17/2022] Open
Abstract
Background Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect. Methods To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis. Results We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances. Conclusions Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1419-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David P Kennedy
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Ryan A Brown
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Penelope Morrison
- The RAND-University of Pittsburgh Health Institute, Pittsburgh, PA, USA.
| | - Loryana Vie
- The Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA. .,The Department of Psychology, University of California, Riverside, CA, USA.
| | - Gery W Ryan
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - Joan S Tucker
- RAND Health, RAND Corporation, P.O. Box 2138, 1776 Main Street, Santa Monica, CA, 90407, USA.
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20
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Sznajder-Murray B, Jang JB, Slesnick N, Snyder A. Longitudinal Predictors of Homelessness: Findings from the National Longitudinal Survey of Youth-97. JOURNAL OF YOUTH STUDIES 2015; 18:1015-1034. [PMID: 27774034 PMCID: PMC5074054 DOI: 10.1080/13676261.2015.1020930] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between the ages of 12 to 18 years. The current study examined whether individual and family risk factors reported during adolescence predict homelessness by the age of 25. The findings showed that multiple runaway episodes, non-traditional family structure, lower educational attainment, and parental work limitations due to health increased the risk of homelessness. A permissive parenting style and being Hispanic protected against homelessness. This study offers unique insight into risk and protective factors for youth homelessness, and has important clinical implications.
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Affiliation(s)
| | - Joy Bohyun Jang
- University of Michigan, 2345 ISR 426 Thompson, Ann Arbor, MI 48104,
| | - Natasha Slesnick
- The Ohio State University, 1787 Neil Ave., 135 Campbell Hall, Columbus, OH 43210, ude.uso.ehe@kcinselsn
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21
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Begun S. The paradox of homeless youth pregnancy: a review of challenges and opportunities. SOCIAL WORK IN HEALTH CARE 2015; 54:444-460. [PMID: 25985287 DOI: 10.1080/00981389.2015.1030058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Compared to their housed counterparts, homeless youth become pregnant at exceptionally high rates. Causes of such pregnancies are multifaceted, while a paradoxically high proportion of these pregnancies are intended. This review discusses causes and risk factors associated with homeless youth pregnancies, and notes experiences of pregnancy decision-making discord, challenges encountered during and following pregnancy, and difficulties faced by homeless youth when or if they become parents. Because homeless youth face a wide array of unique risks, future research would benefit from exploring alternative approaches to prevention to reduce pregnancies and improve sexual and reproductive health outcomes among this population.
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Affiliation(s)
- Stephanie Begun
- a Graduate School of Social Work, University of Denver , Denver , Colorado , USA
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22
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Bender K, Begun S, DePrince A, Haffejee B, Kaufmann S. Utilizing technology for longitudinal communication with homeless youth. SOCIAL WORK IN HEALTH CARE 2014; 53:865-882. [PMID: 25321934 DOI: 10.1080/00981389.2014.925532] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The current study investigated forms of technology (phone calls, texts, email and Facebook) for maintaining contact with homeless youth over baseline, 1-week, 6-week, and 3-month follow-up interviews. The study combined quantitative tracking of youths' response patterns and open-ended interviews regarding youths' preferred methods of communication. Results indicate that maintaining communication with homeless youth requires persistence, including frequent contact attempts over several days. Cell phone contacts (calls or texts) were most successful in communicating with youth, with e-mail and Facebook messaging useful when phones were lost or stolen. Youth who maintained contact were strikingly similar to youth who discontinued contact.
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Affiliation(s)
- Kimberly Bender
- a Graduate School of Social Work , University of Denver , Denver , Colorado , USA
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23
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Rimawi BH, Mirdamadi M, John JF. Infections and Homelessness: Risks of Increased Infectious Diseases in Displaced Women. WORLD MEDICAL & HEALTH POLICY 2014. [DOI: 10.1002/wmh3.95] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Adolescents’ Self-reported Running Away from Home and Suicide Attempts During a Period of Economic Recession in Greece. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9260-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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25
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Dang MT. Social connectedness and self-esteem: predictors of resilience in mental health among maltreated homeless youth. Issues Ment Health Nurs 2014; 35:212-9. [PMID: 24597587 DOI: 10.3109/01612840.2013.860647] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this cross-sectional study was to explore social connectedness and self-esteem as predictors of resilience among homeless youth with histories of maltreatment. Connectedness variables included family connectedness, school connectedness, and affiliation with prosocial peers. The sample included 150 homeless youth aged 14 to 21 (mean age = 18 years) with the majority being an ethnic minority. Participants completed surveys using audio-CASI. Results revealed that youth with higher levels of social connectedness and self-esteem reported lower levels of psychological distress. When all predictor variables were controlled in the analysis, self-esteem remained significant for predicting better mental health.
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Affiliation(s)
- Michelle T Dang
- California State University-Sacramento, School of Nursing , Sacramento, California , USA
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26
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Grant R, Gracy D, Goldsmith G, Shapiro A, Redlener IE. Twenty-five years of child and family homelessness: where are we now? Am J Public Health 2013; 103 Suppl 2:e1-10. [PMID: 24148055 DOI: 10.2105/ajph.2013.301618] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Family homelessness emerged as a major social and public health problem in the United States during the 1980s. We reviewed the literature, including journal articles, news stories, and government reports, that described conditions associated with family homelessness, the scope of the problem, and the health and mental health of homeless children and families. Much of this literature was published during the 1980s and 1990s. This raises questions about its continued applicability for the public health community. We concluded that descriptions of the economic conditions and public policies associated with family homelessness are still relevant; however, the homeless family population has changed over time. Family homelessness has become more prevalent and pervasive among poor and low-income families. We provide public health recommendations for these homeless families.
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Affiliation(s)
- Roy Grant
- Roy Grant, Delaney Gracy, and Grifin Goldsmith are with Children's Health Fund, New York, NY. Alan Shapiro is with Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY. Irwin E. Redlener is with Mailman School of Public Health, Columbia University, New York, NY
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27
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Rice E, Barman-Adhikari A, Rhoades H, Winetrobe H, Fulginiti A, Astor R, Montoya J, Plant A, Kordic T. Homelessness experiences, sexual orientation, and sexual risk taking among high school students in Los Angeles. J Adolesc Health 2013; 52:773-8. [PMID: 23360897 PMCID: PMC3664104 DOI: 10.1016/j.jadohealth.2012.11.011] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 11/05/2012] [Accepted: 11/28/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE Prior studies reported homeless adolescents engage in more sexual risk than their housed peers. However, these comparisons are typically made post hoc by comparing homeless adolescent community-based samples with high school probability samples. This study uses a random sample of high school students to examine homelessness experiences and sexual risk behaviors. METHODS A supplemental survey to the Youth Risk Behavior Survey containing questions regarding homelessness and sexual health was administered to Los Angeles high school students (N = 1,839). Multivariate logistic regressions assessed the associations between demographics, past year homelessness experiences (i.e., place of nighttime residence), and being sexually active and condom use at last intercourse. RESULTS Homelessness experiences consisted of staying in a shelter (10.4%), a public place (10.1%), and with a stranger (5.6%). Lesbian, gay, bisexual, transgender, questioning (LGBTQ), younger, and male adolescents were more likely to experience homelessness. LGBTQ adolescents were also more likely to report staying with a stranger and less likely to report staying in a shelter. Compared to adolescents who stayed in shelters, adolescents who stayed with strangers and in public places were more likely to engage in unprotected sex at last intercourse. CONCLUSIONS Adolescents who report sexual activity and sexual risk taking are more likely to report homelessness experiences. With regard to sexual health, staying with strangers could be a particularly risky form of homelessness; LGBTQ and black adolescents are more likely to experience this form of homelessness. Efforts to reduce homelessness and sexual risk-taking need to recognize the specific vulnerabilities faced by these populations.
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Affiliation(s)
- Eric Rice
- School of Social Work, University of Southern California, Los Angeles, CA 90015, USA.
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28
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Ryan TN, Thompson SJ. Perspectives on housing among homeless emerging adults. EVALUATION AND PROGRAM PLANNING 2013; 36:107-14. [PMID: 23032602 DOI: 10.1016/j.evalprogplan.2012.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 08/29/2012] [Accepted: 09/03/2012] [Indexed: 05/05/2023]
Abstract
Homeless emerging adults need the safety and stability of housing programs if they are to avoid the elements and victimization of the streets, however, barriers to obtaining housing are numerous. This study identified factors associated with perspectives of housing services among 29 homeless emerging adults (ages 18-23 years) through one-on-one interviews. Data were gathered and analyzed using grounded theory methodology for qualitative information. Major themes of peer support and positive personal and programmatic interactions in the context of emerging adult development were noted as important factors in housing service utilization. These major themes should be taken into consideration for current housing programs, due to homeless emerging adults' oscillation between their desire for formal support and personal independence. Greater emphasis on services that do not require long term commitments and are more flexible in addressing specific barriers to housing for homeless emerging adults may increase use.
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Affiliation(s)
- Tiffany N Ryan
- The University of Texas at Austin, Austin, TX 78712, USA.
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29
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Kennedy DP, Tucker JS, Green HD, Golinelli D, Ewing B. Unprotected sex of homeless youth: results from a multilevel dyadic analysis of individual, social network, and relationship factors. AIDS Behav 2012; 16:2015-32. [PMID: 22610421 DOI: 10.1007/s10461-012-0195-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Homeless youth have elevated risk of HIV through sexual behavior. This project investigates the multiple levels of influence on unprotected sex among homeless youth, including social network, individual, and partner level influences. Findings are based on analyses of an exploratory, semi-structured interview (n = 40) and a structured personal network interview (n = 240) with randomly selected homeless youth in Los Angeles. Previous social network studies of risky sex by homeless youth have collected limited social network data from non-random samples and have not distinguished sex partner influences from other network influences. The present analyses have identified significant associations with unprotected sex at multiple levels, including individual, partner, and, to a lesser extent, the social network. Analyses also distinguished between youth who did or did not want to use condoms when they had unprotected sex. Implications for social network based HIV risk interventions with homeless youth are discussed.
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Affiliation(s)
- David P Kennedy
- RAND Health, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA.
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30
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Connolly JA, Joly LE. Outreach with street-involved youth: a quantitative and qualitative review of the literature. Clin Psychol Rev 2012; 32:524-34. [PMID: 22728669 DOI: 10.1016/j.cpr.2012.05.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 05/18/2012] [Accepted: 05/24/2012] [Indexed: 11/17/2022]
Abstract
Outreach workers meet with street-involved youth in their environment, and attempt to engage them in services vital to their well-being. The goal of this study is to conduct a systematic review of both the quantitative and qualitative research that explores outreach with street-involved youth. Using 16 outreach programs with quantitative information, our meta-analysis found that 63% of youth who are contacted through outreach later participate in the offered service. Our meta-synthesis of 31 qualitative articles on outreach uncovered 13 themes across 4 conceptual domains of interest. Themes pertaining to the therapeutic relationship, flexibility, and youth-centric programming had a large presence among the majority of the articles. Outreach with street-involved youth, when characterized through a strong bond between worker and youth, is an effective strategy for involving youth in agency services.
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Affiliation(s)
- J A Connolly
- York University, 5022 TEL, 4700 Keele St., Toronto ON, Canada M3J 1P3.
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31
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A prospective study of childhood and adolescent antecedents of homelessness among a community population of African Americans. J Urban Health 2012; 89:432-46. [PMID: 22234393 PMCID: PMC3368051 DOI: 10.1007/s11524-011-9641-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Much is known about contemporaneous correlates of homelessness from studies of homeless individuals. However, few studies have prospectively examined early antecedents and prevalence of homelessness in community populations. We use data from a 35-year study of a community population of African Americans to examine relationships between homelessness and prior structural, family, school, and behavioral influences. Nearly 22% of males and 16% of females reported homelessness between ages 15 and 42, providing a rare estimate within an African American urban community population. In bivariate analyses, lower school bonds, depressed mood, violent behavior, and running away in adolescence are predictive for both males and females. Teen parenting and angry mood are unique influences for females, while for males, poor first grade classroom conduct and adolescent substance use are unique risks. In multivariate analyses, poor classroom conduct and weaker school bonds predict homelessness among males, while teen parenting does so for females. Running away before age 15 is strongly predictive of later homelessness for both males and females. These results reveal the relative influence of multiple, interrelated early risks on homelessness and confirm our hypothesis that factors linked to other poor outcomes also relate to homelessness, underscoring another benefit to early prevention efforts.
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32
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Rosario M, Schrimshaw EW, Hunter J. Homelessness among lesbian, gay, and bisexual youth: implications for subsequent internalizing and externalizing symptoms. J Youth Adolesc 2012; 41:544-60. [PMID: 21656284 PMCID: PMC3215813 DOI: 10.1007/s10964-011-9681-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 05/25/2011] [Indexed: 10/18/2022]
Abstract
Although lesbian, gay, and bisexual (LGB) youth with a history of homelessness (running away or being evicted from their homes by parents) report more psychological symptoms than homeless heterosexual peers, it is unclear whether symptoms are due to homelessness, given the absence of a non-homeless comparison group. This study longitudinally investigates whether LGB youth with a history of homelessness report more subsequent psychological symptoms than non-homeless LGB youth and examines potential mediators of any such relationships. Of the 156 LGB youth interviewed (49% female; 78% non-White), 48% reported past homeless experiences. Homelessness was associated with subsequent symptoms of anxiety, depression, conduct problems, and substance abuse and to changes in symptoms over time even after controlling for childhood sexual abuse and early development of sexual orientation. Stressful life events, negative social relationships, and social support from friends mediated the relationships between homelessness and symptomatology. These findings suggest the need for interventions to reduce stress and enhance social support among LGB youth with a history of homelessness in order to reduce psychological symptoms.
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Affiliation(s)
- Margaret Rosario
- Department of Psychology, The City University of New York - City College and Graduate Center, NAC Building 7-120, Convent Avenue and 138th Street, New York, NY 10031, USA.
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Milburn NG, Iribarren FJ, Rice E, Lightfoot M, Solorio R, Rotheram-Borus MJ, Desmond K, Lee A, Alexander K, Maresca K, Eastmen K, Arnold EM, Duan N. A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth. J Adolesc Health 2012; 50:358-64. [PMID: 22443839 PMCID: PMC3313467 DOI: 10.1016/j.jadohealth.2011.08.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 08/11/2011] [Accepted: 08/15/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE We evaluate the efficacy of a short family intervention in reducing sexual risk behavior, drug use, and delinquent behaviors among homeless youth. METHODS A randomized controlled trial of 151 families with a homeless adolescent aged 12 to 17 years. Between March 2006 and June 2009, adolescents were recruited from diverse sites in Southern California and were assessed at recruitment (baseline), and at 3, 6, and 12 months later. Families were randomly assigned to an intervention condition with five weekly home-based intervention sessions or a control condition (standard care). Main outcome measures reflect self-reported sexual risk behavior, substance use, and delinquent behaviors over the past 90 days. RESULTS Sexual risk behavior (e.g., mean number of partners; p < .001), alcohol use (p = .003), hard drug use (p < .001), and delinquent behaviors (p = .001) decreased significantly more during 12 months in the intervention condition compared with the control condition. Marijuana use, however, significantly increased in the intervention condition compared with the control condition (p < .001). CONCLUSIONS An intervention to reengage families of homeless youth has significant benefits in reducing risk over 12 months.
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Affiliation(s)
- Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA.
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Rice E, Fulginiti A, Winetrobe H, Montoya J, Plant A, Kordic T. Sexuality and homelessness in Los Angeles public schools. Am J Public Health 2011; 102:200-1; author reply 202. [PMID: 22390454 DOI: 10.2105/ajph.2011.300411] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rice E, Lee A, Taitt S. Cell phone use among homeless youth: potential for new health interventions and research. J Urban Health 2011; 88:1175-82. [PMID: 22076445 PMCID: PMC3232411 DOI: 10.1007/s11524-011-9624-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Cell phone use has become nearly ubiquitous among adolescents in the United States. Despite the potential for cell phones to facilitate intervention, research, and care for homeless youth, no data exists to date on cell phone use among this population. In 2009, a survey of cell phone use was conducted among a non-probability sample of 169 homeless youth in Los Angeles, CA. Levels of ownership and use, instrumental uses (connecting to case workers, employers) and patterns of connecting to various network types were assessed (family, home-based peers, street-based peers). Differences in socio-demographic characteristics and cell phone ownership were assessed via t test and chi-square statistics. Sixty-two percent of homeless youth own a cell phone; 40% have a working phone. Seventeen percent used their phone to call a case manager, 36% to call either a potential or current employer. Fifty-one percent of youth connected with home-based peers on the phone and 41% connected to parents. Cell phones present new opportunities for intervention research, connecting homeless youth to family and home-based peers who can be sources of social support in times of need. Moreover, cell phones provide researchers and providers with new avenues to maintain connections with these highly transient youth.
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Affiliation(s)
- Eric Rice
- University of Southern California, Los Angeles, CA, USA.
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Waller MW, Sanchez RP. The Association Between Same-Sex Romantic Attractions and Relationships and Running Away Among a Nationally Representative Sample of Adolescents. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2011; 28:475-493. [PMID: 33737762 PMCID: PMC7967292 DOI: 10.1007/s10560-011-0242-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sexual minorities are overrepresented among the runaway population, and sexual minority runaways are at greater risk for adverse health outcomes than their heterosexual peers. Our knowledge of this vulnerable population has been restricted by methodological limitations of existing studies. This study used a nationally representative sample of U.S. adolescents to explore the association between same-sex romantic attractions and relationships and run away behavior over a two year period. Results indicated that although the association between sexual orientation and running away appears to be partially attenuated by other risk factors for running away, there remains a significant positive association between same-sex romantic attractions and running away. Furthermore, youth with no romantic or sexual relationships were significantly less likely to report running away compared to youth with only opposite-sex relationships. These associations remained significant even after controlling for other risk factors.
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Affiliation(s)
- Martha W Waller
- Pacific Institute for Research and Evaluation, Chapel Hill, NC
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37
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Rice E, Barman-Adhikari A, Milburn NG, Monro W. Position-specific HIV risk in a large network of homeless youths. Am J Public Health 2011; 102:141-7. [PMID: 22095350 DOI: 10.2105/ajph.2011.300295] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined interconnections among runaway and homeless youths (RHYs) and how aggregated network structure position was associated with HIV risk in this population. METHODS We collected individual and social network data from 136 RHYs. On the basis of these data, we generated a sociomatrix, accomplished network visualization with a "spring embedder," and examined k-cores. We used multivariate logistic regression models to assess associations between peripheral and nonperipheral network position and recent unprotected sexual intercourse. RESULTS Small numbers of nominations at the individual level aggregated into a large social network with a visible core, periphery, and small clusters. Female youths were more likely to be in the core, as were youths who had been homeless for 2 years or more. Youths at the periphery were less likely to report unprotected intercourse and had been homeless for a shorter duration. CONCLUSIONS HIV risk was a function of risk-taking youths' connections with one another and was associated with position in the overall network structure. Social network-based prevention programs, young women's housing and health programs, and housing-first programs for peripheral youths could be effective strategies for preventing HIV among this population.
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Affiliation(s)
- Eric Rice
- University of Southern California School of Social Work, Los Angeles, CA, USA.
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Corliss HL, Goodenow CS, Nichols L, Austin SB. High burden of homelessness among sexual-minority adolescents: findings from a representative Massachusetts high school sample. Am J Public Health 2011; 101:1683-9. [PMID: 21778481 DOI: 10.2105/ajph.2011.300155] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared the prevalence of current homelessness among adolescents reporting a minority sexual orientation (lesbian/gay, bisexual, unsure, or heterosexual with same-sex sexual partners) with that among exclusively heterosexual adolescents. METHODS We combined data from the 2005 and 2007 Massachusetts Youth Risk Behavior Survey, a representative sample of public school students in grades 9 though 12 (n = 6317). RESULTS Approximately 25% of lesbian/gay, 15% of bisexual, and 3% of exclusively heterosexual Massachusetts public high school students were homeless. Sexual-minority males and females had an odds of reporting current homelessness that was between 4 and 13 times that of their exclusively heterosexual peers. Sexual-minority youths' greater likelihood of being homeless was driven by their increased risk of living separately from their parents or guardians. CONCLUSIONS Youth homelessness is linked with numerous threats such as violence, substance use, and mental health problems. Although discrimination and victimization related to minority sexual orientation status are believed to be important causal factors, research is needed to improve our understanding of the risks and protective factors for homelessness and to determine effective strategies to prevent homelessness in this population.
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Affiliation(s)
- Heather L Corliss
- Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, MA 02115, USA.
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Social networking technology, social network composition, and reductions in substance use among homeless adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2011; 12:80-8. [PMID: 21194011 PMCID: PMC3040814 DOI: 10.1007/s11121-010-0191-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Peer-based prevention programs for homeless youth are complicated by the potential for reinforcing high-risk behaviors among participants. The goal of this study is to understand how homeless youth could be linked to positive peers in prevention programming by understanding where in social and physical space positive peers for homeless youth are located, how these ties are associated with substance use, and the role of social networking technologies (e.g., internet and cell phones) in this process. Personal social network data were collected from 136 homeless adolescents in Los Angeles, CA. Respondents reported on composition of their social networks with respect to: home-based peers and parents (accessed via social networking technology; e.g., the internet, cell phone, texting), homeless peers and agency staff (accessed face-to-face) and whether or not network members were substance-using or non-substance-using. Associations between respondent’s lifetime cocaine, heroin, and methamphetamine use and recent (previous 30 days) alcohol and marijuana use were assessed by the number of non-substance-using versus substance-using ties in multivariate linear regression models. 43% of adolescents reported a non-substance-using home-based tie. More of these ties were associated with less recent alcohol use. 62% of adolescents reported a substance-using homeless tie. More of these ties were associated with more recent marijuana use as well as more lifetime heroin and methamphetamine use. For homeless youth, who are physically disconnected from positive peers, social networking technologies can be used to facilitate the sorts of positive social ties that effective peer-based prevention programs require.
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Crawford DM, Trotter EC, Hartshorn KJS, Whitbeck LB. Pregnancy and mental health of young homeless women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2011; 81:173-83. [PMID: 21486259 PMCID: PMC3383651 DOI: 10.1111/j.1939-0025.2011.01086.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pregnancy rates among young women who are homeless are significantly higher than rates among housed young women in the United States (J. M. Greene & C. L. Ringwalt, 1998). Yet, little research has addressed mental health or risk and resilience among young mothers who are homeless. Based on a sample from the Midwest Longitudinal Study of Homeless Adolescents, this study explores pregnancy and motherhood in unaccompanied homeless young women over a period of 3 years. The data are supplemented by in-depth interviews with a subset of young women. Results show that almost half (46.4%) of sexually active young women who are homeless (n=222, M age = 17.2) had been pregnant at baseline. Among those who stated they had children between Waves 2 and 13 (n=90), only half reported caring for their children consistently over time, and one fifth reported never seeing their children. Of the participants with children in their care at the last interview (Wave 13), almost one third met criteria for lifetime major depressive episode, lifetime posttraumatic stress disorder, and lifetime drug abuse, and half met criteria for lifetime antisocial personality disorder. Twelve-month diagnoses are also reported. The impacts of homelessness on maternal and child outcomes are discussed.
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Affiliation(s)
- Devan M. Crawford
- Department of Sociology, University of Nebraska-Lincoln, 206 Benton Hall, Lincoln NE 68588-0623, (402) 472-2243,
| | - Emily C. Trotter
- Department of Sociology, University of Nebraska-Lincoln, 209 Benton Hall, Lincoln NE 68588-0623, (402) 472-3632,
| | - Kelley J. Sittner Hartshorn
- Department of Sociology, University of Nebraska-Lincoln, 209 Benton Hall, Lincoln NE 68588-0623, (402) 472-3632,
| | - Les B. Whitbeck
- Department of Sociology, University of Nebraska-Lincoln, 739 Oldfather Hall, Lincoln, NE 68588-0324, (402) 472-5562,
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Scivoletto S, da Silva TF, Rosenheck RA. Child psychiatry takes to the streets: a developmental partnership between a university institute and children and adolescents from the streets of Sao Paulo, Brazil. CHILD ABUSE & NEGLECT 2011; 35:89-95. [PMID: 21377731 DOI: 10.1016/j.chiabu.2010.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 11/01/2010] [Accepted: 11/02/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE High levels of domestic violence, mental illness, and alienation from authorities are associated with high incidence of children/adolescents living on the streets in low and middle income countries. The Equilibrium Project (Programa Equilíbrio) was created to facilitate social reintegration through a virtual partnership between an academic psychiatric institute and highly vulnerable children and adolescents living on the streets, in group shelter with supervision, and in other high risk situations. METHODS Descriptive presentation of qualitative data and analysis of preliminary empirical data collected over a 24-month period. RESULTS Dialogue between academic professionals, street children, and city officials shaped The Equilibrium Project over the last 2 years. The program has progressively moved from a professional clinic setting to a community-based but protected activity center with recreational and professional services and an emphasis on linkage with social service agencies, city government and law enforcement officials in an academic research context. A total of 351 patients have been served of whom virtually all were neglected by their parents, 58.4% report physical or sexual abuse, 88.89% have been diagnosed with a psychiatric disorder, 40.4% drug use. After 2 years of operation, 63.5% (n=223) successfully completed or continue in treatment and 34.8% (n=122) were reunited with their families. CONCLUSIONS AND PRACTICE IMPLICATIONS Program development guided by consumer input led to a successful program offering professional services in a protected community setting that facilitates social reintegration by providing "go between" services integrating relationships between alienated consumers and formal psychiatric, pediatric, social service, and criminal justice systems.
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Affiliation(s)
- Sandra Scivoletto
- Department and Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo (USP), R. Ovídio Campos Pires Campos, 785, Sao Paulo, CEP: 05403-010, Brazil
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McCart MR, Zajac K, Danielson CK, Strachan M, Ruggiero KJ, Smith DW, Saunders BE, Kilpatrick DG. Interpersonal victimization, posttraumatic stress disorder, and change in adolescent substance use prevalence over a ten-year period. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2011; 40:136-43. [PMID: 21229450 PMCID: PMC3106225 DOI: 10.1080/15374416.2011.533411] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Epidemiological studies have identified recent declines in specific types of adolescent substance use. The current study examined whether these declines varied among youth with and without a history of interpersonal victimization or posttraumatic stress disorder (PTSD). Data for this study come from two distinct samples of youth (12-17 years of age) participating in the 1995 National Survey of Adolescents (N = 3,906) and the 2005 National Survey of Adolescents-Replication (N = 3,423). Results revealed significant declines in adolescents' use of cigarettes and alcohol between 1995 and 2005; use of marijuana and hard drugs remained stable. Of importance, declines in nonexperimental cigarette use were significantly greater among youth without versus with a history of victimization and declines in alcohol use were significantly greater among youth without versus with a history of PTSD.
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Affiliation(s)
- Michael R McCart
- Family Services Research Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
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Nyamathi A, Marfisee M, Slagle A, Greengold B, Liu Y, Leake B. Correlates of depressive symptoms among homeless young adults. West J Nurs Res 2010; 34:97-117. [PMID: 21131507 DOI: 10.1177/0193945910388948] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Adolescent homelessness has received increasing attention because of its fast growth throughout the United States and the poor mental outcomes experienced by homeless young people. This cross-sectional study (N = 156) identified correlates of depressive symptomatology among homeless young adults and investigated how depressive symptoms are influenced by the coping strategies these young adults use. The findings are based on analysis of baseline data collected for a hepatitis vaccination intervention pilot study conducted in partnership with a young adult's drop-in center in Santa Monica, California. Standardized tools assessed drug use history, coping ability, and psychiatric symptomatology. Linear regression modeling was used to identify correlates of depressive symptom severity. Poor perceived physical health, recent crack cocaine use, and recent use of tranquilizers were significantly associated with increased severity of depressive symptoms. Self-destructive escape, nondisclosure/avoidance, passive problem solving, and thoughts of harming self were also associated with increased severity of depressive symptoms.
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Rice E, Monro W, Barman-Adhikari A, Young SD. Internet use, social networking, and HIV/AIDS risk for homeless adolescents. J Adolesc Health 2010; 47:610-3. [PMID: 21094441 PMCID: PMC2994071 DOI: 10.1016/j.jadohealth.2010.04.016] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 04/24/2010] [Accepted: 04/28/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the association between sexual health and internet use, including social networking websites such as MySpace and Facebook, among a sample of homeless adolescents at high risk of contracting HIV/AIDS. METHODS In 2009, a survey of internet use among 201 homeless adolescents was carried out. Multivariate logistic regression models assessed how patterns of use were associated with engaging in exchange sex (sex for money, drugs, or housing), recent HIV testing, and online partner-seeking behaviors. RESULTS Among the surveyed adolescents, 96.5% reported internet use. Most youth accessed the internet at public libraries or youth service agencies. Increased time online and recent engagement in exchange sex were both positively associated with online partner-seeking. Youth connected to family members online were less likely to practice exchange sex and more likely to report a recent HIV test. Youth connected to street-based peers online were more likely to practice exchange sex, whereas youth connected to home-based peers online were more likely to report a recent HIV test. CONCLUSIONS Although these data are preliminary, homeless youth need more access to the internet, as access facilitates connecting with family and home-based peers whose presence may reduce sexual risk-taking. Access, however, must be carefully monitored to prevent youth soliciting sex online.
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Affiliation(s)
- Eric Rice
- School of Social Work, University of Southern California, Los Angeles, California 90015, USA.
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45
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Hughes JR, Clark SE, Wood W, Cakmak S, Cox A, MacInnis M, Warren B, Handrahan E, Broom B. Youth Homelessness: The Relationships among Mental Health, Hope, and Service Satisfaction. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2010; 19:274-83. [PMID: 21037918 PMCID: PMC2962540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 06/15/2010] [Indexed: 05/30/2023]
Abstract
INTRODUCTION This paper reports a mental health assessment of 60 homeless youth. Our study explored the mental health needs of youth accessing an overnight youth shelter (maximum stay 8 weeks). METHODS Participants completed an interview (45 to 120 minutes in duration) using one demographic form and one of two standardized questionnaires (Youth Self Report, Adult Self Report). Questions assessed youth mental health symptoms, examined various contacts that youth made with mainstream society (services, family), and identified potential motivating factors (hope, service satisfaction) that may play a role in fostering street survival during adolescence. RESULTS Forty-eight percent of the youth were clinically symptomatic and most youth accessed a range of general health services. CONCLUSION However, those most in need had significantly less service satisfaction, less hope about the future, and had not accessed mental health services.
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Affiliation(s)
- Jean R. Hughes
- School of Nursing, Dalhousie University and Department of Psychiatry, IWK Health Centre, Halifax, Nova Scotia
| | - Sharon E. Clark
- Adolescent Centre for Treatment, IWK Health Centre, Halifax, Nova Scotia
| | - William Wood
- North End Community Health Centre, Halifax, Nova Scotia
| | | | - Andy Cox
- Mental Health Advocate for Children and Youth, IWK Health Centre, Halifax, Nova Scotia
| | | | - Bonnie Warren
- Shared Care, IWK Health Centre, Halifax, Nova Scotia
| | | | - Barbara Broom
- Child and Youth Mental Health Services, Health Canada, Atlantic Region, Halifax, Nova Scotia
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Gonyea JG, Mills-Dick K, Bachman SS. The complexities of elder homelessness, a shifting political landscape and emerging community responses. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2010; 53:575-590. [PMID: 20865621 DOI: 10.1080/01634372.2010.510169] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Despite their growing numbers, homeless older adults remain largely invisible in society and there has been a pervasive lack of public focus on elder homelessness. In this article, we seek to shine light on this forgotten population and deepen understanding of difficult challenges they confront in regaining housing security. We also examine the shifting political climate regarding homelessness, particularly the enactment and subsequent reauthorizations of the McKinney-Vento Homeless Assistance Act, and how these shifts are influencing community responses to elder homelessness. Finally, future challenges and policy directions for breaking the cycle of elder homelessness in the U.S. are discussed.
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Affiliation(s)
- Judith G Gonyea
- School of Social Work, Boston University, Boston, Massachusetts 02215, USA.
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47
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Rice E. The positive role of social networks and social networking technology in the condom-using behaviors of homeless young people. Public Health Rep 2010; 125:588-95. [PMID: 20597459 DOI: 10.1177/003335491012500414] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine the impact of condom-using peers in the social networks of homeless young people, differences in behaviors were assessed based on the social location of ties (home-based vs. street-based) and how those ties are maintained (face-to-face vs. via social networking technology). METHODS "Ego-centric" social network data were collected from 103 currently sexually active homeless young people aged 16-26 years in Los Angeles, California. Associations between condom use and the condom-using behaviors of social network influences were assessed using standard logistic regression. RESULTS About 52% of respondents had a street-based peer who was a condom user. Having such a peer was associated with a 70% reduction in the odds of having unprotected sex at last intercourse. About 22% of respondents had a condom-using, home-based peer with whom they communicated only via social networking technology. Having such a peer was associated with a 90% reduction in risky sexual behavior and a 3.5 times increase in safer sex behavior. CONCLUSION The study revealed several implications for new human immunodeficiency virus-prevention interventions that mobilize these networks and social networking technologies.
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Affiliation(s)
- Eric Rice
- University of Southern California, School of Social Work, Los Angeles, CA, USA.
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Abstract
The 'new homelessness' has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus.
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Affiliation(s)
- Barrett A Lee
- Department of Sociology The Pennsylvania State University 517 Oswald Tower University Park, PA 16802-6207
| | - Kimberly A Tyler
- Department of Sociology University of Nebraska Lincoln, NE 68588-0324
| | - James D Wright
- Department of Sociology University of Central Florida Orlando, FL 32816-1360
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Krüsi A, Fast D, Small W, Wood E, Kerr T. Social and structural barriers to housing among street-involved youth who use illicit drugs. HEALTH & SOCIAL CARE IN THE COMMUNITY 2010; 18:282-8. [PMID: 20102394 PMCID: PMC2883636 DOI: 10.1111/j.1365-2524.2009.00901.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In Canada, approximately 150,000 youth live on the street. Street-involvement and homelessness have been associated with various health risks, including increased substance use, blood-borne infections and sexually transmitted diseases. We undertook a qualitative study to better understand the social and structural barriers street-involved youth who use illicit drugs encounter when seeking housing. We conducted 38 semi-structured interviews with street-involved youth in Vancouver, Canada from May to October 2008. Interviewees were recruited from the At-risk Youth Study (ARYS) cohort, which follows youth aged 14 to 26 who have experience with illicit drug use. All interviews were thematically analyzed, with particular emphasis on participants' perspectives regarding their housing situation and their experiences seeking housing. Many street-involved youth reported feeling unsupported in their efforts to find housing. For the majority of youth, existing abstinence-focused shelters did not constitute a viable option and, as a result, many felt excluded from these facilities. Many youth identified inflexible shelter rules and a lack of privacy as outweighing the benefits of sleeping indoors. Single-room occupancy hotels (SROs) were reported to be the only affordable housing options, as many landlords would not rent to youth on welfare. Many youth reported resisting moving to SROs as they viewed them as unsafe and as giving up hope for a return to mainstream society. The findings of the present study shed light on the social and structural barriers street-involved youth face in attaining housing and challenge the popular view of youth homelessness constituting a lifestyle choice. Our findings point to the need for housing strategies that include safe, low threshold, harm reduction focused housing options for youth who engage in illicit substance use.
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Affiliation(s)
- Andrea Krüsi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital; Vancouver, Canada
| | - Danya Fast
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital; Vancouver, Canada
| | - Will Small
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital; Vancouver, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital; Vancouver, Canada
- Department of Medicine; Faculty of Medicine; University of British Columbia, Vancouver, Canada
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital; Vancouver, Canada
- Department of Medicine; Faculty of Medicine; University of British Columbia, Vancouver, Canada
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Thrane LE, Chen X. Impact of running away on girls' sexual onset. J Adolesc Health 2010; 46:32-6. [PMID: 20123255 DOI: 10.1016/j.jadohealth.2009.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 05/01/2009] [Accepted: 05/04/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to longitudinally examine the impact of running away on sexual onset, and to determine the 12-month prevalence of sexual onset among runaway females. METHODS The sample consists of adolescent females from Waves 1 and 2 of the Longitudinal Study of Adolescent Health (N=4,564; age range=11-18 years). Voluntary or involuntary sexual onset at Wave 1 results in exclusion from the analysis. A logistic regression model is fit, which examines sociodemographic characteristics, protective factors (e.g., parental and academic bonds), and running away and other risk behaviors on sexual onset. RESULTS Our study confirms that more than one out of thee females becomes sexually active within 12 months of running away. Only 17% of females who never report a runaway episode experience sexual onset. School bonds, dating and romance, alcohol use, delinquency, and runaway behavior have main effects in the longitudinal analysis. Runaways are 1.7 times more likely to report sexual onset. CONCLUSIONS This study applies the risk amplification model to runaways in the general population. Running away is a turning point in the developmental trajectory, and puts girls at risk of sexual onset a year later compared to their nonrunaway counterparts. A multipronged approach is needed to address the sexual risk characteristics of girls who return home.
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Affiliation(s)
- Lisa E Thrane
- Department of Sociology, Wichita State University, Wichita, Kansas 67260, USA.
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