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Prakash J, Goel R, Mu Y, Rosner B, Stoklosa H. Risk Prediction Model for Child Sex Trafficking Among Female Child Welfare-Involved Youth: Welfare-Involved Female Sexual Exploitation Risk Assessment Tool. J Womens Health (Larchmt) 2024. [PMID: 39286874 DOI: 10.1089/jwh.2024.0415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Background: Female child welfare-involved youths who are removed from the home are at risk of commercial sexual exploitation of children (CSEC). The aim of this study was to develop a prediction model to identify those at greatest risk of trafficking. Methods: Data were from the Florida Department of Children and Families' Florida Safe Families Network Database. A Cox proportional hazard regression of 60 cases and 3857 controls generated the proposed risk model. Results: Factors found to be associated with a higher risk of trafficking were quantified into point scores, generating the Welfare-Involved Female Sexual Exploitation Risk Assessment (WISER) tool with a cutoff of 20 points: first out-of-home placement at ≥15 years of age (11 points); run away from home in past year and age <15 years (40 points) or ≥15 years (16 points); English spoken as other language (14 points); on a psychotropic drug (17 points); congregate first placement (14 points); runaway/abducted status first "placement" (16 points); psychiatric facility experience (9 points); residential facility experience (7 points); and no time in temporary shelter (9 points). Of those who experienced CSEC, 92% had a WISER score above 20. Discussion: The WISER tool achieved good discrimination and calibration ability with a receiver operating characteristic for the validation data set of 0.923. The WISER tool can (1) inform risk assessment for CSEC among child welfare-involved females and (2) identify youths at greatest risk before they are harmed by trafficking.
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Affiliation(s)
- Jaya Prakash
- HEAL Trafficking, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rishi Goel
- HEAL Trafficking, Harvard Medical School, Boston, Massachusetts, USA
| | - Yi Mu
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Hanni Stoklosa
- HEAL Trafficking, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Balma B, Vasilakos L, Osman I, Elgonda A, Gewirtz O'Brien JR. COVID-19 vaccine attitudes among youth experiencing homelessness: a qualitative analysis with opportunities for action. BMC Public Health 2023; 23:1672. [PMID: 37648987 PMCID: PMC10469469 DOI: 10.1186/s12889-023-16413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Youth experiencing homelessness (YEH) are uniquely vulnerable to COVID-19 infection, yet are often excluded from response planning during the COVID-19 pandemic and other public health crises. As part of a larger community- and youth-engaged project through a national network of Prevention Research Centers, our qualitative study sought to describe youth perspectives that influence COVID-19 vaccine confidence and uptake, and identify youth-driven strategies to guide public health efforts to improve vaccine confidence and access. We conducted focus groups with youth experiencing homelessness (n = 20) and semi-structured interviews with staff members (n = 10) at youth-serving agencies to solicit youth perspectives about COVID-19 vaccination. Focus groups and interviews were recorded, transcribed, and analyzed using thematic qualitative analysis. In partnership with youth and cross-sector partners, we distilled eight salient themes that influenced COVID-19 vaccine uptake and confidence among YEH: 1. historical harms and mistrust of systems, 2. access to reliable health information, 3. prioritization of basic needs, 4. personal health influence, 5. barriers to healthcare, 6. fear and uncertainty of the vaccines, 7. sense of bodily autonomy, and 8. community influence. We also identified three youth-driven opportunities to increase COVID-19 vaccination among this population: emphasizing autonomy, leveraging trusted sources of information, and improving vaccine access.Our study elucidates perspectives of YEH on COVID-19 vaccination, and identifies several opportunities to improve youth vaccine confidence and access. It also underscores the importance of centering youth voice in response planning during current and future public health crises.
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Affiliation(s)
- Brandon Balma
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA.
| | - Lauren Vasilakos
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Ingie Osman
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Asha Elgonda
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Janna R Gewirtz O'Brien
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
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Kim HR, Moon SH. Predictors for runaway behavior in adolescents in South Korea: national data from a comprehensive survey of adolescents. Front Psychiatry 2023; 14:1195378. [PMID: 37663596 PMCID: PMC10469315 DOI: 10.3389/fpsyt.2023.1195378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Background Runaway behavior is reported to impede the growth, mental health development, and social adjustment of adolescents. Exposure to harmful media causes problematic behaviors in adolescents, sometimes inducing them to run away from home. Methods This study examined the factors influencing adolescents' runaway behavior. Utilizing the data of 11,354 adolescents from the Survey of Media Usage and Harmful Environment among Adolescents, a hierarchical logistic regression analysis was conducted using the SPSS 24.0 program. Results The significant predictors of runaway behavior were the grade of the adolescent, deviant behaviors (drinking, smoking), autonomous control ability, relationship with family, and harmful media (p < 0.001). This regression model explained 13.1% of the variance in runaway behavior. A significant outcome of this study is that harmful media was identified as one of the factors affecting adolescents' runaway behavior. Adjusted OR and 95% CI of harmful media was 1.23 (1.10-1.38). Conclusion This study showed that individual, family, social factors, and harmful media influence adolescents' runaway behavior. The results emphasize the importance of health teachers and the need for early intervention programs, for the identification and prevention of risk factors for adolescents' runaway behavior.
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Affiliation(s)
- Hyung Ran Kim
- Department of Health Insurance Review and Assessment Service, Kwangju Christian Hospital, Gwangju, Republic of Korea
| | - So-Hyun Moon
- Department of Nursing, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Jones LM, Mitchell KJ. Predictors of Multidisciplinary Team Sustainability in Work With Child Sex Trafficking Cases. VIOLENCE AND VICTIMS 2022; 37:222-243. [PMID: 35264454 DOI: 10.1891/vv-d-19-00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A coordinated response by a trained multidisciplinary team (MDT) can help support child sex trafficking (CST) victims, but little is known about factors that influence the development and sustainability of MDTs in this work. An online survey was conducted with 171 professionals who attended a Multidisciplinary Team Child Sex Trafficking (MDT-CST) training to identify factors related to team growth. Increased MDT success was related to: (1) the presence of a CST-specific advocacy organization in the community; (2) other community agencies active in supporting CST victims (e.g., SANE nurses, faith-based organizations, and runaway shelters); (3) a greater breadth of professional representation on the MDT; and (4) agency leadership support for the CST action plan. Most of the MDTs sustained and increased their coordination with other community agencies over time, but the study identified that growth is improved when administrators support team efforts and there are resources and supports for CST victims elsewhere in the community.
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Affiliation(s)
- Lisa M Jones
- Crimes Against Children Research Center, University of New Hampshire
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Johnson ME, Lloyd SL, Bristol SC, Rosel G, Otufowora AA, Epps NN. Runaway History and Past 30-Day Opioid Misuse in Justice-Involved Adolescents. JUVENILE & FAMILY COURT JOURNAL 2021; 72:21-35. [PMID: 34955571 PMCID: PMC8699162 DOI: 10.1111/jfcj.12206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study used a sample from the Florida Department of Juvenile Justice (n= 79,960) to analyze the association between runaway history and past 30-day opioid misuse (OM) among justice involved adolescents. Past 30-day OM was confirmed using a urine analysis. Adolescents who were runaways in their lifetime were twice as likely to misuse opioids, and those who were runaways at the time of arrest were three times as likely to be opioid misusers compared to adolescents who never ran away or been kicked out of a home. These findings emphasize a need for resources that focus on developing strong attachment bonds.
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Affiliation(s)
- Micah E Johnson
- Department of Mental Health Law and Policy in the College of Behavioral and Community Sciences at the University of South Florida
| | | | - Skye C Bristol
- College of Behavioral and Community Sciences at the University of South Florida
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Variation in Health Among Unstably Housed Youth From Cities, Suburbs, Towns, and Rural Areas. J Adolesc Health 2021; 69:134-139. [PMID: 33342720 DOI: 10.1016/j.jadohealth.2020.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Youth face similar rates of homelessness across rural and urban areas, yet little is known about how the health of unstably housed youth varies by location. We assessed differences in health by location (city, suburb, town, and rural) and housing status among youth facing a range of unstable housing experiences. METHODS This secondary data analysis from 8th, 9th, and 11th graders completing the 2019 Minnesota Student Survey examined youth who had experienced housing instability in the prior year (n = 10,757), including running away (48%) or experiencing homelessness (staying in shelter, couch-surfing, or rough sleeping) with (42%) or without (10%) an adult family member. We conducted multifactor analysis of variance to assess differences by location (urban, suburban, town, and rural) and housing experience for each of five health indicators: suboptimal health, depressive symptoms, suicide attempts, ≥2 sexual partners, and e-cigarette use. RESULTS In main effects models, all health indicators varied based on housing status; suboptimal health, ≥2 sexual partners, and e-cigarette use also varied by location. Interaction models showed that unaccompanied homeless youth in suburbs reported poorer health compared with those in cities. Compared with suburbs, youth in towns were more likely to report ≥2 sexual partners (19.9%, 24.1%) and e-cigarette use (39.5%, 43.3%). CONCLUSIONS Our findings suggest that unstably housed youth face a similar burden of poor health across locations, with only subtle differences in health indicators, yet most research focuses on urban youth. Future research is needed to identify how to best meet the health needs of unstably housed youth across locations.
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Gewirtz O'Brien JR, Edinburgh LD, Barnes AJ, McRee AL. Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth. Pediatrics 2020; 145:peds.2019-2674. [PMID: 32152134 DOI: 10.1542/peds.2019-2674] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2019] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
| | - Laurel D Edinburgh
- Midwest Children's Resource Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota
| | - Andrew J Barnes
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; and
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; and
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8
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Gambon TB, Gewirtz O'Brien JR. Runaway Youth: Caring for the Nation's Largest Segment of Missing Children. Pediatrics 2020; 145:peds.2019-3752. [PMID: 31964756 DOI: 10.1542/peds.2019-3752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
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.
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Hutchings E, Browne KD, Chou S, Wade K. Repeat missing child reports in Wales. CHILD ABUSE & NEGLECT 2019; 88:107-117. [PMID: 30468965 DOI: 10.1016/j.chiabu.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 10/29/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND There were approximately 306,000 reports of missing persons in the UK from 2012 to 2013, 64% involved children. Repeat missing incidents account for approximately 38% of reported missing incidences. Within their research Biehal et al. (2003) identified that 70% of missing children had voluntarily left their home and the majority of these were considered to have 'run away'. Research suggests that there is heavy demand on public services in responding to children that are regularly reported missing. OBJECTIVE The purpose of this study was to explore data recorded in respect of children reported missing as a result of running away. The main objective of this study was to develop a set of risk factors to predict repeat missing incidences using a logistic regression method. PARTICIPANTS AND SETTING This study explored the characteristics of 523 children who were reported missing to Gwent (Wales) Police as a result of running away. METHODS Using data collected by the Gwent Missing Children's Team in Wales, over a one-year period, this study compared two groups of children: 275 (53%) who were reported missing once ('low risk') and 248 (47%) who were reported more than once ('high risk'). RESULTS Results indicated that five significant risk factors identified by logistic regression could distinguish outcome in 73% of cases. The five risk factors were; looked after children, substance use, suspected sexual exploitation, known to Youth Offending Services and a history of abuse/neglect. CONCLUSIONS These risk factors could potentially be used in Gwent to guide intervention strategies, with those children identified as 'high risk' of repeat missing incidents requiring more comprehensive intervention and support.
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Affiliation(s)
- Emma Hutchings
- Centre for Forensic and Family Psychology, School of Medicine, University of Nottingham, England, UK.
| | - Kevin D Browne
- Centre for Forensic and Family Psychology, School of Medicine, University of Nottingham, England, UK.
| | - Shihning Chou
- Centre for Forensic and Family Psychology, School of Medicine, University of Nottingham, England, UK
| | - Kerry Wade
- Gwent Missing Children's Team, Gwent Police, Brecon House Pontypool, Wales, UK
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10
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Holliday SB, Edelen MO, Tucker JS. Family Functioning and Predictors of Runaway Behavior Among At-Risk Youth. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2017; 34:247-258. [PMID: 28496291 PMCID: PMC5421563 DOI: 10.1007/s10560-016-0459-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Adolescent runaway behavior is associated with a host of negative outcomes in young adulthood. Therefore, it is important to understand the factors that predict running away in youth. METHODS Longitudinal data from 111 at-risk families were used to identify proximal predictors of runaway behavior over a 12-week period. On average, youth were 14.96 years old, and 45% were female. Ten percent of youth ran away during the 12-week follow-up period. RESULTS In bivariate analyses, running away was predicted by poorer youth- and parent-rated family functioning, past runaway behavior, and other problem behaviors (e.g., substance use, delinquency), but not poorer perceived academic functioning. Results of a hierarchical logistic regression revealed a relationship between youth-rated family functioning and runaway behavior. However, this effect became non-significant after accounting for past runaway behavior and other problem behaviors, both of which remained significant predictors in the multivariable model. CONCLUSION These findings suggest that youth who run away may be engaged in a more pervasive pattern of problematic behavior, and that screening and prevention programs need to address the cycle of adolescent defiant behavior associated with running away. Recommendations for clinical practice with this at-risk population are discussed.
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Lee M, Oi-Yeung Lam B, Ju E, Dean J. Part-Time Employment and Problem Behaviors: Evidence From Adolescents in South Korea. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2017; 27:88-104. [PMID: 28498539 DOI: 10.1111/jora.12258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study explores the impact of adolescent part-time work experience on problem behaviors in the South Korean context. To achieve this, propensity score matching (PSM) analyses were employed based on data from the Korean Education Employment Panel (KEEP). Results indicate that adolescents' part-time employment during their secondary school years had significantly undesirable effects on drinking and smoking, even after preexisting differences between the two groups (i.e., those adolescents who participated in part-time work and those who did not) were controlled by PSM. However, an insignificant difference was detected in the likelihood of running away from home. Implications of the results are discussed in terms of changes in the meanings of adolescence and of participating in part-time work in South Korea.
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Rew L, Powell T, Brown A, Becker H, Slesnick N. An Intervention to Enhance Psychological Capital and Health Outcomes in Homeless Female Youths. West J Nurs Res 2016; 39:356-373. [PMID: 27411974 DOI: 10.1177/0193945916658861] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Female homeless youths are vulnerable to risky sex and substance use behaviors, yet they have strengths known as psychological capital. A quasi-experimental pre-post research design with repeated measures was used to examine the feasibility and preliminary efficacy of a brief intervention to enhance psychological capital, reduce health-risk behaviors, and achieve short-term behavioral goals. Study participants were 80 ethnically diverse homeless women between the ages of 18 and 23 years. Intervention participants had significant improvements in psychological capital, hope, resilience, and self-efficacy to refuse alcohol, social connectedness, and substance use ( p < .05). There was a significant group by time interaction for safe sex self-efficacy; intervention participants had greater self-confidence in negotiating safer sex practices than comparison participants. At the follow-up post-test, 82% of intervention participants who remained in the study had met or exceeded their short-term goals. This brief, street-based intervention was feasible and showed preliminary efficacy.
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Affiliation(s)
- Lynn Rew
- 1 The University of Texas at Austin, Austin, TX, USA
| | - Tara Powell
- 2 University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Adama Brown
- 1 The University of Texas at Austin, Austin, TX, USA
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Aratani Y, Cooper JL. The Effects of Runaway-Homeless Episodes on High School Dropout. YOUTH & SOCIETY 2015; 47:173-198. [PMID: 25641997 PMCID: PMC4308975 DOI: 10.1177/0044118x12456406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This article uses data from the National Longitudinal Survey of Youth 1997 to examine the relationship between running away from home between the ages of 12 and 14 and dropping from high school among youth. Propensity score matching was conducted in estimating the effect of running away on high school dropout while controlling for confounding factors, such as familial instability and socioemotional health risks. The findings suggest that having runaway-homeless episodes have a detrimental effect on academic achievement.
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Affiliation(s)
- Yumiko Aratani
- National Center for Children in Poverty Columbia University Mailman School of Public Health, New York, NY, USA
| | - Janice L. Cooper
- The Carter Center, and Emory University Rollins School of Public Health Atlanta, GA, USA
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Sznajder-Murray B, Jang JB, Slesnick N, Snyder A. Longitudinal Predictors of Homelessness: Findings from the National Longitudinal Survey of Youth-97. JOURNAL OF YOUTH STUDIES 2015; 18:1015-1034. [PMID: 27774034 PMCID: PMC5074054 DOI: 10.1080/13676261.2015.1020930] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between the ages of 12 to 18 years. The current study examined whether individual and family risk factors reported during adolescence predict homelessness by the age of 25. The findings showed that multiple runaway episodes, non-traditional family structure, lower educational attainment, and parental work limitations due to health increased the risk of homelessness. A permissive parenting style and being Hispanic protected against homelessness. This study offers unique insight into risk and protective factors for youth homelessness, and has important clinical implications.
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Affiliation(s)
| | - Joy Bohyun Jang
- University of Michigan, 2345 ISR 426 Thompson, Ann Arbor, MI 48104,
| | - Natasha Slesnick
- The Ohio State University, 1787 Neil Ave., 135 Campbell Hall, Columbus, OH 43210, ude.uso.ehe@kcinselsn
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Dang MT. Social connectedness and self-esteem: predictors of resilience in mental health among maltreated homeless youth. Issues Ment Health Nurs 2014; 35:212-9. [PMID: 24597587 DOI: 10.3109/01612840.2013.860647] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this cross-sectional study was to explore social connectedness and self-esteem as predictors of resilience among homeless youth with histories of maltreatment. Connectedness variables included family connectedness, school connectedness, and affiliation with prosocial peers. The sample included 150 homeless youth aged 14 to 21 (mean age = 18 years) with the majority being an ethnic minority. Participants completed surveys using audio-CASI. Results revealed that youth with higher levels of social connectedness and self-esteem reported lower levels of psychological distress. When all predictor variables were controlled in the analysis, self-esteem remained significant for predicting better mental health.
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Affiliation(s)
- Michelle T Dang
- California State University-Sacramento, School of Nursing , Sacramento, California , USA
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Meltzer H, Ford T, Bebbington P, Vostanis P. Children who run away from home: risks for suicidal behavior and substance misuse. J Adolesc Health 2012; 51:415-21. [PMID: 23084161 DOI: 10.1016/j.jadohealth.2012.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 03/18/2012] [Accepted: 04/07/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE The primary aim of this study is to examine the extent to which running away from home as a child is associated with behavioral problems and victimization during childhood and with suicidal behavior and substance abuse during early adulthood. METHODS A random probability sample comprising 7,461 respondents was interviewed for the 2007 survey of psychiatric morbidity of adults in England. A subsample of 16- to 34-year-old individuals was selected for secondary analysis (N = 2,247). All survey respondents were asked whether they had run away from home and asked specific questions on being physically, emotionally and sexually abused as children. They were also asked about suicidal behavior and alcohol and drug dependence in early adulthood. RESULTS Approximately 7% of 16- to 34-year-old individuals reported running away from home before the age of 16 years, with higher rates in women than in men (9.8% compared with 5.3%). Overall, 45.3% reported being bullied, 25.3% experienced violence at home, and 8.8% reported unwanted sexual intercourse. Runaways were far more likely than other children to have suffered victimization and family difficulties and to exhibit behavioral problems. Adults who reported running away from home were three times more likely than other adults to have thought about or attempted suicide, but the relationship with substance abuse was far less pronounced. CONCLUSIONS Sexual, physical, and emotional abuse, along with family difficulties, can all impact children who run away from home. Running away from home was strongly associated with suicidal behavior in adulthood, regardless of other childhood adversities.
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Affiliation(s)
- Howard Meltzer
- Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, United Kingdom.
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Thompson SJ, Cochran G, Barczyk AN. Family functioning and mental health in runaway youth: association with posttraumatic stress symptoms. J Trauma Stress 2012; 25:598-601. [PMID: 23047596 DOI: 10.1002/jts.21744] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examined the direct effects of physical and sexual abuse, neglect, poor family communication and worries concerning family relationships, depression, anxiety, and dissociation on posttraumatic stress symptoms. Runaway youth were recruited from emergency youth shelters in New York and Texas. Interviews were completed with 350 youth who averaged 15 years of age. Structural equation modeling was used to examine family functioning, maltreatment, depression, dissociation, and anxiety in relation to posttraumatic stress symptoms. Results indicated that direct effects of family relationship worry to dissociation, β = .77, p < .001; depression, β = .85, p < .001; and anxiety, β = .90, p < .001 were significant, as were relationships between family communication and youth dissociation, β = .42, p < .001; depression, β = .46, p < .001; and anxiety, β = .32, p < .001. No significant effects of physical/sexual abuse or neglect were found. Higher levels of dissociation, β = .21, p < .001 and anxiety symptoms, β = .34, p = .01 were positively and significantly associated with posttraumatic stress symptoms, but depression was not. Findings underscore the critical role of family relationships in mental health symptoms experienced by runaway adolescents.
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Affiliation(s)
- Sanna J Thompson
- School of Social Work, University of Texas at Austin, Austin, Texas 78712, USA.
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Abstract
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.
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Thrane LE, Chen X. Impact of running away on girls’ pregnancy. J Adolesc 2012; 35:443-9. [DOI: 10.1016/j.adolescence.2011.07.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 07/01/2011] [Accepted: 07/06/2011] [Indexed: 11/26/2022]
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Waller MW, Sanchez RP. The Association Between Same-Sex Romantic Attractions and Relationships and Running Away Among a Nationally Representative Sample of Adolescents. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2011; 28:475-493. [PMID: 33737762 PMCID: PMC7967292 DOI: 10.1007/s10560-011-0242-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sexual minorities are overrepresented among the runaway population, and sexual minority runaways are at greater risk for adverse health outcomes than their heterosexual peers. Our knowledge of this vulnerable population has been restricted by methodological limitations of existing studies. This study used a nationally representative sample of U.S. adolescents to explore the association between same-sex romantic attractions and relationships and run away behavior over a two year period. Results indicated that although the association between sexual orientation and running away appears to be partially attenuated by other risk factors for running away, there remains a significant positive association between same-sex romantic attractions and running away. Furthermore, youth with no romantic or sexual relationships were significantly less likely to report running away compared to youth with only opposite-sex relationships. These associations remained significant even after controlling for other risk factors.
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Affiliation(s)
- Martha W Waller
- Pacific Institute for Research and Evaluation, Chapel Hill, NC
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Keeshin BR, Campbell K. Screening homeless youth for histories of abuse: prevalence, enduring effects, and interest in treatment. CHILD ABUSE & NEGLECT 2011; 35:401-407. [PMID: 21652074 DOI: 10.1016/j.chiabu.2011.01.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Revised: 01/25/2011] [Accepted: 01/26/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse. METHODS Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in a structured assessment of histories of abuse, tobacco use and substance abuse. RESULTS Sixty-four homeless youth in Salt Lake City, Utah completed the study, 43 males and 21 females. Eighty-four percent screened positive for childhood physical and/or sexual abuse occurring before the age of 18; 42% screened positive for both physical and sexual abuse; 72% reported still being affected by their abuse. Among all abuse victims, 44% were interested in treatment for their abuse history and 62% of homeless youth who reported still being affected by their abuse were interested in treatment. Individuals were more likely to be interested in treatment if they were female, had not completed high school or had been previously asked about family dysfunction. Many victims who declined treatment offered spontaneous insight into their decision. Interest in treatment was similar to interest in treatment for other behaviors such as smoking and substance abuse. CONCLUSIONS Histories of abuse are common among homeless youth. A majority of those reporting a history of abuse are still affected by their abuse. Interest in treatment for a history of abuse was comparable to interest in treatment for other morbidities in the homeless youth population such as tobacco use and substance abuse. Our finding that homeless youth continue to be impacted by their abuse and are interested in treatment should prompt more screening for histories of abuse.
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Affiliation(s)
- Brooks R Keeshin
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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Thrane LE, Yoder KA, Chen X. The influence of running away on the risk of female sexual assault in the subsequent year. VIOLENCE AND VICTIMS 2011; 26:816-829. [PMID: 22288098 DOI: 10.1891/0886-6708.26.6.816] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study explores the sexual risk trajectories of female youths and sheds light on the long-term effects of running away. It evaluates whether running away increases the risk of sexual assault in the following year, which is after runaways return home. The sample consists of 5,387 heterosexual females between the ages of 11 and 18 years from the Longitudinal Study of Adolescent Health. Nearly one quarter (23%) of runaways report a previous sexual assault in contrast to 5% of nonrunaways. In a logistic regression model, childhood neglect increases the risk of sexual assault between Waves 1 and 2 by nearly two times. Poor mental health is statistically significant. Alcohol use doubles the odds of sexual assault. The risk of sexual assault is approximately three-fold for girls with a history of sexual onset and sexual touching in a romantic relationship. Running away increases the risk by nearly two and a half times. There is evidence that alcohol use and sexual onset partially mediates the relationship between running away and sexual assault.
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Affiliation(s)
- Lisa E Thrane
- Wichita State University, Wichita, Kansas 67260, USA.
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Lightfoot M, Stein JA, Tevendale H, Preston K. Protective factors associated with fewer multiple problem behaviors among homeless/runaway youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2011; 40:878-89. [PMID: 22023279 PMCID: PMC4562907 DOI: 10.1080/15374416.2011.614581] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Although homeless youth exhibit numerous problem behaviors, protective factors that can be targeted and modified by prevention programs to decrease the likelihood of involvement in risky behaviors are less apparent. The current study tested a model of protective factors for multiple problem behavior in a sample of 474 homeless youth (42% girls; 83% minority) ages 12 to 24 years. Higher levels of problem solving and planning skills were strongly related to lower levels of multiple problem behaviors in homeless youth, suggesting both the positive impact of preexisting personal assets of these youth and important programmatic targets for further building their resilience and decreasing problem behaviors. Indirect relationships between the background factors of self-esteem and social support and multiple problem behaviors were significantly mediated through protective skills. The model suggests that helping youth enhance their skills in goal setting, decision making, and self-reliant coping could lessen a variety of problem behaviors commonly found among homeless youth.
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Affiliation(s)
- Marguerita Lightfoot
- Center for AIDS Prevention Studies, University of California San Francisco, CA 94105, USA.
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Tucker JS, Edelen MO, Ellickson PL, Klein DJ. Running away from home: a longitudinal study of adolescent risk factors and young adult outcomes. J Youth Adolesc 2010; 40:507-18. [PMID: 20640881 DOI: 10.1007/s10964-010-9571-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Accepted: 07/02/2010] [Indexed: 11/30/2022]
Abstract
Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at Grade 10 and/or Grade 11. Controlling for demographics and general delinquency, running away from home was predicted by lack of parental support, school disengagement, greater depressive affect, and heavier substance use at Grade 9. In turn, runaways had higher drug dependence scores and more depressive symptoms at age 21 than non-runaways, even after taking these antecedent risk factors into account. Runaway status did not predict alcohol dependence risk at age 21. Results highlight the importance of substance use and depression, both as factors propelling adolescents to run away and as important long-term consequences of running away.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
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Thrane LE, Chen X. Impact of running away on girls' sexual onset. J Adolesc Health 2010; 46:32-6. [PMID: 20123255 DOI: 10.1016/j.jadohealth.2009.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 05/01/2009] [Accepted: 05/04/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to longitudinally examine the impact of running away on sexual onset, and to determine the 12-month prevalence of sexual onset among runaway females. METHODS The sample consists of adolescent females from Waves 1 and 2 of the Longitudinal Study of Adolescent Health (N=4,564; age range=11-18 years). Voluntary or involuntary sexual onset at Wave 1 results in exclusion from the analysis. A logistic regression model is fit, which examines sociodemographic characteristics, protective factors (e.g., parental and academic bonds), and running away and other risk behaviors on sexual onset. RESULTS Our study confirms that more than one out of thee females becomes sexually active within 12 months of running away. Only 17% of females who never report a runaway episode experience sexual onset. School bonds, dating and romance, alcohol use, delinquency, and runaway behavior have main effects in the longitudinal analysis. Runaways are 1.7 times more likely to report sexual onset. CONCLUSIONS This study applies the risk amplification model to runaways in the general population. Running away is a turning point in the developmental trajectory, and puts girls at risk of sexual onset a year later compared to their nonrunaway counterparts. A multipronged approach is needed to address the sexual risk characteristics of girls who return home.
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Affiliation(s)
- Lisa E Thrane
- Department of Sociology, Wichita State University, Wichita, Kansas 67260, USA.
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Coward Bucher CE. Toward a needs-based typology of homeless youth. J Adolesc Health 2008; 42:549-54. [PMID: 18486863 DOI: 10.1016/j.jadohealth.2007.11.150] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 10/25/2007] [Accepted: 11/06/2007] [Indexed: 11/20/2022]
Abstract
PURPOSE Research on homeless youth consistently suggests a need for a broad matrix of services to facilitate a successful transition into housed society. This paper seeks to develop distinct matrices of services for youth according to their involvement in, or experience with, high-risk factors. Such a typology may increase the ability of providers to maximize the impact of scarce resources and organize treatment and reintegration efforts to match the needs of vulnerable youth. METHODS Seven risk categories were identified in the literature: abusive experiences, involvement in prostitution, involvement in criminal activities, suicidal ideation/attempt, living circumstances, alcohol/marijuana use, and the use of drugs other than alcohol and marijuana. K-means cluster analysis was then used to separate 422 homeless youth based on their involvement in or experience with these categories. RESULTS Four distinct treatment needs were identified: Group 1--minimal treatment; Group 2--therapeutic housing with an emphasis on substance abuse; Group 3--therapeutic housing with an emphasis on behavior management; Group 4--comprehensive treatment. CONCLUSIONS According to this typology, less than 18% of this sample are adequately served by the current system of federal intervention, whereas the largest group is in need of comprehensive services to successfully re-enter housed society.
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Harper GW, Davidson J, Hosek SG. Influence of gang membership on negative affect, substance use, and antisocial behavior among homeless African American male youth. Am J Mens Health 2008; 2:229-43. [PMID: 19477786 DOI: 10.1177/1557988307312555] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The current study examined differences between gang-involved and non-gang-involved homeless African American male youth with regard to negative affect, substance use, and antisocial/violent behavior. A total of 69 homeless African American young men were recruited from community agencies and completed structured face-to-face interviews. Overall, gang members reported higher rates of negative mental and physical health outcomes than did non-gang members, with current gang members reporting higher levels of depression and anxiety, greater levels of antisocial and violent behavior, and higher levels of lifetime alcohol and marijuana use. Multiple linear regression analyses revealed that greater levels of gang involvement were associated with more frequent lifetime use of alcohol and marijuana and higher levels of participation in violent behaviors. Implications of these findings for interventions with homeless African American male youth and future research directions are discussed.
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Affiliation(s)
- Gary W Harper
- DePaul University, 2219 N. Kenmore Avenue, Chicago, IL 60614, USA.
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Abstract
Adolescents from a variety of backgrounds are among the growing number of homeless Americans. Although they lack maturity and various skills, they manage to survive in dangerous and stressful environments. This article asserts that social policy that leads to services such as housing, education, and healthcare should be based on a philosophy, ethic, and theory of caring and connectedness, which have been shown to protect adolescents as they mature. The article includes brief descriptions of theories of caring, pathways to homelessness for adolescents, survival needs of homeless youth, and characteristics of service programs that incorporate caring and connectedness.
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Affiliation(s)
- Lynn Rew
- School of Nursing, The University of Texas at Austin, 1700 Red River, Austin, TX 78701, USA.
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