Reaching non-system connected, substance abusing homeless youth

描述(申请人提供)：正如前联合国秘书长科菲·安南所说：“年轻人应该站在全球变化和创新的前沿。赋予他们权力，他们可以成为发展与和平的关键推动者。然而，如果他们被留在社会的边缘，我们所有人都将陷入贫困。让我们确保所有年轻人都有机会充分参与他们的社会生活。”无家可归的青年是世界上最脆弱的人群之一。鉴于难以确定无家可归青年的身份，对每年无家可归的青年人数的估计是粗略的。然而，无家可归在美国并不少见，估计有170万无家可归的青年(Sedlak，Finkelhor，Hammer，&Schultz，2002)。鉴于青年无家可归与吸毒、艾滋病毒风险、缺乏教育、心理和身体健康问题有关，确定吸引无家可归青年的战略是预防/干预工作的重要重点。这种关注可能会防止长期无家可归、药物使用和精神疾病进入成年，并可能对公共卫生产生重大影响。那些为干预那些与家庭和系统隔绝的年轻人无家可归的轨迹提供指导的人建议以社区为基础的方案和资金，将这些年轻人与学校、住房和就业联系起来(Chamberlain&MacKenzie，2004)。许多人指出，需要为街头生活的青年提供外展、收容中心和重新融入社会的服务(Robertson，1991；Slesnick等人，2008)。这项研究提供了外展干预的第一个正式测试 对与服务无关的无家可归青年滥用药物。无服务联系的无家可归青年(N=60)将被随机分配到两种外展条件中的一种，目的是将青年吸引到危机收容所或收容中心。外展工作人员将与青年见面6个月，协助青年导航服务体系。将在基线后3、6和9个月进行随访。如果成功，这项研究将提供成功战略的重要文件，以帮助这些弱势青年并使其参与服务。 与公共卫生相关：这些文献的特点是缺乏关于外展活动对吸纳与非服务有关的、滥用药物的无家可归青年提供服务的影响的信息。此外，没有关于将青年与药物使用和其他结果的服务联系起来的外展干预措施的影响的纵向信息。这项研究旨在解决这些差距，目的是确定有效的战略，将无家可归的青年重新连接到现有的服务，并减少相关的问题行为，如药物滥用、艾滋病毒风险、住房、心理和身体健康问题。

DESCRIPTION (provided by applicant): As noted by Kofi Annan, former United Nations Secretary-General "Young people should be at the forefront of global change and innovation. Empowered, they can be key agents for development and peace. If, however, they are left on society's margins, all of us will be impoverished. Let us ensure that all young people have every opportunity to participate fully in the lives of their societies." Homeless youth are one of the mot vulnerable populations worldwide. Estimates of the number of youth that experience homelessness each year are crude given difficulties identifying such youth. However, homelessness is not uncommon in the United States with an estimated 1.7 million homeless youth (Sedlak, Finkelhor, Hammer, & Schultz, 2002).Given that youth homelessness is associated with substance use, HIV risk, lack of education, mental and physical health problems, identification of strategies to engage homeless youth is an important focus of prevention/intervention efforts. Such focus might prevent chronic homelessness, substance use and mental illness into adulthood and can have significant public health consequences. Those who provide guidance for intervening in the homeless trajectory of youth who are cut-off from family and the system, recommend community based programs and funding to link these youth back to school, housing and employment (Chamberlain & MacKenzie, 2004). Many note the need for outreach, drop-in centers and reintegration services for street living youth (Robertson, 1991; Slesnick et al., 2008). This study provides the first formal test of an outreach intervention for substance abusing homeless youth who are not connected to services. Non- service connected homeless youth (N = 60) will be randomly assigned to one of two outreach conditions with the goal to engage youth to either a crisis shelter or to a drop-in center. The outreach worker will meet with the youth for 6 months to assist the youth's navigation of the service system. Follow-up will be conducted at 3, 6 and 9 months post-baseline. If successful, this study will provide important documentation of successful strategies to reach and engage these vulnerable youth into services. PUBLIC HEALTH RELEVANCE: The literature is characterized by a dearth of information regarding the impact of outreach on engaging non-service connected, substance abusing homeless youth into services. And, no longitudinal information is available regarding the impact of outreach interventions that link youth to services on substance use and other outcomes. This study seeks to address these gaps with the goal to identify effective strategies to reconnect homeless youth to existing services and to reduce associated problem behaviors such as substance abuse, HIV risk, housing, mental and physical health problems.