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Background Young adults experiencing homelessness (YAEH) engage in substantially higher substance use rates than housed young adults. This current study builds on previous research by investigating the prevalence of and salient correlates of illicit substance use across a seven-city sample. Methods This study used the Homeless Youth Risk and Resiliency Survey (HYRRS) dataset, n=1426 Young adults experiencing homelessness to study patterns and correlates of illicit substance use. Results Multivariate logistic regression analyses were used to assess correlates of substance use. Study site, age, gender identity, sexual orientation, history of suicidal ideation, use of specific substances, and trading sex for drugs were associated with five types of illicit substance use (ecstasy, cocaine, crack, methamphetamine, and injection drug use). Conclusion Findings indicate that substance use interventions for YAEH must be multifaceted, addressing illicit and multiple substance use, along with the myriad factors associated with substance use among this at-risk group.

Young adults experiencing homelessness (YAEH) are at high risk for discrimination. Limited research has documented the extent of discrimination experiences and their relationship to mental health outcomes among this group. This study used data from YAEH who completed self-administered surveys across seven U.S. cities (N = 1,426) to examine the rates and correlates of discrimination experiences and their association with psychological distress and suicidal ideation. Chi-square and multivariate logistic regressions were used to examine the relations between perceived discrimination and race, gender identity, sexual orientation, foster care history, criminal justice history, reasons for homelessness, and length of time homeless. Then, logistic regression was used to examine whether discrimination increased the odds of psychological distress and suicidal ideation, controlling for other factors. Three-fourths (75.8%) of the sample (n = 1,055) reported experiencing at least one of the five forms of everyday discrimination experiences at least a few times a year, with the most common reason attributed to their housing situation (46%). Sexual orientation, juvenile justice involvement, and having been homeless for 2 years or more were associated with increased odds of experiencing discrimination. Discrimination was a strong predictor of psychological distress but was significant only at the bivariate level for suicidal ideation. Study results suggest that experiences of discrimination are common among YAEH and that these experiences increase risk for psychological distress. Providers working with YAEH need to validate and acknowledge the impact of these experiences on mental health. And, communities need to work to reduce discrimination experiences by targeting stigma against YAEH. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PURPOSE: Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors. METHODS: We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9 months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors. RESULTS: Factor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality. CONCLUSION: Nearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function. IMPLICATIONS FOR CANCER SURVIVORS: Improving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors’ HRQOL.

Abstract. Background: Young adults experiencing homelessness (YAEH) report high rates of suicidal crises. Having access to firearms during suicidal crises elevates risk of death by suicide. Yet, no known information exists about firearm access among YAEH. Aims: We aimed to examine the proportion of participants who had firearm access, as well as the association between past-year suicidal crises and firearm access among participants. Method: We recruited 1,426 YAEH (18–26 years old) from homelessness service settings in seven US cities. Logistic regression analyses were used to examine the association between past-year suicidal crises and firearm access. Results: One third of the sample reported having easy firearm access. YAEH who experienced suicidal ideation and suicide attempts were more likely to report firearm access. Limitations: Results from this cross-sectional study cannot be causally interpreted nor generalized to all YAEH. Conclusion: A substantial segment of YAEH had easy firearm access and it was more common for YAEH with suicidal crises to have firearm access. Reducing firearm access should be part of suicide prevention planning for YAEH in the US but requires comprehensive and innovative solutions.

Young adults experiencing homelessness (YAEH) face discrimination experiences placing them at risk for negative health outcomes. Prior research demonstrates discrimination and perceived stress amon...

Opportunity youth (OY; i.e., youth ages 16–24 who are neither working nor in school) are a population who is difficult to engage and retain in educational programs, particularly in community colleg...

Limited research has explored whether young adults that experience homelessness and housing instability (YAEH) self-identify as homeless. This study uses the Homeless Youth Risk and Resilience Surv...

Opportunity youth, 16- to 24-year-olds who are neither in school nor working, are a population that is difficult to engage and retain in services. Population-level data and local data from coalitio...

Purpose This study aimed to explore the association between direct exposure, indirect exposure, and perpetration of gun violence and suicidal ideation among young adults experiencing homelessness (YAEH). Methods YAEH (n = 1,426) in seven cities across the U.S. were surveyed. Logistic regression analyses were conducted to examine the association between lifetime gun violence exposure and suicidal ideation in the past 12 months. Results Forty-five percent (n = 641) of YAEH had experienced direct or indirect gun violence, whereas 17% (n = 247) had engaged in gun violence perpetration. Gun violence perpetration is associated with elevated suicidal ideation risk (odds ratio = 1.46; 95% confidence interval = 1.02–2.01) among YAEH. Conclusions A high percentage of YAEH were exposed to firearm violence. Cross-sector, multiagency collaborations are warranted to reduce firearm violence exposure among this vulnerable population. Homeless service providers should screen for gun violence exposure and suicide risk and target prevention efforts on YAEH with a history of gun violence perpetration.

Disclosure of one's suicidal thoughts is a pivotal but under-investigated mechanism for preventing suicide among young adults experiencing homelessness (YAEH). In a sample of 527 YAEH, we adopted a multi-level perspective to assess patterns and correlates of disclosure in their friendship networks. Less than one-third of YAEH disclosed their suicidal thoughts-half of them doing so during a suicidal crisis-and only disclosed to 21% of their friends. Multilevel modeling showed that YAEH who reported a history of unmet mental health needs were more likely to have disclosed to a friend, and friends who were sources of social support were most highly sought out for disclosures. Our findings highlight the need for cultivating safe environments that promote disclosures among YAEH.

Summary Opportunity youth (i.e. ages 16–24 who are neither working nor in school) are difficult to engage in services. Population-level data and Geographic Information System (GIS) technology play a critical role in helping social work practitioners understand where target populations reside and which characteristics are most salient to their service needs. This case study of the Opportunities for Youth Coalition demonstrates the use of population-level data and GIS technology in social work research and practice. We describe the collective impact approach, extant methods of youth outreach, and the Coalition’s efforts to address youth disconnection. We used American Community Survey data, ArcGIS software, and hot spot analysis to answer three research questions. Findings In the Phoenix Metro Area, there are 75,200 opportunity youth. Greater percentages of youth of color are opportunity youth in comparison with White youth. One in three individuals who have limited English proficiency and who have a disability are opportunity youth. Nearly one in five individuals living in poverty is an opportunity youth. We identify the top five high population density areas for opportunity youth. Further, we highlight three ways that the Coalition’s use of data and GIS technology has enhanced youths’ and service providers’ engagement: (1) increased referrals, (2) increased involvement of organizations, and (3) increased understanding of special populations. Applications We discuss the benefits and challenges of using population data and GIS technology to guide youth engagement. We conclude with strategies for community practitioners to replicate in other geographic areas and with other hard-to-reach populations.

Young adults experiencing homelessness (YAEH) with pregnancy history are at higher depression risk. Receiving social support is protective for depression in pregnancy. This study differentiates social support sources associated with depression by pregnancy history among YAEH.Using a subsample of data collected from YAEH in seven US cities that were collected through REALYST, we conducted stratified logistic regression models (by pregnancy history) to identify support sources associated with depression. Logistic regression analysis including the interaction term (i.e., pregnancy history x support sources) using the full sample was then conducted.A higher proportion with pregnancy history reported depression compared to those without. Support from home-based peers was significantly associated with reduced depression risks among YAEH with pregnancy history, but not among youth without. Home-based supports were less frequently indicated by homeless female youth with pregnancy experience.Home-based social support is protective against major depression for YAEH with pregnancy experience. Findings of this study suggest that interventions addressing depression among YAEH should take their pregnancy history and social support sources into consideration. Specifically, for YAEH with pregnancy history, facilitating supportive social ties with home-based peers may be promising in reducing their depression risks.

The purpose of this qualitative study was to explore homeless young adults’ perceptions of the systemic, situational, and intrapersonal barriers they encounter across multiple systems in trying to exit homelessness and the ways these barriers are interrelated. Thirty-one homeless young adults (ages 18–26) in Phoenix and Tempe, Arizona were recruited for in-depth interviews from two resource centers serving homeless youth. Template analysis was used to systematically analyze and code participants’ verbatim transcripts from the interviews into a template (codebook). Characteristic quotes from the interviews are used to illustrate the emergent themes. Findings indicate that structural barriers faced by homeless youth include inadequate homeless resources, employment challenges, discrimination by law enforcement, hot climate, lack of transportation, and legal concerns. Situational barriers include interpersonal relationships, the street environment, and lack of personal resources. Intrapersonal barriers include behavioral, mental, and physical health challenges, reluctance to reach out for help, money management, and lack of desire for stable housing. Participants also outlined multiple ways in which these barriers interact to hinder their exiting homelessness. Findings support current literature applying ecological theory to the issue of homelessness while highlighting young people’s own contextual descriptions of their lived experiences. Three approaches are recommended for improving homeless services with integrated housing, employment, and clinical interventions to help young adults successfully exit homeless.

Youth experiencing homelessness (YEH) have a high risk of contracting HIV; however, they remain relatively unreached by pre-exposure prophylaxis (PrEP)-based HIV prevention initiatives. We used a cross-sectional mixed-methods study to explore PrEP knowledge, interest, facilitators, and barriers among YEH. Young adults were recruited from agencies serving YEH in Houston, TX (n = 30) and Los Angeles, CA (n = 15) to participate in an electronic self-report survey and a semistructured interview. Survey results indicate that 68.2% of YEH had low or no prior knowledge of PrEP, though 63.7% reported interest in taking PrEP. Qualitative results revealed facilitators of PrEP use, including high PrEP acceptability and awareness, and supportive social networks. Several barriers emerged, including medication-related barriers, adherence, cost, access barriers, low perceived HIV risk, perceived stigma of PrEP use, and low PrEP awareness. Despite high PrEP acceptability, PrEP use among YEH remains low partly due to low PrEP awareness, low perceived HIV risk, and medical mistrust.

Contrary to the perception that the business community can be hostile and exclusive toward individuals experiencing homelessness, local businesses can and do serve homeless populations at m...

We examine the challenges formerly homeless young adults (FHYAs) face after they transition out of homelessness. Considering the adversities FHYAs face, it is unclear how transitioning to stable housing may affect their mental well-being or what types of stressors they may experience once housed. This study investigates the social environment young adults encounter in their transition to stable housing and examines trauma and social coping predictors of mental health symptoms in a sample of FHYAs to generate new knowledge for better intervening to meet their needs. Data were obtained from REALYST, a national research collaborative comprised of interdisciplinary researchers investigating young adults’ (ages 18–26) experiences with homelessness. Cross-sectional data for 1426 young adults experiencing homelessness were collected from 2016 to 2017 across seven cities in the United States (i.e., Los Angeles, Phoenix, Denver, Houston, San Jose, St. Louis, and New York City). The analytical sub-sample for this study consisted of 173 FHYAs who were housed in their own apartment (via voucher from Housing and Urban Development or another source) or in transitional living programs during their participation in the study. Ordinary Least Squares regression was used to examine the influence of trauma and social coping strategies on indicators of mental well-being. Findings indicated that higher adversity scores and higher mental health help-seeking intentions were positively associated with higher levels of stress, psychological distress, and depression severity. Higher level of social coping was associated with lower levels of depression severity. Logistic regression results showed that young adults with higher adversity scores had higher odds of reporting clinical levels of post-traumatic symptoms. The study implications suggest that FHYAs who transition to stable housing continue to need support navigating and coping with stressful life events; and interventions that help FHYAs develop strong networks of social supports are needed to promote positive mental well-being., Highlights • Formerly homeless young adults experienced significant stress and mental distress. • Mental health help-seeking intentions were associated with higher mental distress. • Young adults may need additional social support coping with stressful life events. • Interventions promoting well-being for formerly homeless young adults are needed.

INTRODUCTION: Young adults experiencing homelessness are vulnerable to firearm violence. This study aims to explore the correlates of firearm violence involvement among this vulnerable population, which may inform firearm violence reduction intervention development. METHODS: Between 2016 and 2017, young adults experiencing homelessness aged 18–26 years (N=1,426) were recruited in 7 U.S. cities. Respondents completed a self-administered computer-assisted anonymous survey regarding their homeless experiences and violence involvement. Separate multivariate logistic regression models were conducted in 2020 to explore the correlates of direct firearm violence victimization, witness of firearm violence, and firearm violence perpetration. RESULTS: A high proportion of young adults experiencing homelessness were involved in firearm violence (witnessing firearm violence: 40%; direct firearm violence victimization: 28%; perpetration: 18%). Stressful experiences, such as childhood trauma and street victimization, were associated with greater odds of firearm violence involvement. Black (OR=2.4, p

Little is known about human papillomavirus (HPV) vaccination uptake among youth experiencing homelessness (YEH), who may be at higher risk for HPV than their housed counterparts. We examined the prevalence and associations of HPV vaccination initiation and completion among YEH. Guided by the Behavioral Model for Vulnerable Populations, we analyzed cross-sectional data collected from YEH (N = 1074; ages 18–26) in seven U.S. cities to assess HPV vaccination prevalence and to identify predisposing, enabling, and need factors associated with HPV vaccination status. Due to timing differences in the release of HPV vaccine recommendations, we conducted separate logistic regression analyses for men (n = 673) and women (n = 401). Approximately 19% of men and 37% of women had initiated and completed HPV vaccination. Several factors among men (i.e., older age, Latinx ethnicity, San Jose or St. Louis residence compared with New York City, never having had sex, and not previously being tested for STIs) and women (i.e., lower education level, San Jose or Houston residence compared with New York City, and never having had sex) were associated with lower odds of HPV vaccination initiation, completion, or both. Gay men had higher odds of initiating and completing the vaccination series than their heterosexual counterparts. Our findings reveal that HPV vaccination uptake is low among YEH and that there are vaccination disparities among subgroups of YEH. HPV vaccination strategies and resources that are easy-to-understand, facilitate point-of-care services, and address societal and system-level vaccination barriers encountered by YEH are needed.

Objective: Previous research has indicated high rates of intercity movement among homeless young adults (HYAs) for a variety of prosocial (e.g., avoiding domestic violence and seeking new e...

SummaryDue to the focus of micro-practice interventions on clinical outcomes and macro-practice interventions on structural outcomes, limited research exists on the clinical benefits resulting from...

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.

Background and Purpose: Youth from continuation high schools (CHS) exhibit riskier sexual behaviors than other high school youth, yet the associations between intrapersonal and interpersonal constructs and condom-using behavior are not fully understood within this population. It is unknown which of these variables may be more strongly associated with condom use. This study explored the effects of parentadolescent communication, perceived HIV susceptibility, condom use peer norms, and condom use selfefficacy on lifetime and recent condom use and the potential moderating effects by gender and Latino ethnicity. Methods: A non-experimental study was conducted with 111 CHS young adults in Southern California who previously participated in a substance abuse prevention intervention. Ordinal logistic regression models assessed the associations between each construct and condom use and included interaction terms by gender and Latino ethnicity. Results: Parent-adolescent communication during adolescence and within the past 6 months as well as peer norms that support condom use were significantly associated with lifetime and recent condom use. Perceived HIV risk and condom use selfefficacy showed no effect. Relationships were not moderated by gender or Latino ethnicity. Conclusion: Findings highlight the salutary influence of parents and peers on personal condom use. Future research should explore intrapersonal factors that may motivate consistent condom use.

Homelessness itself is traumatic, and more than half of homeless young adults have also experienced abuse as children and/or victimization while homeless. These experiences increase the likelihood of developing trauma-related symptoms and posttraumatic stress disorder (PTSD). Few studies have, however, examined correlates of trauma and PTSD to identify targets for prevention and intervention. We used multinomial logistic regression to assess whether child abuse, victimization once homeless, features of homelessness (duration and transience), and personal resilience (self-efficacy and social connectedness) were associated with trauma and PTSD among 600 homeless young adults. Compared with those who had not experienced trauma, those who had were more likely to have been physically and/or sexually abused in childhood and physically victimized once homeless. Compared with those who had not experienced trauma, those who had experienced trauma and met criteria for PTSD were more likely to have been physically and/or sexually abused in childhood and physically and/or sexually victimized once homeless, and to have lower self-efficacy and social connectedness. Attention should be paid to these correlates of trauma and PTSD in developing and refining trauma-informed prevention and intervention approaches.

Purpose: This randomized controlled trial compared the efficacy between the Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS) with homeless youth with mental illness to assess their impact on nonvocational outcomes. Method: Seventy-two homeless youth were recruited from one agency and randomized to the SEI ( n = 36) or IPS ( n = 36) conditions. Over 20 months, SEI participants received four SEI components, and IPS participants received eight IPS components. Data were collected on mental health, housing, and social support outcomes at baseline and one follow-up period. Results: Findings from mixed analysis of variance indicate that both SEI and IPS participants displayed statistically significant changes in their self-esteem, attention-deficit/hyperactivity disorder (ADHD) problems, inattention problems, living in a shelter, and living in a private residence. Conclusions: This is the first study to demonstrate the comparative efficacy and short-term nonvocational outcomes of SEI and IPS with homeless youth with mental illness. Assessment of long-term outcomes of both interventions is warranted.

BACKGROUND: Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. OBJECTIVE: To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. METHODS: Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. RESULTS: Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. CONCLUSIONS/IMPORTANCE: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.

Homelessness is a multidimensional problem that requires intervention and support across sectors (e.g., businesses, government, civil society). For example, people experiencing homelessness not only need health and social services but also community-based supports to help them obtain and maintain quality housing and employment. To address homelessness from multiple dimensions and aspects, various cross-sector collaborative approaches have been developed and implemented. This chapter describes general characteristics of multisectoral collaboration and discusses two specific models: interagency collaboration and collaboration with the business sector. We discuss in depth the role of the business sector, in particular, as the business sector can be an active partner in solving homelessness, contrary to the perception that the business sector is indifferent, if not hostile, toward homeless populations. At the end of the chapter, we synthesize helpful strategies and skills for social workers engaged in collaborations across multiple sectors.

Prior research reveals high rates of geographic mobility (i.e., transience) among homeless young adults (HYAs). Yet to date, little is known about predictors of different aspects of their transience as well as characteristics of the most highly transient HYAs. This study thus used the risk/resilience framework to identify predictors of three measures of HYAs’ transience (i.e., number of intercity moves, total distance traveled, and average distance traveled) as well as to identify the characteristics of the most highly transient HYAs: frequent flyers (i.e., HYAs with seven or more intercity moves), distance travelers (i.e., HYAs who have traveled average distances greater than 1,092 kilometers), and combined frequent flyers and distance travelers (i.e., HYAs with seven or more intercity moves and average travel distances greater than 1,092 kilometers). Purposive sampling was used to recruit 601 HYAs (ages 18–24) from Los Angeles, Austin, and Denver. Three Ordinary Least Squares regression models i...

Purpose: The purpose of this pilot study was to evaluate the influence of a community-based, service-coordination and delivery intervention (CONNECT Program) on urban, minority parents’ human capital, financial capital, community social capital, and service utilization. Method: This study used a pre–posttest single group design and mixed methods as well as incorporated principles of community-based research. Peer outreach workers engaged 80 urban, minority parents living in Manhattan (New York City) in the CONNECT Program, which offered them referrals to formal agency services and informal community supports as well as psychoeducational workshops on varied topics. Results: Findings from paired-samples t-tests indicate that at follow-up, 49 participants displayed significant improvements after 12 months in their education, neighborhood trust, service use, and problem resolution. Discussion: Findings suggest that CONNECT was feasible within the agency and community. Moreover, CONNECT was associated with higher human and community social capital as well as service utilization outcomes.

Homeless youth experience elevated rates of victimization, yet few studies have identified malleable intervention targets that could mitigate risk for such adverse experiences. Building on a prior study that used latent class analysis to identify 3 victimization profiles among homeless youth (low-victimization class, high-victimization class, and witness class), we investigate how different coping styles (active, avoidant, and social coping) were associated with each victimization profile among a large purposive sample of homeless youth (N = 601). Results indicate that youth who report employing greater avoidant coping are more likely to have a witness or high-victimization profile, while social coping is associated with having a low-victimization profile. Coping styles may represent malleable factors that offer promising intervention targets for helping homeless youth safely navigate stressful street environments.

Homeless youth frequently meet diagnosis criteria for depressive and/or substance use disorder(s). Although prior research has established that both social connectedness and self-efficacy buffer vulnerable youth’s adverse health outcomes, few studies have compared the potential of these protective factors on homeless youth’s mental well-being. The current study analyzes comparative effects of social connectedness and self-efficacy on meeting criteria for major depressive disorder, substance use disorder, and the co-occurrence of both disorders among a sample of 601 service-seeking homeless youth in Austin, Denver, and Los Angeles. Hierarchical logistic regressions indicate that while both social connectedness and self-efficacy constructs are valuable protective factors, social connectedness may offer greater utility, particularly in buffering against more complex mental health outcomes, such as the co-occurrence of depressive and substance use disorders. Accordingly, resource-strapped homeless youth service providers and researchers may benefit from tailoring mental health intervention strategies to further emphasize social connectedness in future efforts.

The social work literature is largely silent regarding the role of supported employment and social entrepreneurship in promoting behavioral health. This article establishes a case for viewing clients with behavioral health challenges as entrepreneurs who can use employment and social entrepreneurship to improve health, mental health, and economic well-being. The author identifies the relevance of employment and social entrepreneurship to behavioral health by drawing on theories of recovery and rehabilitation and community, economic, and social development. Changes to social work education, research, and practice are recommended to establish a professional niche in integrating employment in behavioral health interventions.

This study identified human, financial, and social capital correlates of agency-based, help-seeking behavior among minority parents in an urban community. Sixty-six parents participating in a community-based, case-management intervention (the CONNECT Program) were recruited using purposive sampling. Social capital theory guided the selection of variables in our model. Significant predictors of greater help-seeking behavior include higher household income, greater financial distress, and greater formal advice networks, yet fewer informal advice and informal help networks. Understanding the human, financial, and social capital factors associated with help-seeking behavior has implications for strengthening informal support networks within communities to complement formal agency-based services.

This article identifies gaps in services to lesbian, gay, bisexual, transgender, and queer (LGBTQ) runaway and homeless youth (RHY) and offers recommendations from the literature to fill them. Participants were 24 staff from 19 LGBTQ-RHY-serving agencies across the country. Over a 2-month period, researchers conducted 1-hour phone interviews with program staff and agency directors. Data from the interview transcripts were coded using template analysis, and the researchers modified the themes using an iterative coding process. Analyses yielded the following themes: a) housing services, b) educational services, c) employment services, d) family services, e) LGBTQ-affirming services, f) cultural competency training, and g) advocacy and organizing. Participants' perceptions of these gaps are provided, as are literature-driven recommendations to address those gaps. The findings from this study have the potential to guide program developers and policy makers in providing comprehensive, LGBTQ-affirming services for a substantial portion of the RHY population.

This study examined gender differences among homeless young adults' engagement in illegal economic activity (i.e., panhandling, selling drugs, survival sex, gambling, theft). A purposive sample of 601 homeless young adults (ages 18–24) was recruited from three U.S. cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews. General strain theory was used to identify predictors of illegal economic activity, including strains (childhood abuse, street victimization, length of homelessness, transience) and responses to strain (deviant peer associations, substance use, post-traumatic stress disorder, arrest history). The full hypothesized path models for males and females separately were tested using observed-variable path analysis. Among females, a greater variety of illegal income sources was reported by those who had experienced greater street victimization and who had used a greater number of substances in the past year. Among males, a greater variety of illegal income sources was reported by those who had more deviant peer associations, experienced greater street victimization, and used a greater number of substances in the past year. Findings have implications for research and preventive interventions to address engagement in illegal economic activity among male and female homeless young adults.

Homeless young adults (HYA) with and without a history in foster care in the United States experience lower high school graduation rates than young adults in the general population. Few studies examine the risk and resilience factors that promote positive educational outcomes for these subpopulations. This study explores the factors that are associated with positive educational outcomes for HYA with and without a foster care history. This study uses data from a 3-city cross-sectional study of HYA, which included quantitative interviews of HYA between the ages of 18 and 24 (N = 601) in Austin, TX (n = 200), Los Angeles, CA (n = 200), and Denver, CO (n = 201). Positive educational outcomes consisted of HYAs being currently enrolled in or previously attaining a degree from a secondary, postsecondary or technical education program. This study uses two logistic regression models to identify the risk and resilience factors associated with positive educational outcomes for HYA with and without a history in foster care. For HYA with a history in foster care, city was a significant predictor of positive educational outcomes as well as being an older age, formal employment, not having an arrest record, having a lower score of emotional neglect, and having a higher score of physical abuse. For HYA without a history in foster care, significant predictors included not having an arrest record and having a higher score of emotional abuse. Findings highlight the need for an expansion of federal and state postsecondary education financial aid programs for HYA with and without a history in foster care.

Young adults experiencing homelessness (YAEH) have been found to have high rates of prior involvement with foster care and juvenile justice, but little is known about whether YAEH differ in their risk behaviors based on exposure to different systems. This study used a dataset of 1426 YAEH from 7 different US cities to examine the historical risk and resilience characteristics of those involved in foster care alone, juvenile justice alone, both systems (dual status), and no system involvement. Logistic regression was used to examine whether different types of childhood system involvement predicted risk behaviors in young adulthood including substance use, trade sex, suicide attempts, unplanned pregnancy, and involvement in the adult criminal justice system. Notably, 57% of youth had been exposed to one of the systems – 20% foster care only (n = 291), 18% juvenile justice only (n = 254), and 18% dual status (n = 261). YAEH without a history of system involvement had significantly lower childhood trauma scores and lower rates of lifetime mental health diagnoses compared to all three system involved groups, with dual status youth having the highest rates of both. In relation to risk outcomes, youth with dual status histories had higher odds of trading sex and those with juvenile justice involvement, either alone or as dual status, had higher odds of being arrested after age 18 and of problematic substance use. Results suggest YAEH with prior involvement in child-serving systems have unique risk characteristics that vary by type of system involvement, with dual-system involved youth at particularly high risk. Findings highlight the need for foster care and juvenile justice systems to work collaboratively in providing preventive interventions prior to system exit.

OBJECTIVE: Limited research exists on how employment interventions contribute to employment outcomes for homeless youth. This study examines the comparative efficacy of 2 interventions—Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS)—provided to homeless youth with mental illness in a randomized controlled trial. METHOD: Participants were recruited from 1 homeless youth agency in Los Angeles, CA, and randomized to the SEI (n = 36) or IPS (n = 36) conditions. Over 20 months, SEI participants received 4 SEI components, and IPS participants received IPS services based on 8 principles. Data were collected at baseline and follow-up for the primary employment outcome (paid employment) and 5 secondary employment outcomes. RESULTS: Over 20 months, 39% of SEI participants and 32% of IPS participants reported any paid employment. Across both groups, participants who reported working at baseline had nearly 8 times the odds of working at follow-up (OR = 7.91, p < 0.05). No statistically significant differences were detected across the full sample or between groups on the primary or secondary employment outcomes. CONCLUSIONS: Future effectiveness research is needed to compare the long-term employment outcomes of the SEI and IPS with a more heterogeneous sample of homeless youth using customized homelessness support services and more nuanced employment outcomes.

Purpose Evidence suggests that young adults experiencing homelessness (YEH) are at elevated risk of HIV compared to housed youth. Given the limited research on pre-exposure prophylaxis (PrEP) awareness among YEH, this study examined their PrEP knowledge and attitudes. Methods Data from a cross-sectional survey among YEH (ages 18–26) (n = 1,427) in seven U.S. cities were used to assess their knowledge and attitudes regarding PrEP to inform HIV prevention efforts. Results Participants were primarily male youth of color. The mean age was 20.9years. While 66% felt at risk for HIV, only 14% strongly agreed that they try to protect themselves from getting infected with HIV. Most (84%) were eligible for PrEP based on risk, yet only 29% had knowledge of PrEP. Despite this, 59% reported they were likely/extremely likely to take PrEP. Access to free PrEP (55%), HIV testing (72%), healthcare (68%), and one-on-one (62%), and text messaging support (57%) were rated as very/extremely important for PrEP uptake and adherence. Conclusions The results of this study suggest missed opportunities to prevent new HIV infections among YEH. Efforts to increase PrEP uptake among this population should consider provider- and system-level interventions to increase PrEP awareness, decrease PrEP-associated healthcare costs, improve access to PrEP providers, and provide in-person and text messaging support.

This qualitative study identified promising programs across the United States for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) runaway and homeless youth (RHY). Twenty-four administrative staff and service providers from 19 nonprofit organizations serving LGBTQ RHY participated in telephone interviews about promising programs, service gaps, and recommendations for practice, policy, and research for LGBTQ RHY. Researchers used template analysis to code and analyze interview transcripts. Participating organizations offered integrated programs for all subgroups of LGBTQ and heterosexual RHY as well as separate programs for specific subpopulations of LGBTQ RHY. Researchers identified integrated programs in health, mental health/substance use, case-management, family, legal, education and employment, and housing services and also noted promising separate programs for subpopulations of LGBTQ RHY. Collectively, integrated and separate programs were characterized by 5 novel program c...

This study used the risk and resilience framework to examine predictors of formal and informal sources of income among homeless young adults. Formal sources of income generation consisted of full-time, part-time, or paid, temporary work. Informal sources included earning money from selling personal possessions, selling drugs, and theft. In all, 601 homeless young adults from three U.S. cities participated in semi-structured interviews. Structural equation modeling assessed whether demographic, homelessness history, mental health, problem behaviors, and resilience predicted income generation source. Income generation from formal sources was associated with being male, having a greater number of problem behaviors, and reporting higher levels of resilience. Informal income generation was associated with younger age, being transient, and reporting a greater number of problem behaviors. Findings underscore the need to address homelessness risk factors to support homeless young adults in securing stable, formal employment as an alternative to informal survival behaviors to earn income.

Youth exiting the foster care system through emancipation are at an increased risk for homelessness and adverse social, health, and financial outcomes. However, because youth exiting foster care are difficult to locate once homeless, few studies have examined their needs and experiences on the streets. Quantitative interviews were conducted in a large multi-site pilot study of youth (N = 601) seeking homeless services in Denver ( n = 201), Austin ( n = 200) and Los Angeles ( n = 200). Over one-third of the sample ( n = 221) included youth who reported a history of foster care involvement. The study aimed to 1) describe youth with a history of foster care in terms of their homeless contexts (primary living situations, time homeless, peer substance use, transience, and victimization) and areas of need (education, income generation, mental health, and substance use); 2) determine how homeless youth with foster care history differ from their non-foster care homeless counterparts; and 3) identify factors associated with longer duration of homelessness among youth with a history of foster care. Findings suggest that youth with a history of foster care were generally living in precarious situations, characterized as dangerous and unstable, and they had significant needs in regards to education, income generation, mental health, and substance use treatment. Although few differences were observed between youth who reported a history of foster care and those who did not, foster youth reported greater childhood maltreatment and longer duration of homelessness. Foster care youth who reported greater transience and childhood physical neglect, as well as those who were living with relatives, friends, foster parents, or in facilities in the 6 months preceding the interview reported a longer duration of homelessness. Implications are discussed for child welfare and homeless youth service organizations regarding the unique needs of foster care youth who become homeless.

This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population.

Criminological research on homeless young adults has shown that males are more often arrested for violent offenses, while females engage more frequently in self-destructive behaviors. General strain theory (GST) provides a useful theoretical framework for understanding criminal behaviors and arrest history among homeless young adults. This study examined strains and responses to strains that significantly predict the likelihood of multiple arrests and investigated how predictors of multiple arrests vary by gender. FINDINGS indicate that predictors for multiple arrests do indeed vary by gender, with exposure to the drug culture of the streets being an important variable for males, while being robbed with a weapon and drug distribution are significant predictors for females. Resilience showed an inverse relationship with multiple arrests, as did sexual assault for females. Study findings and implications for service provision are discussed.

This study aimed to identify homeless youths’ lifestyle and trauma-related risk factors as well as protective factors associated with alcohol use disorder or no disorder and drug use disorder or no disorder. Youth receiving homeless services in Denver (n = 201), Austin (n = 200), and Los Angeles (n = 200; N = 601) completed quantitative interviews assessing demographic information, alcohol and drug use, homeless lifestyle risk factors, trauma-related risk factors, and protective factors. Findings showed differences in trauma-related risk factors between alcohol and drug use disorders, but not homeless lifestyle risks. Protective factors predicted substance use disorders beyond risk factors. Understanding trauma-related risk and protective factors associated with substance use disorders could improve interventions.