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Aims and objectives: The purpose of this study was to compare prevalence of substance use, high-risk sexual behaviors, and depression symptoms between homeless youth with and without a history of foster care placement. Background: Approximately 26,000 young persons exit foster care annually in the United States. Once they 'age out' of foster care, however, many young persons do not have access to comprehensive health care. They also are at risk for substance abuse, homelessness, or mental illness. Because persons with a history of foster care are at risk for negative psycho-social outcomes, it is unclear if these young people might be different than homeless youth without this history. Design: The design is descriptive and cross-sectional. Methods: A total of 156 homeless young persons, of whom 44 had a history of foster care placement, were recruited from a drop-in center that caters to homeless youth and young adults. Results: The sample was majority male and white; ages were 16-25. Significantly higher proportion of homeless former foster youth used methamphetamine within the last six months compared to non-fostered homeless youth p = 0.03). Homeless former foster youth were significantly older (p = 0.02) and less educated (p = 0.02) than their homeless counterparts without a history of foster care placement. Prevalence of using tobacco, marijuana, alcohol, crack cocaine, and powder cocaine were similar for both groups. Although not significant, a higher proportion of homeless former foster youth reported trading sex for money or drugs compared to non-fostered, homeless youth (19% versus 12% [trading sex for money], and 26% versus 14% [trading sex for drugs], respectively. Conclusions: Findings from this study show that, in general, homelessness is a negative outcome, irrespective of having a foster care history. However, those with that history need continued support when transitioning to independent living, such as access to health care, and encouragement to further their education. Relevance to clinical practice: It is important that nurses, who serve homeless youth populations, conduct a risk assessment profile, in order to ascertain a history of foster care placement, link former foster youth to social service agencies that provide risk reduction/health promotion education, and advocate for stable housing. [ABSTRACT FROM AUTHOR]

Baseline data were collected to evaluate the effectiveness of interventions on completion of the hepatitis A and B vaccine series among 664 sheltered and street-based homeless adults who were: (a) homeless; (b) recently (<1 year) discharged from prison; (c) discharged 1 year or more; and (d) never incarcerated. Group differences at baseline were assessed for socio-demographic characteristics, drug and alcohol use, sexual activity, mental health and public assistance. More than one-third of homeless persons (38%) reported prison time and 16% of the sample had been recently discharged from prison. Almost half of persons who were discharged from prison at least 1 year ago reported daily use of drugs and alcohol over the past 6 months compared to about 1 in 5 among those who were recently released from prison. As risk for HCV and HIV co-infection continues among homeless ex-offenders, HIV/HCV prevention efforts are needed for this population. [ABSTRACT FROM AUTHOR]

PROBLEM: This cross-sectional study identified a number of factors that were correlated with drug-use severity among homeless youth. METHODS: To examine a commonly used measure of substance-use severity, the TCU Drug Screen II, in a convenience sample of 156 homeless youth, ages 15-25 from a drop-in site in Santa Monica, California. FINDINGS: Higher drug-use severity scores were independently related to low levels of perceived health and maladaptive coping strategies. CONCLUSIONS: The findings from this study are particularly relevant in that they support previous results showing that psychosocial variables are related to substance use behavior among young populations. [ABSTRACT FROM AUTHOR]

Posttraumatic stress symptoms are a pressing issue among women experiencing incarceration and homelessness. Baseline data were collected among formerly incarcerated homeless women (N = 130) who were on average 38.9 (SD = 11.36, range 19-64) years of age and recruited into a pilot randomized control trial (RCT) intervention program. A logistic regression was used to assess correlates of PTSD symptoms. The majority of the sample self-reported witnessing violence (85%) and had moderate PTSD symptoms (M = 1.61, SD = 1.62, range: 0-4). No past month drug use ( p  = 0.006), higher anger scores ( p  = 0.002), greater emotional support ( p  = 0.009), and psychological frailty ( p  = 0.02) were significantly associated with higher odds of PTSD symptoms. Moreover, women who experienced minor family conflicts had lower odds of PTSD symptoms relative to those that had family conflicts most of the time ( p  = 0.02). Similarly, controlling for all other variables, women who had a higher positive social interaction score also had lower odds of PTSD symptoms ( p  = 0.006). These findings are a call to action for academicians, service providers, and health practitioners to develop an intervention which integrates comprehensive PTSD screening, and discussion of ways to build coping skills, relationships with family and social networks, and utilizes a trauma-informed approach during reentry.

Background: Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults., Objectives: The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons., Methods: This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults., Results: Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general)., Discussion: Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services.

The purpose of this study was to explore homeless youths' perspectives on the power of drugs in their lives, the preferred type of drugs used, barriers to treatment, and strategies to prevent drug initiation and abuse. This was a descriptive, qualitative study using focus groups with a purposeful sample of 24 drug-using homeless youth. The results provided insight into the lives of drug-using homeless youth. The most commonly used drugs were marijuana and alcohol. Reported reasons for drug use were parental drug use, low self-esteem, and harsh living conditions on the streets. Barriers to treatment were pleasurable enjoyment of the drug, physical dependence, and non-empathetic mental health providers. Strategies to prevent initiation and abuse of drugs were creative activities, such as art, sports, and music, and disdain for parental/family drug use and abuse. Comparative research is needed on specific personal factors that cause initiation and deterrence of drugs use/abuse among homeless youth.

In the United States, youth run away from home due to poor interpersonal relationships with parents or guardians; often times, they have been the recipients of parental neglect or abuse. As youth become increasingly entrenched in street-based living and problem substance use, their ability to rehabilitate their lives is incumbent upon trusting and engaging relationships with adult service providers. A total of 54 substance-using homeless youth (18-25 years) participated in focus groups to provide their perspectives on encounters and interpersonal relationships with health care providers. Participants were recruited from shelters in Hollywood, California, and from a drop-in shelter in Santa Monica, California. Four themes related to interpersonal barriers to care from service providers were identified: authoritative communication, one-way communication, disrespect, and empathy. Participants appreciate care providers who convey information in a helpful, meaningful manner and prefer providers who can, themselves, share similar life experiences. Implications point to the need for agencies and services specifically tailored to homeless, drug-using youth. These agencies should employ care providers who are trained to understand the developmental needs and histories of runaway youth. For proper reintegration of this vulnerable population into mainstream society, the narratives of these youth underscore the necessity of targeted services.