Impact of running away on girls’ pregnancy

Health and Healthcare Service Use: The Experiences of Runaway Trans Adolescents Compared to their Peers

This study is the first trans-inclusive exploration of the relation between running away from home, health, and access to healthcare and supportive figures as a function of gender among adolescents. Secondary data analysis of the 2013 BC Adolescent Health Survey found that trans adolescents were 4.25 times as likely as males, and 3.0 times as likely as females, to have run away. Logistic regressions indicated that runaway adolescents of all genders had greater odds of reporting poor or fair overall health (OR: 2.9) and mental health (OR: 4.5), and of foregoing needed physical (OR: 4.8) and mental health care (OR: 4.5) compared to adolescents who had not run away. The relation between running away and health was exacerbated among trans adolescents. Trans and female youth were also less likely than males to report receiving helpful support. Findings highlight the importance of offering trans-affirming services and care to mitigate harms associated with running away from home.

Housing interventions for emerging adults experiencing homelessness: A scoping review

INTRODUCTION

This review aims to identify and synthesize literature focused on housing interventions for young adults experiencing homelessness.

METHODS

Following a five-stage approach to scoping reviews, a computerized search was conducted between February 4-8, 2019 to include peer-reviewed articles from a total of eight electronic databases: PsychINFO, Google Scholar, PubMed, Web of Science, Social Work Abstracts, Cochrane, Clinicaltrials.gov, and CINAHL. The search was limited to include literature published between January 1, 1987 and December 31, 2018. Search parameters included three domains: homelessness, housing intervention, and age.

RESULTS

Of the initial 7,344 sources identified, 29 articles met the search criteria and were included in the final sample. Housing models discussed in the reviewed literature include Permanent Supportive Housing, Transitional and Independent Housing and Living Programs, the Foyer model, Housing First, and general Supportive Housing. Housing models were discussed in the context of outcome domains including quality of life, education, employment, housing tenure, cost of intervention, systems and service use, HIV, and social network and relationships.

DISCUSSION

Housing interventions for young adults experiencing homelessness remains a relatively new intervention to combat homelessness among younger demographics. While the evidence base continues to grow, there remains a need for quality research to generate empirical evidence in this area, though studies included in this review showed promise for the development of best housing practices with this population.

Die Entwicklung von Sexualität bei Kindern und Jugendlichen mit sexuellen Gewalterfahrungen

Zusammenfassung. Theoretischer Hintergrund: Zu den Folgen sexueller Gewalt gehören neben somatischen und psychischen Folgen auch Veränderungen in der Entwicklung der Sexualität. Fragestellung: Ziel dieses Reviews ist es, einen systematischen Überblick über den aktuellen Forschungsstand bezüglich der Entwicklung von Sexualität bei Kindern und Jugendlichen nach sexuellen Gewalterfahrungen zu geben. Methode: Eine systematische Literaturrecherche wurde in den Datenbanken PubMed, ERIC, Cochrane und PubPsych durchgeführt. Die Folgen von sexueller Gewalt bezüglich der Sexualität wurden systematisch analysiert. Ergebnisse: Es konnten insgesamt 127 Studien zur Sexualität nach sexueller Gewalt identifiziert werden, die acht Unterkategorien zugeordnet werden konnten: Sexuelles Risikoverhalten, Teenagerschwangerschaft, jugendliche Sexualstraftäter_innen, sexuelle Verhaltensauffälligkeiten, sexuelle Überzeugungen, Prostitution, Geschlechtskrankheiten und körperliche Symptome. Diskussion und Schlussfolgerung: Insgesamt zeigt die Literaturrecherche, dass die Sexualität von Kindern und Jugendlichen mit sexuellen Gewalterfahrungen teilweise nur lückenhaft untersucht wurde.

Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth

BACKGROUND AND OBJECTIVES

Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations.

METHODS

We conducted a secondary data analysis of ninth- and 11th-graders in the 2016 minnesota Student Survey (n = 68 785). We categorized youth into 4 subgroups based on housing status in the previous year: (1) unaccompanied homeless youth (0.5%), (2) runaway youth (4%), (3) youth who had both run away and been homeless (0.6%), and (4) stably housed youth (95%). We performed multivariable logistic regression to compare 4 mental health outcomes (self-injury, suicidal ideation, suicide attempts, and depressive symptoms) across groups, controlling for demographics and abuse history.

RESULTS

Unstably housed youth had poorer mental health outcomes when compared with their stably housed peers (P < .05). For example, 11% of homeless youth, 20% of runaways, and 33% of youth who had experienced both had attempted suicide in the previous year compared with 2% of stably housed youth (adjusted odds ratios 2.4, 4.9, and 7.1, respectively). Other outcomes showed a similar pattern.

CONCLUSIONS

Our findings suggest that runaway and homeless youth represent unique populations with high levels of mental health needs who would benefit from targeted clinical and community interventions. Pediatric clinicians represent one potential point of screening and intervention.

Runaway Youth: Caring for the Nation's Largest Segment of Missing Children

The largest segment of missing children in the United States includes runaways, children who run away from home, and thrownaways, children who are told to leave or stay away from home by a household adult. Although estimates vary, as many as 1 in 20 youth run away from home annually. These unaccompanied youth have unique health needs, including high rates of trauma, mental illness, substance use, pregnancy, and sexually transmitted infections. While away, youth who run away are at high risk for additional trauma, victimization, and violence. Runaway and thrownaway youth have high unmet health care needs and limited access to care. Several populations are at particular high risk for runaway episodes, including victims of abuse and neglect; lesbian, gay, bisexual, transgender, and questioning youth; and youth in protective custody. Pediatricians and other health care professionals have a critical role to play in supporting runaway youth, addressing their unique health needs, fostering positive relationships within their families and with other supportive adults, and connecting them with available community resources. This report provides clinical guidance for pediatricians and other health care professionals regarding (1) the identification of adolescents who are at risk for running away or being thrown away and (2) the management of the unique medical, mental health, and social needs of these youth. In partnership with national, state, and local resources, pediatricians can significantly reduce risk and improve long-term outcomes for runaway youth.

Experiência de gravidez e aborto em crianças, adolescentes e jovens em situação de rua

Resumo O objetivo deste estudo é identificar a prevalência de experiência de gravidez e aborto e os fatores associados em crianças, adolescentes e jovens em situação de rua, das cidades de Porto Alegre e Rio Grande, RS, Brasil. Neste estudo transversal, como método de amostragem, foi utilizado o Respondent-Driven Sampling (RDS), inovador em pesquisas com populações de difícil acesso. Foram entrevistados 307 indivíduos, com idade entre 10 e 21 anos. Na análise multivariada foi utilizada regressão de Poisson, com ajuste robusto da variância. A maioria dos participantes foi do sexo masculino, sem vínculos com escola e com a família. Quase metade estava há cinco anos ou mais na rua, permanecendo mais de 15 horas diárias nela. A prevalência de experiência de gravidez foi de 29,3%, estando independentemente associada com ser do sexo feminino, ter mais de 10 parceiros sexuais no último ano, ter parceiro sexual fixo no último ano e ter mais idade. A prevalência de experiência de aborto foi de 10,4%, estando associado com não morar com a família, ter duas ou mais gravidezes e ter menos idade. A alta prevalência de experiência de gravidez e aborto aponta para a necessidade de melhores políticas de saúde sexual e reprodutiva específicas para esta população.

Sexual behavior and pregnancy among adolescents in foster family homes

Objective To examine the prevalence of and factors associated with sexual behavior and pregnancy involvement among adolescents in foster family homes. Methods A cross-sectional study was conducted among a random sample of children living in foster family homes. Logistic regression with Firth's correction was used to determine factors associated with sexual risk behavior and pregnancy involvement (i.e. having been pregnant or gotten someone pregnant). Results About half of adolescents (aged 13-18 years) in foster family homes ever had sex, of whom, one third had first sex before the age of 14 and one sixth had two or more sexual partners in the past 3 months. Of adolescents in the study, 9% had ever been pregnant or gotten someone pregnant. Although adolescents in foster family homes had higher rates of sex initiation and pregnancy involvement than those in the general population, the two groups had comparable rates of current sexual risk behavior. Being placed in kin/fictive kin foster homes [odds ratio (OR): 3.04; 95% confidence interval (CI): 1.18-7.80] and number of placement settings (OR: 1.20; 95% CI: 1.02-1.42) were associated with multiple sexual partners, while a history of running away from a foster home (OR: 7.64; 95% CI: 1.87-31.18) was associated with pregnancy involvement. Conclusions Efforts targeting placement stability including prevention of running away may reduce sexual risk behavior and pregnancy involvement among adolescents in foster family homes.

The paradox of homeless youth pregnancy: a review of challenges and opportunities

Compared to their housed counterparts, homeless youth become pregnant at exceptionally high rates. Causes of such pregnancies are multifaceted, while a paradoxically high proportion of these pregnancies are intended. This review discusses causes and risk factors associated with homeless youth pregnancies, and notes experiences of pregnancy decision-making discord, challenges encountered during and following pregnancy, and difficulties faced by homeless youth when or if they become parents. Because homeless youth face a wide array of unique risks, future research would benefit from exploring alternative approaches to prevention to reduce pregnancies and improve sexual and reproductive health outcomes among this population.

Clusters of markers identify high and low prevalence of adolescent pregnancy in the US

STUDY OBJECTIVE

To identify markers that, when clustered, are associated with the highest and lowest pregnancy prevalence among US adolescent females.

DESIGN

Secondary database analysis of the National Survey of Family Growth.

PARTICIPANTS

Adolescent females 15-19 years old.

SETTING

United States.

METHODS

Bivariate analyses were performed of the 2002 and 2006-08 cycles to identify markers associated with pregnancy in females 15-19 years old. Recursive partitioning analysis (RPA) was done to identify markers which, when combined, identify adolescent females with the highest and lowest pregnancy prevalence.

RESULTS

Pregnancy prevalence in 2,528 adolescent females was 14%. In RPA, females who ever HIV tested had a 48% pregnancy prevalence vs 4% in those never tested. The highest pregnancy prevalence (78%) was associated with the combination of ever HIV tested, never lived away from parents before 18 years old, age >17 years old, and age of sexual debut ≤14 years old. Adolescent females with a combination of ever HIV tested, never lived away from parents before 18 years old, age >17 years old, age of sexual debut at 15-16 years old, and the adolescent's father not having a high-school diploma had a pregnancy prevalence of 75%.

CONCLUSIONS

Two clusters of markers yield adolescent females with a very high adolescent pregnancy prevalence, at 75%-78%. Pregnancy prevention efforts might be especially effective when targeting combinations of HIV-testing history, never living away from home before 18 years old, adolescent age, age of sexual debut, and paternal educational attainment.

The impact of running away on teen girls' sexual health

This article reviews three recent studies investigating the impact of running away on adolescent females' sexual health. There are between 500,000 and 2.8 million runaway and homeless youth in the U.S. at any point in time, and adolescent females are at increased risk as compared to males. All three studies analyzed data from The National Longitudinal Study of Adolescent Health and each examined a different health risk related to runaways including sexual debut, sexual assault and pregnancy. These studies show how health risks are persistent even after adolescents return home to their primary residence.

Health supervision of young women during pregnancy and early motherhood: a Norwegian qualitative study

This study describes and interprets midwives' and public health nurses' perceptions of their experiences of caring for young women during pregnancy and early motherhood. A number of studies suggest that teenage pregnancy is associated with many adverse psychological, physical, social, and financial outcomes. Multistage focus group interviews were conducted with six professionals, and a qualitative content analysis was performed. The result of this descriptive and explorative study comprised one main theme, creating a trusting and committed relationship to support immature young women, characterized by two themes: searching for security and love in daily life and active involvement with "the children of their hearts". In summary, in order to support the young women, the informants used modeling as a strategy to achieve self-esteem, thus helping them to cope with daily life. Continuity of team supervision should be improved to enhance midwives' and public health nurses' professional roles.