Long-term benefits of providing transitional services to youth aging-out of the child welfare system: Evidence from a cohort of young people who use drugs in Vancouver, Canada.
Long-term benefits of providing transitional services to youth aging-out of the child welfare system: Evidence from a cohort of young people who use drugs in Vancouver, Canada.
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DOI：
10.1016/j.drugpo.2020.102912
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
DeBeck K
中科院分区：
文献类型：
--
作者：
Barker B;Shoveller J;Grant C;Kerr T;DeBeck K
青少年老龄化--脱离儿童福利系统(CWS)--经历了许多脆弱性，包括物质使用率和物质使用障碍。呼吁改善服务以使青年向独立过渡是很常见的；然而，关于过渡时期服务利用所产生的长期影响的证据很少。此外，现有的服务往往缺乏对使用物质的青年的适当支持，青年是否能够获得这种服务也不得而知。在本研究中，我们评估了一组使用药物(PWUD)的人群中过渡性服务利用与健康和社会结果之间的关系。数据来自加拿大温哥华PWUD的两个协调队列。那些报告老化的人被问及服务利用率、可用性、障碍和对七类过渡性服务的兴趣。多变量Logistic回归分析评估了以前使用过渡性服务与当前健康和社会结果之间的关系。在2014年12月至2017年11月期间，217名PWUD报告以前因老化而退出CWS。在服务类别中，报告的服务使用率从16.6%到61.8%不等，而未得到满足的需求从64.8%到78.4%不等。在多变量分析中，与在外出时使用≤1服务的个人相比，使用4-7服务的人当前无家可归(调整后的优势比=0.29)和参与日常吸毒(调整后的优势比=0.35)的几率显著降低(P<；0.05)。研究结果显示，这群未获充分研究的残障高危人士和社区服务中心的非高龄人士，可获得与过渡性服务使用有关的长期利益，并有兴趣及愿意参与这些服务。然而，鉴于大量未得到满足的需求，调查结果也突显出在提供服务和支助方面存在相当大的差距，呼吁延长妇女地位委员会所有青年的解放年龄，特别是在服务模式中嵌入额外的减少伤害和药物使用支助。
Youth aging-out of the child welfare system (CWS) experience numerous vulnerabilities including, elevated rates of substance use and substance use disorders. Calls to improve services to transition youth to independence are common; however, evidence of the long-term impacts associated with transitional service utilization is scarce. Further, existing services frequently lack appropriate supports for substance using youth and it is unknown if youth are able to access such services. In the present study, we assess the relationship between transitional service utilization and health and social outcomes among a cohort of people who use drugs (PWUD) that aged-out of the CWS. Data were obtained from two harmonized cohorts of PWUD in Vancouver, Canada. Those who re- ported aging-out were asked about service utilization, availability, barriers, and interest across seven categories of transitional services. Multivariable logistic regression analyses were conducted to assess the relationship between having previously utilized transitional services and current health and social outcomes. Between December 2014 and November 2017, 217 PWUD reported having previously aged-out of the CWS. Across service categories, reported service utilization prevalence ranged from 16.6–61.8% while unmet demand ranged from 64.8–78.4%. In multivariable analyses, compared to individuals who utilized ≤1 service while aging-out, having utilized 4–7 services was significantly associated with reduced odds of current home- lessness (adjusted odds ratio [AOR]=0.29) and engaging in daily drug use (AOR=0.35) (both p<0.05). Findings suggest that this understudied high-risk population of PWUD and aged-out of the CWS experience long-term benefits associated with transitional service utilization and are interested and willing to engage in these services. However, given high unmet demand, findings also highlight considerable gaps in service delivery and support calls for extending the age of emancipation for all youth in the CWS and in particular, for additional harm reduction and substance use supports embedded into service models.
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