Hollywood Homeless Youth Point-in-Time Estimate Project: An Innovative Method for Enumerating Unaccompanied Homeless Youth

Homeless youth are greatly undercounted in the United States.  Census methods for homeless adults are inappropriate for homeless youth; thus, nationally, organizations are determining new methods for counting homeless youth.  In collaboration with the Hollywood Homeless Youth Partnership, we utilized an agency-based approach to count and survey all homeless youth entering their facilities and encountered on their outreach activities. Between October 19 and October 25, 2012, 460 unique homeless youth were counted and surveyed in Hollywood. Of these, 222 experienced literal homelessness on the night of Thursday, October 18, 2012, and 381 experienced literal homelessness within the previous year.  Literal homelessness refers to youth who are either living in emergency or transitional housing or living on the streets or in parks, abandoned buildings, cars, subway tunnels, or other places not meant for human habitation. Of the surveyed youth who experienced literal homelessness in the last year, 65% were male, their average age was 21 years, their average age of first literal homelessness experience was17 years, and 43% were from Los Angeles. Our week-long, agency-based approached was successful in enumerating homeless youth in Hollywood.

A Multilevel Intervention Framework for Supporting People Experiencing Homelessness with Pets

Approximately one in 10 people experiencing homelessness have pets. Despite the psychosocial benefits derived from pet ownership, systemic and structural barriers can prevent this group from meeting their basic needs and exiting homelessness. A multilevel framework is proposed for improving the health and well-being of pet owners experiencing homelessness. Informed by a One Health approach, the framework identifies interventions at the policy, public, and direct service delivery levels. Policy interventions are proposed to increase the supply of pet-friendly emergency shelters, access to market rental housing and veterinary medicine, and the use of a Housing First approach. At the public level, educational interventions are needed to improve knowledge and reduce stigma about the relationship between homelessness and pet ownership. Direct service providers can support pet owners experiencing homelessness by recognizing their strengths, connecting them to community services, being aware of the risks associated with pet loss, providing harm reduction strategies, documenting animals as emotional support animals, and engaging in advocacy. By targeting policies and service approaches that exacerbate the hardships faced by pet owners experiencing homelessness, the framework is a set of deliberate actions to better support a group that is often overlooked or unaccommodated in efforts to end homelessness

But Everyone is Doing It (Sort of)! Perceived Sexual Risks in the Social Environment and the Impact on Homeless Youth Engagement in Concurrent Sexual Relationships

Although homeless youth are likely to engage in concurrent sexual relationships and doing so can accelerate HIV transmission, the issue of sexual concurrency (i.e., having sexual partnerships that overlap in time) has received scarce attention in this vulnerable population. The literature that exists tends to focus on individuals’ characteristics that may be associated with concurrency and overlooks the influence of their social environment. Informed by the risk amplification and abatement model (RAAM), this study explored the association between pro-social and problematic social network connections, and sexual concurrency among homeless youth using drop-in center services (N = 841). Nearly 37% of youth engaged in concurrency. Partially consistent with the RAAM, regression analyses showed that affiliation with more problematic ties (i.e., having more network members who practice concurrency and unprotected sex) was associated with greater sexual concurrency. Programs addressing HIV risk among homeless youth in drop-in centers should consider the role youths’ network composition may play in concurrency

Explaining behavioral health differences in urban and rural sexual minority adolescents

PurposeExperiences of sexuality-based discrimination (ie, minority stressors) against youth who identify as nonheterosexual (ie, sexual minority) have been associated with increased symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) for sexual minority adolescents (SMA; ages 14-17). However, little is known about the experiences of SMA living in rural communities across the United States. Thus, the present study sought to examine differences in mental health patterns between urban and rural dwelling SMA, and to see whether these differences are, at least in part, explained by experiences of lifetime minority stress.MethodsA nationwide sample of SMA residing in the United States (N = 2,558; aged 14-17, M = 15.90 years, SD = 0.98) was recruited through purposive social media and respondent-driven sampling methods to complete a cross-sectional survey online. Measures included those of minority stress, urbanicity, and symptoms of anxiety, depression, and PTSD. Parallel multiple mediation (PMM) analysis was employed to test whether urbanicity was associated with anxiety, depressive, and PTSD symptoms through reported lifetime minority stress.FindingsOn average, SMA living in rural areas significantly reported more lifetime minority stress, depressive, and PTSD symptoms than SMA living in urban settings. Results from our PMM analysis indicated that heightened experiences of lifetime minority stress indirectly linked the effects of living in rural areas on anxiety (b = –0.288, 95% CI = [–0.491, –0.085]), depressive (b = –0.158, 95% CI = [–0.270, –0.047), and PTSD symptoms PTSD (b = –0.349, 95% CI = [–0.596, –0.105]). The model accounted for 16.8%, 18%, and 24.1% of the variability in anxiety symptoms, depressive symptoms, and PTSD symptoms, respectively.ConclusionsSMA in our study who reside in rural areas reported elevated minority stress, depressive, and PTSD symptoms as compared to their urban dwelling peers. Our study found that lifetime experiences of minority stress fully mediated the relationship between urbanicity and both depressive and PTSD symptoms, and partially mediated the relationship between urbanicity and anxiety. These findings highlight the need to increase support for rural youth who are growing into adulthood and may find continuing challenges in their family, peer, and community relationships.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/175524/1/jrh12706_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/175524/2/jrh12706.pd

Population-level Network Structure Over Time and Marijuana Use among Homeless Youth

Homeless youth report more marijuana use than stably housed youth; their marijuana use has been linked to the marijuana-using behaviors of their peers. This study was the first to examine the process of network influences in marijuana use with population-level (sociometric) social network data over time. Network data were collected from a population of homeless youth recruited from a drop-in center in Los Angeles every 6 months for 1 year (n = 237, 263, and 312). For each panel, a sociomatrix was generated based on youth nominating other youth in the sample. Degree centrality, betweenness, eigen vector centrality, and number of marijuana-using linkages represented network influence; logistic regression assessed associations with heavy marijuana use. Approximately 60% of the network membership changed between panels. Individuals with more network connections to other heavy marijuana users and youth with more connections to any other youth reported more heavy marijuana use. These results suggest that in transient, high-risk populations, social influence processes largely affect individual substance use patterns. Heavy marijuana use appears to be popular and important to the construction and reconstruction of these networks over time

Social Context of Service Use Among Homeless Youth in Los Angeles, California.

Little is known about rates and correlates of service use or the role that social context plays in service engagement among homeless youth. This study compares two distinct service areas and uses a social network approach to examine how environmental factors (e.g., neighborhood), social factors (e.g., social capital and network engagement) and individual level factors that relate to service use patterns among homeless youth in Los Angeles, California. A sample of 938 youth was recruited from three drop-in centers in two distinct service sites. Individuals were surveyed about their individual and social network attributes. Univariable and multivariable analyses were utilized to understand the influence of social-contextual variables on service use. Service use behaviors varied across site and service type with youth in Hollywood showing greater engagement than youth at the Beach site. Across both sites and several service types, staff emotional support was positively correlated with levels of service use. The site comparisons also point to the fact that even within a single geographic area, like Los Angeles County, client profiles and rates of service use can significantly vary. Future research needs are presented with specific emphasis on understanding the needs of non-service-seeking youth

Social Networking Technology Use and Engagement in HIV-Related Risk and Protective Behaviors Among Homeless Youth

Preliminary studies with homeless youth have found surprisingly pervasive social media use and suggest that youth’s online interactions may be associated with their HIV-related risk and protective behaviors. As homeless youth are transient and difficult to engage in place-based services, social media may represent a novel venue for intervention. A critical 1st step in intervention development is gaining greater understanding of how homeless youth use social media, especially as it relates to who they connect to and around what topics. Given the salience of social networking sites in the lives of these otherwise difficult-to-reach adolescents, and their potential to disseminate prevention interventions, this study assessed associations between online social networking technology use and HIV risk behaviors among homeless youth in Los Angeles, California. Homeless youth ages 13 through 24 (N = 1,046) were recruited through 3 drop-in centers and surveyed about their social media use and self-reported HIV-related risk behaviors. Results suggest that social media use is widely prevalent among this population, and the content of these online interactions is associated with whether youth engage in risk or protective behaviors. Implications for interventions and further research are discussed