Skip to main content

Advertisement

SpringerLink
Log in

A Test of Outreach and Drop-in Linkage Versus Shelter Linkage for Connecting Homeless Youth to Services

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Outreach and service linkage are key for engaging marginalized populations, such as homeless youth, in services. Research to date has focused primarily on engaging individuals already receiving some services through emergency shelters, clinics, or other programs. Less is known about those who are not connected to services and, thus, likely the most vulnerable and in need of assistance. The current study sought to engage non-service-connected homeless youth (N = 79) into a strengths-based outreach and advocacy intervention. Youth were randomly assigned to receive 6 months of advocacy that focused on linking youth to a drop-in center (n = 40) or to a crisis shelter (n = 39). All youth were assessed at baseline and 3, 6, and 9 months post-baseline. Findings indicated that youth prefer drop-in center services to the shelter. Also, the drop-in center linkage condition was associated with more service linkage overall (B = 0.34, SE = 0.04, p < 0.01) and better alcohol-l [B = −0.39, SE = 0.09, t(75) = −4.48, p < 0.001] and HIV-related outcomes [B = 0.62, SE = 0.10, t(78) = 6.34, p < 0.001] compared to the shelter linkage condition. Findings highlight the importance of outreach and service linkage for reconnecting service-marginalized youth, and drop-in centers as a primary service option for homeless youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andersen, M., Booth, R., Smereck, G., Tinsley, J., Ross, D., Haith, D., & Matzger, H. (1998). Community outreach with active drug users: The Detroit experience. AIDS and Behavior, 2, 23–29.

    Article  Google Scholar 

  • Ashworth, C. S., DuRant, R. H., Newman, C., & Gaillard, G. (1992). An evaluation of a school-based AIDS/HIV education program for high school students. Journal of Adolescent Health, 13, 582--588.

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II, beck depression inventory: Manual (2nd ed.). Boston, MA: Harcourt Brace.

    Google Scholar 

  • Beech, B. M., Myers, L., Beech, D. J., & Kernick, N. S. (2003). Human immunodeficiency syndrome and hepatitis A and B infections among homeless adolescents. Seminars in Pediatric Infectious Diseases, 14, 12–19.

    Article  PubMed  Google Scholar 

  • Burt, M. R. (2007). Understanding homeless youth: Numbers, characteristics, multisystem involvement, and intervention options. Testimony submitted to the U.S. House Committee on Ways and Means, Subcommittee on Income Security and Family Support.

  • Cauce, A. M., Tyler, K. A., & Whitbeck, L. B. (2004). Maltreatment and victimization in homeless adolescents: Out of the frying pan and into the fire. Prevention Researcher, 11, 12–14.

    Google Scholar 

  • Centers for Disease Control and Prevention. (1994). Behavioral risk factor surveillance system survey questionnaire. Atlanta, GA: Author.

    Google Scholar 

  • Connolly, J. A., & Joly, L. E. (2012). Outreach with street-involved youth: A quantitative and qualitative review of the literature. Clinical Psychology Review, 32, 524–534.

    Article  CAS  PubMed  Google Scholar 

  • DiClemente, R. J. (1991). Predictors of HIV-preventive sexual behavior in a high-risk adolescent population: The influence of perceived peer norms and sexual communications on incarcerated adolescents’ consistent use of condoms. Journal of Adolescent Health, 12, 385--390.

  • Dworsky, A. L., & Piliavin, I. (2000). Homeless spell exits and returns: Substantive and methodological elaborations on recent studies. Social Service Review, 74, 193–213.

    Article  Google Scholar 

  • Ensign, J., & Gittelsohn, J. (1998). Health and access to care: Perspectives of homeless youth in Baltimore City, USA. Social Science & Medicine, 47, 2087–2099.

    Article  CAS  Google Scholar 

  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245–258.

    Article  CAS  PubMed  Google Scholar 

  • Ferguson, K. M., Bender, K., Thompson, S., Xie, B., & Pollio, D. (2011). Correlates of street-survival behaviors in homeless young adults in four U.S. cities. American Journal of Orthopsychiatry, 81, 401–409. doi:10.1111/j.1939-0025.2011.01108.x.

    Article  PubMed  Google Scholar 

  • Gaetz, S. (2004). Safe streets for whom? Homeless youth, social exclusion, and criminal victimization. Canadian Journal of Applied Physiology, 46, 423–455.

    Google Scholar 

  • Greenwood, R. M., Schaefer-McDaniel, N. J., Winkel, G., & Tsemberis, S. J. (2005). Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. American Journal of Community Psychology, 36, 223–238.

    Article  PubMed  Google Scholar 

  • Johnson, T. P., Aschkenasy, J. R., Herbers, M. R., & Gillenwater, S. A. (1996). Self-reported risk factors for AIDS among homeless youth. AIDS Education and Prevention, 8, 308--322.

  • Johnson, M., Samberg, L., Calsyn, R., Blasinksy, M., Landow, W., & Goldman, H. (1999). Case management models for persons who are homeless and mentally ill: The ACCESS demonstration project. Community Mental Health Journal, 35, 325–345.

    Article  Google Scholar 

  • Kann, L., Nelson, G. D., Jones, J. T., & Kolbe, L. J. (1989). Establishing a system of complementary school-based surveys to annually assess HIV-related knowledge, beliefs, and behaviors among adolescents. Journal of School Health, 59, 55–58.

    Article  CAS  PubMed  Google Scholar 

  • Keyes, K. M., Vo, T., Wall, M. M., Caetano, R., Suglia, S. F., Martins, S. S., Galea, S., & Hasin, D. (2015). Racial/ethnic differences in use of alcohol, tobacco, and marijuana: Is there a cross-over from adolescence to adulthood? Social Science & Medicine, 124, 132–141.

    Article  Google Scholar 

  • Kryda, A. D., & Compton, M. T. (2009). Mistrust of outreach workers and lack of confidence in available services among individuals who are chronically street homeless. Community Mental Health Journal, 45, 144–150.

    Article  PubMed  Google Scholar 

  • Masten, A. S. (2011). Resilience in children threatened by extreme adversity: Frameworks for research, policy, and practice. Development and Psychopathology, 23, 493–506.

    Article  PubMed  Google Scholar 

  • McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., Pettinati, H., & Argeriou, M. (1992). The fifth edition of the addiction severity index. Journal of Substance Abuse Treatment, 9, 199–213. doi:10.1016/0740-5472(92)90062-S.

    Article  CAS  PubMed  Google Scholar 

  • McKinney-Vento Homeless Assistance Act of 2002, 11431 et. seq., 42 U.S.C. (2002).

  • Merscham, C., Van Leeuwen, J. M., & McGuire, M. (2009). Mental health and substance abuse indicators among homeless youth in Denver, Colorado. Child Welfare, 88, 93–110.

    PubMed  Google Scholar 

  • Milburn, N., Rotheram-Borus, M., Rice, E., Mallet, S., & Rosenthal, D. (2006). Cross-national variations in behavioral profiles among homeless youth. American Journal of Community Psychology, 37, 63–76. doi:10.1007/s10464-005-9005-4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mojola, S. A., & Everett, B. (2012). STD and HIV risk factors among U.S. young adults: Variations by gender, race, ethnicity and sexual orientation. Perspectives on Sexual and Reproductive Health, 44, 125–133.

    Article  PubMed  Google Scholar 

  • National Alliance to End Homelessness. (2014). FY 2015 discretionary homelessness budget chart. Washington, DC: Author.

    Google Scholar 

  • Pable, J. (2005). Design response to homelessness. Implications, 4, 1–6. Retrieved from https://www.acsa-arch.org/files/competitions/Steel/jul_v04r-p.pdf. Accessed April 2015.

  • Pacek, L. R., Malcolm, R. J., & Martins, S. S. (2012). Race/ethnicity differences between alcohol, marijuana, and co‐occurring alcohol and marijuana use disorders and their association with public health and social problems using a national sample. The American Journal on Addictions, 21, 435–444.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.

    Article  CAS  PubMed  Google Scholar 

  • Piccinelli, M., & Wilkinson, G. (2000). Gender differences in depression Critical review. The British Journal of Psychiatry, 177(6), 486--492.

  • Raleigh-DuRoff, C. (2004). Factors that influence homeless adolescents to leave or stay living on the street. Child and Adolescent Social Work, 21, 561–572.

    Article  Google Scholar 

  • Rapp, C., & Chamberlain, R. (1985). Case management services for the chronically mentally ill. Social Work, 30, 417–422.

    CAS  PubMed  Google Scholar 

  • Raudenbush, S. W., Bryk, A. S., Cheong, Y. F., Congdon, R. T., & du Toit, M. (2011). HLM 7: Hierarchical linear and nonlinear modeling. Chicago, IL: Scientific Software International.

    Google Scholar 

  • Ray, N. (2006). Lesbian, gay, bisexual and transgender youth: An epidemic of homelessness. New York: National Gay and Lesbian Task Force Policy Institute and the National Coalition for the Homeless.

    Google Scholar 

  • Robertson, M. J., & Toro, P. A. (1999). Homeless youth: Research, intervention, and policy. In L. B. Fosburg & D. L. Dennis (Eds.), Practical lessons: The 1998 National Symposium on Homelessness Research (pp. 3–32). Washington DC: U.S. Department of Housing and Urban Development.

    Google Scholar 

  • Rosenheck, R., Bassuk, E., & Salomon, A. (1999). Special populations of homeless Americans. In L. B. Fosburg & D. L. Dennis (Eds.), Practical lessons: The 1998 national Housing and Urban Development, U.S. Department of Health and Human Services.

  • Ross, C. E., & Mirowsky, J. (2002). Age and the gender gap in the sense of personal control. Social Psychology Quarterly, 65, 125–145.

    Article  Google Scholar 

  • Rotheram-Borus, M. J., Song, J., Gwadz, M., Lee, M., Van Rossem, R., & Koopman, C. (2003). Reductions in HIV risk among runaway youth. Prevention Science, 4, 173–187.

    Article  PubMed  Google Scholar 

  • Scutella, R., Johnson, G., Moschion, J., Yi-Ping, T., & Wooden, M. (2013). Understanding lifetime homeless duration: Investigating wave 1 findings from the Journeys Home Project. Australian Journal of Social Issues, 48, 83–110.

    Google Scholar 

  • Shern, D., Tsemberis, S., Anthony, W., Lovell, A. M., Richmond, L., Felton, C., Winarski, J., & Cohen, M. (2000). Serving street-dwelling individuals with psychiatric disabilities: Outcomes of a psychiatric rehabilitation clinical trial. American Journal of Public Health, 90, 1873–1878.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Slesnick, N., Glassman, M., Garren, R., Toviessi, P., Bantchevska, D., & Dashora, P. (2008a). How to open and sustain a drop-in center for homeless youth. Children and Youth Services Review, 30, 727–734. PMC2440711.

    Article  PubMed  PubMed Central  Google Scholar 

  • Slesnick, N., Kang, M., Bonomi, A. E., & Prestopnik, J. L. (2008b). Six-and twelve-month outcomes among homeless youth accessing therapy and case management services through an urban drop-in center. Health Services Research, 43, 211–229.

    Article  PubMed  PubMed Central  Google Scholar 

  • Slesnick, N., Dashora, P., Letcher, A., Erdem, G., & Serovich, J. (2009). A review of services and interventions for runaway and homeless youth: Moving forward. Children Youth Services Review, 31, 731–742.

    Article  Google Scholar 

  • Sowell, R. L., Bairan, A., Akers, T. A., & Holtz, C. (2004). Social services needs and case management implications for individuals accessing a faith-based suburban homeless shelter. Professional Case Management, 9, 72–86.

    Google Scholar 

  • Springfield’s Housing Collaborative. (2007). 2007 High risk and homeless youth survey results. Housing Collaborative Homeless Youth Subcommittee.

  • United States Interagency Council on Homelessness (2010). Opening Doors, Retrieved from https://www.usich.gov/opening-doors. Accessed April 2015.

  • United Nations Educational, Scientific and Cultural Organization (UNESCO) (2015). What do we mean by “youth”? Retrieved Oct. 15, 2015 from http://www.unesco.org/new/en/social-and-human-sciences/themes/youth/youth-definition.

  • Ware, J. E., Snow, K. K., Kosinksi, M., & Ganguli, M. (1993). SF-36 health survey: Manual and interpretation guide. Boston, MA: Nimrod Press.

    Google Scholar 

  • Werner, E. E., & Johnson, J. L. (2004). The role of caring adults in the lives of children of alcoholics. Substance Use & Misuse, 39, 699–720.

    Article  Google Scholar 

  • Wiebel, W. W. (1993). The indigenous leader outreach model: Intervention manual. Rockville, MD: National Institute on Drug Abuse.

    Google Scholar 

  • Zerger, S., Strehlow, A. J., & Gundlapalli, A. V. (2008). Homeless young adults and behavioral health: An overview. American Behavioral Scientist, 51, 824–841.

    Article  Google Scholar 

  • Zlotnick, C., Tam, T., & Robertson, M. J. (2003). Disaffiliation, substance abuse and exiting homelessness. Substance Use and Misuse, 38, 577–599.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by National Institute on Drug Abuse Grant No. R34DA032699 to the first author.

Author information

Authors and Affiliations

  1. Department of Human Sciences, The Ohio State University, Columbus, OH, USA

    Natasha Slesnick, Xin Feng, Brittany Brakenhoff, Jasmin Carmona & Aaron Murnan

  2. College of Social Work, The Ohio State University, Columbus, OH, USA

    Scottye Cash

  3. College of Public Health, The Ohio State University, Columbus, OH, USA

    Annie-Laurie McRee

  4. Xiamen University, Xiamen, China

    Xiamei Guo

Authors
  1. Natasha Slesnick
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xin Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiamei Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brittany Brakenhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jasmin Carmona
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aaron Murnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Scottye Cash
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Annie-Laurie McRee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Natasha Slesnick.

Ethics declarations

This study has been approved by The Ohio State University IRB and was performed in accordance with ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no competing interests.

Informed Consent

Informed consent was obtained from all individual participants in this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Slesnick, N., Feng, X., Guo, X. et al. A Test of Outreach and Drop-in Linkage Versus Shelter Linkage for Connecting Homeless Youth to Services. Prev Sci 17, 450–460 (2016). https://doi.org/10.1007/s11121-015-0630-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-015-0630-3

Keywords

Search

Navigation