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Objective: This article highlights key lessons learned while conducting a nurse‐led community‐based HIV prevention trial with youth experiencing homelessness (YEH), focusing on sexually transmitted infections testing and treatment, intervention sessions, community partnerships, and participant recruitment and retention. Design: The insights and experiences shared aim to inform future research and the design of interventions targeting populations at high risk, particularly when facing unanticipated challenges. By addressing these areas, the article contributes to the decision‐making for the design and delivery of effective strategies to improve the health outcomes among marginalized populations. Results: The findings underscore the importance of flexibility and active participant engagement, cultivating strong relationships with community partners, utilizing technology and social media, and fostering a diverse research team that represents the heterogeneity of youth experiencing homelessness across race/ethnicity, gender identity, sexual orientation, and lived experiences. Conclusions: These recommendations aim to enhance participant access, engagement, and retention, while promoting rigorous research and meaningful study outcomes for YEH. [ABSTRACT FROM AUTHOR]

The relationships that youth experiencing homelessness (YEH) have with supportive family members (i.e. those who provide them with social support) may be protective against risk behaviours and buffer adverse health outcomes. However, little is known about the nature of YEH's supportive family relationships and the type of social support that these family relationships offer them. Thus, we conducted in‐depth interviews with 30 YEH to examine the type of social support received from family relationships and to explore the social dynamics of these relationships. We found that many YEH not only continued to maintain relationships with family members after becoming homeless but also received emotional and/or instrumental support from these family members. Beyond providing this type of social support, family members served as a source of motivation for these youth. Additionally, YEH contributed to their family relationships and gained a sense of connectedness in return. Lastly, we found that YEH's family support was influenced by their family circumstances and their need for autonomy. Collectively, our findings suggest there may be a need for interventions designed to strengthen relationships with supportive family members among YEH, who may derive multiple positive benefits from relating with the 'hidden champions' in their lives. [ABSTRACT FROM AUTHOR]

Background: Young adults experiencing homelessness (YAEH) experience more stressors compared to housed peers, yet little is known about the impact of the COVID‐19 pandemic on these youth. The purpose of this qualitative study was to explore how YAEH perceived the pandemic's impact on their well‐being and coping. Methods: YAEH were recruited from those participating in an HIV prevention study. Semi‐structured interviews were conducted and analysis was guided by Lazarus and Folkman's transactional theory of stress and coping. Results: Four major themes were identified from interviews with 40 youth: (1) ongoing harms, (2) COVID‐19 as a stressor, (3) mental health impacts, and (4) coping strategies. Participants described unmet basic needs, emotions of frustration and anxiety, and several coping strategies including substance use. Conclusion: Many YAEH reported experiencing continued challenges that were compounded by the stressors related to the COVID‐19 pandemic. Special considerations are needed to address pandemic‐related exacerbations of mental health symptoms and substance use among YAEH. [ABSTRACT FROM AUTHOR]

This study explored the perceptions and experiences related to pregnancy and parenting support among youth while homeless. This study employed a qualitative descriptive design using data collected from focus group discussions. We assessed the experiences and perceptions of youth related to pregnancy and parenting support. Eighty‐one youth participated in eight focus group discussions and were recruited from shelters, drop‐in centers, and organizations that serve youth in a large metropolitan areas in the southern United States. Thematic content analyses were used to generate results from the qualitative data. Four main themes emerged: youth encountered barriers to accessing healthcare services at the individual and system levels; pregnancy and parenting are stressful, especially during homelessness; support can help overcome the stresses of parenting; and embracing responsibility or "stepping up" is a positive influence of pregnancy and parenting during homelessness. Youth experiencing homelessness (YEH) face significant challenges to accessing healthcare services and adjusting to the parental role. Interventions for pregnant and parenting youth should be co‐designed with and tailored for youth and address the existing health inequities within the healthcare and social service systems. [ABSTRACT FROM AUTHOR]

Objectives: While health promotion and patient education are central to the scope of practice of professional nurses, they often feel ill‐equipped to assume the role of sexual health educator and lack adequate knowledge and skills to effectively engage parents in adolescent sexual and reproductive health efforts. Design and Sample: Employing a mixed‐methods study consisting of both pre‐ and post‐test survey and exit interviews, a pilot study was conducted to assess the impact of implementing a parent‐based adolescent sexual health intervention on baccalaureate nursing student outcomes (N = 31). Results: We found statistically significant improvements in student outcome expectancies of parenting strategies, barriers to sexual health communication, self‐efficacy, and sexual health counseling experience. Using thematic content analysis of exit interview content, emerging themes were (1) need for increased sexual and reproductive health (SRH) preparation, (2) wanting greater experience and opportunity for involvement in nursing research, and (3) educational gaps in family‐focused community public health. Conclusions: Incorporating adolescent sexual health education into public health nursing clinical training can prepare nurses as parent‐based adolescent sexual health educators, a core competency for nurses working with families in communities and across all health care delivery settings. [ABSTRACT FROM AUTHOR]

CONTEXT HIV disproportionately affects homeless youth, and interventions to date have had minimal success in reducing sexual risk behaviors in this population. Few qualitative studies have been conducted to provide insight into the influence of homelessness-related factors on sexual risk behaviors. METHODS A qualitative study with a quantitative component was conducted with a nonprobability sample of 64 homeless youth aged 14-24; participants were recruited from a variety of venues in Houston between October 2013 and March 2014. Thirteen focus group discussions were conducted; thematic analysis was used to identify themes related to HIV risk. RESULTS Participants were predominantly black (75%), sheltered (67%) and aged 18 or older (77%). Youth discussed how the circumstances of their homelessness and the struggle to meet their immediate needs led to behaviors and experiences that put them at risk for HIV. Three themes emerged: Homeless youth frequently engage in risky sexual behavior, sometimes as a way to cope with stress; they often trade sex, either voluntarily or involuntarily, for such necessities as money or a place to sleep; and many experienced childhood sexual victimization or have been victimized since becoming homeless. Youth also described how stress, stigma and self-reliance contributed to their involvement in HIV risk behaviors. CONCLUSIONS HIV prevention methods that target stress and stigma while respecting youths' self-reliance may help reduce sexual risk behaviors. Further research is needed to determine suitable behavioral change techniques to address these potentially modifiable factors. [ABSTRACT FROM AUTHOR]

CONTEXT Parent-based adolescent sexual health interventions aim to reduce sexual risk behaviors by bolstering parental protective behaviors. Few studies of theory use, methods, applications, delivery and outcomes of parent-based interventions have been conducted. METHODS A systematic search of databases for the period 1998-2013 identified 28 published trials of U.S. parent-based interventions to examine theory use, setting, reach, delivery mode, dose and effects on parent-child communication. Established coding schemes were used to assess use of theory and describe methods employed to achieve behavioral change; intervention effects were explored in meta-analyses. RESULTS Most interventions were conducted with minority parents in group sessions or via self-paced activities; interventions averaged seven hours, and most used theory extensively. Meta-analyses found improvements in sexual health communication: Analysis of 11 controlled trials indicated a medium effect on increasing communication (Cohen's d, 0.5), and analysis of nine trials found a large effect on increasing parental comfort with communication (0.7); effects were positive regardless of delivery mode or intervention dose. Intervention participants were 68% more likely than controls to report increased communication and 75% more likely to report increased comfort. CONCLUSIONS These findings point to gaps in the range of programs examined in published trials-for example, interventions for parents of sexual minority youth, programs for custodial grandparents and faith-based services. Yet they provide support for the effectiveness of parent-based interventions in improving communication. Innovative delivery approaches could extend programs' reach, and further research on sexual health outcomes would facilitate the meta-analysis of intervention effectiveness in improving adolescent sexual health behaviors. [ABSTRACT FROM AUTHOR]