Exploring the impact of network characteristics on substance use outcomes among homeless former foster youth

Understanding Homelessness Among Young People to Improve Outcomes

In the United States, an estimated 4.2 million young people experience homelessness during critical stages in their development-adolescence and emerging adulthood. While research on youth homelessness often emphasizes risk and vulnerability, the field must situate these issues within the developmental trajectories of adolescence and emerging adulthood to effectively prevent and end youth homelessness. This review uses the Risk Amplification and Abatement Model (RAAM) as a conceptual framework for contextualizing the landscape of youth homelessness research in the United States since 2010. An extension of ecological models of risk-taking, RAAM emphasizes both risk and resilience, positing that negative as well as positive socialization processes across interactions with family, peers, social services, and formal institutions affect key housing, health, and behavioral outcomes for youth experiencing homelessness. This review applies RAAM to our understanding of the causes and consequences of youth homelessness, recent interventions, and recommendations for future directions.

Research Participation of Minor Adolescents in Foster Care

STUDY OBJECTIVE

In this study we evaluated published studies about foster care to: (1) determine the types of data used; (2) describe the degree to which a sexual/reproductive health topic was addressed; and (3) describe the consent process.

DESIGN

Analysis of published literature.

SETTING

PubMed was searched using "foster care" for English articles published between January 1, 2017 and September 4, 2019.

PARTICIPANTS

None.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Articles were coded into 4 data source categories: primary, secondary, peripheral, or perspective data. Articles with a primary data source were coded for participant ages: only 9 years old and younger, 10- to 17-year-olds (minor adolescents), and only 18 years old and older. Articles using a secondary data source were coded for the source of the data registry. All articles were coded for presence of a sexual/reproductive health outcome. The primary data articles that included minor adolescents were coded for the study topic and consent process.

RESULTS

Of the 176 articles about foster care, 72/176 (41%) used primary data, 53/176 (30%) used secondary data, and 51/176 (29%) used peripheral/perspective data. Forty-eight of the primary data articles included minor adolescents. Secondary data sources included few national research surveys. Sexual/reproductive health outcomes were measured in 17 articles, 4 of which used primary data. The consent process for minor adolescents varied and had no consistent pattern across studies.

CONCLUSION

Research on best practices for consent processes and use of registries could be developed to increase research on sexual/reproductive health outcomes among adolescents in foster care.

Individual and interpersonal factors associated with psychosocial functioning among adolescents in foster care: A scoping review

Risk reduction and strength enhancement are both necessary strategies to improve outcomes for youth in foster care who have experienced adversity. Decades of research have articulated the negative long-term outcomes of youth in foster care, but less is known about youth-level modifiable protective factors that can be nurtured through intervention to improve well-being. This scoping review was conducted to synthesize the state of the science on proximal, modifiable individual and interpersonal factors that are associated with psychosocial well-being among adolescent youth in foster care. Following rigorous and recommended methods, we systematically searched, selected and synthesized 20 years of peer-reviewed literature focused on 13-19 year olds in foster care. 41 peer-reviewed, quantitative studies met specified inclusion criteria and were included in this review. We charted the data and synthesized our findings in consultation with an advisory group of researchers, practitioners, and youth with lived experience. Overall, the review highlighted key categories of individual factors (individual strengths, psychosocial needs, and developmental skills) and interpersonal factors (relationships with peers/siblings, caregiving adults, and caring adults in the community) that can have protective value and are associated with psychosocial functioning for adolescent youth in foster care. Moreover, when youth have their needs met, increase their skills and develop strengths, it often leads to better outcomes as well as more and/or higher quality relationships with important people in their lives. Similarly, when youth develop and maintain quality relationships, those connections often lead to opportunities to advance their skills, strengths and positive outcomes. The results of this review contribute new insights for research, practice, and policy intended to enhance psychosocial well-being for young people in foster care. Findings also highlight specific individual and interpersonal factors that interventionists might consider as potential targeted mechanisms of change when developing programming for this population. Implications are discussed.

Exploring the Relationship between Foster Care Experiences and Social Network Engagement Among a Sample of Homeless Former Foster Youth

INTRODUCTION

Recent research has begun to demonstrate high rates of poor behavioral health outcomes among homeless former foster, but with relatively little attention in the scientific literature. Because social networks have been shown to impact behavioral health outcomes, we need to better understand the network characteristics of homeless young adults with a history of foster care.

METHODS

Data were collected from 184 homeless former foster youth at a drop-in center in Hollywood, California. A series of logistic regressions were conducted for network engagement behaviors that may be impacted by foster care experiences.

RESULTS

Youth were largely African American, Latino, and Mixed race, approximately 22 years old, and majority male. Significant results from the logistic regressions indicated that youth experiencing homelessness for the first time before exiting foster care were more likely to have alters engaging in condomless sex, and youth with higher numbers of foster care placements were more likely to have alters engaging in methamphetamine use.

CONCLUSION

These results suggest that certain foster care experiences impact the types of alters with which youths engage. Time spent in placement was significantly associated with alter behaviors, evident from homeless experiences and multiple foster care placements, negatively impacting the types of alters with which youths are connected, and thusly the risk factors for the youth themselves. Frequent network disruptions may be associated with engagement with risky alters. Included are intervention-based implications for providers as well as structural-based implications for child welfare systems.

Sociodemographic and substance use characteristics associated with typologies and composition of social support networks among youth experiencing homelessness in Los Angeles, USA

Youth experiencing homelessness are a vulnerable population with increased behavioural health risks. Social networks are a consistent correlate of youths' substance use behaviours. However, less is known about the reciprocal relationships among these constructs. This study classified youth experiencing homelessness according to their social support network type (e.g. instrumental, emotional, service) and composition (e.g. family, peers, service staff) and linked their membership in these social network classes to sociodemographic and substance use characteristics. Four waves of cross-sectional data were collected between October 2011 and June 2013 from youth experiencing homelessness, ages 14-29, at three drop-in centres in Los Angeles, CA (N = 1,046). This study employed latent class analysis to identify subgroups of youth experiencing homelessness according to the type and composition of their social support networks. Multinomial logistic regression analyses were then conducted to identify the sociodemographic and substance use characteristics associated with social support network class membership. Five latent classes of youths' social support networks were identified: (a) high staff emotional and service support; (b) high home-based peer and family emotional, service and instrumental support; (c) moderate street- and home-based peer emotional support; (d) low or no support and (e) high home-based peer and family emotional and instrumental support. Multinomial logistic regression models indicated that race/ethnicity, gender, sexual orientation, literal homelessness, former foster care experience, depression, heroin and marijuana use were significant correlates of social support network class membership. Results indicate distinct classes of social support networks among youth experiencing homelessness, with certain sociodemographic and substance use characteristics implicated in youths' social networks.

Exploring the Relationship Between Foster Care Experiences and HIV Risk Behaviors Among a Sample of Homeless Former Foster Youth

Recent research shows high rates of poor behavioral health outcomes among homeless former foster youth, including increased risk for HIV-risk behaviors. In the current study, data were collected from 184 youth at drop-in centers in Los Angeles using behavioral health questionnaires to explore the relationships between specific aspects of foster care experiences and engagement in HIV-risk behaviors. Results indicated that youth whose first homelessness experience occurred before leaving foster care were significantly more likely to engage in drug use with sex and exchange sex than those whose first homelessness experience occurred after leaving foster care. Intervention services targeting HIV-risk behaviors should consider the aspects of foster care placements that may increase the risk of these behaviors, such as long periods of placement or experiencing homelessness before exiting foster care, as well as those that may decrease the risk of these behaviors, such as exiting placement at an older age.