Transitioning Youth Out of Homelessness 2.0: A Pilot Randomized Controlled Trial of a Rent Subsidy and Identity Capital Intervention for Youth Exiting Homelessness
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Feasibility and Acceptability of the Intervention Over 12 Months (Measured by Recruitment, Enrolment, and Dropout Metrics)
研究概览
简要总结
Introduction: This 12-month pilot randomized controlled trial (RCT) built on previous community-engaged work and explored whether portable rent subsidies and an intervention targeting identity capital (purpose, control, self-efficacy, and self-esteem) hold promise as a way to facilitate socioeconomic inclusion for youth (age 16 - 24 years) exiting homelessness and living in market rent housing in Ontario, Canada. All (n = 40) participants received rent subsidies; half were randomly assigned an identity capital intervention (co-designed leadership guide + coach).
Methods and analysis: This study employed a convergent mixed methods, two-arm parallel RCT, open-label design with 1:1 allocation embedded within a Community Based Participatory Action Research framework and underpinned by Critical Social Theory.
Specifically, the objectives and measures were:
- Primary - to examine whether targeted economic and identity-based supports are a feasible and acceptable way to foster socioeconomic inclusion. Measures: recruitment/enrolment/dropout metrics; self-report composite checklists regarding intervention engagement; coaching session attendance; qualitative focus groups.
- Secondary - to assess differences between targeted economic and identity-based supports (intervention group) and economic supports only (control group) at the 12-month primary endpoint with respect to self-reported socioeconomic inclusion measures of: 1) education, employment and training (EET); 2) housing security; and 3) identity capital. Measures: self-report composite EET checklist; self-report measures of housing security and identity capital.
- Exploratory - to explore whether the estimated effect of the intervention differed by baseline variables or level of engagement with the intervention. Measures: select variables from the baseline demographic questionnaire; GAIN-Short Screener questionnaire for those in the intervention group.
Ethics and dissemination: This study received ethical approval from the Unity Health Toronto Research Ethics Board. The investigators will continue working alongside community partners - including youth with lived expertise - to disseminate findings broadly and in diverse formats.
详细描述
The overarching aim of this mixed methods study was to determine the feasibility and acceptability of a strengths-based intervention focused on building identity capital, as a way to facilitate socioeconomic inclusion for youth (age 16 - 24 years) exiting homelessness and living in market rent housing.
Specifically, the objectives were to:
- Primary - examine the feasibility and acceptability of a RCT of targeted economic and identity-based supports to foster socioeconomic inclusion.
- Secondary - estimate the effect of adding identity-based supports to economic supports (intervention group) compared with economic supports alone (control group) at the 12-month endpoint with respect to self-reported proxy indicators of socioeconomic inclusion.
- Exploratory - among the intervention group, explore whether the estimated effect of the intervention differs by baseline variables or level of engagement with the intervention.
This pilot study employed a convergent mixed methods (quantitative and qualitative data collected concurrently and the findings combined), two-arm parallel RCT (participants randomly assigned to either the intervention or control group), open-label (participants and research team aware of random assignment) design with 1:1 allocation (equal number of participants in each study arm) embedded within a CBPAR framework.
The study was conducted collaboratively with four community partners who serve youth who are experiencing or have experienced homelessness: 1) Covenant House Toronto (Toronto, ON); 2) Living Rock (Hamilton, ON); 3) The RAFT (St. Catharines, ON); and 4) StepStones for Youth (Toronto, ON). Study participants were recruited from the cities in which our community partners are located: Toronto, ON (Greater Toronto Area population 6.7 million); Hamilton, ON (population 785,000); and St. Catharines, ON (St. Catharines-Niagara population 416,000).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 24 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Eligible young people ages 16 - 24 years who have left homelessness within the past 12 months and are currently living or planning to live in market rent housing will be identified by the community partners. This age mandate was chosen because this is the age group served by the community partners. The investigators have chosen to target the first year of exiting homelessness because their collective experience has shown that this is a particularly precarious time for youth in terms of mental health challenges and risk of returning to homelessness.
- •Inclusion Criteria:
- •Be able to provide free and informed consent.
- •Be able to understand English (intervention and data collection will be conducted in English).
- •Have experienced homelessness (e.g., all non-parental and unstable housing arrangements including shelter stays, couch surfing, and time-limited housing) in the past 12 months.
- •Be willing to actively participate in the intervention (co-designed leadership program + coach) if randomized to this arm.
排除标准
- •In imminent danger of losing their housing and not able to utilize the rent subsidy to sustain market rent housing.
- •Currently receiving rent subsidies.
- •Enrolled in a program or study with similar features to the TYOH 2.0 intervention.
研究组 & 干预措施
Portable Rent Subsidies + Identity Capital Intervention
Young people randomized to the intervention group will receive 12 months of: portable rent subsidies, engage in a co-designed leadership guide, and be assigned a coach (one coach/10 youth).
干预措施: Identity Capital Intervention (Coach + Co-designed Leadership Guide) (Behavioral)
Portable Rent Subsidies + Identity Capital Intervention
Young people randomized to the intervention group will receive 12 months of: portable rent subsidies, engage in a co-designed leadership guide, and be assigned a coach (one coach/10 youth).
干预措施: Monthly Rent Subsidies (Other)
Portable Rent Subsidies Only
The control group will be offered 12 months of portable rent subsidies.
干预措施: Monthly Rent Subsidies (Other)
结局指标
主要结局
Feasibility and Acceptability of the Intervention Over 12 Months (Measured by Recruitment, Enrolment, and Dropout Metrics)
时间窗: Assessed at baseline and 12-months.
To examine intervention feasibility and acceptability, quantitative measures consisting of recruitment/enrolment/dropout metrics will be utilized. Recruitment rate will be estimated as the proportion of contacted individuals who express interest in participating in the study. The enrollment rate will be calculated as the proportion of recruited individuals who are eligible and consent to participate in the study. Dropout rates will be separately calculated for intervention and control groups at the end of the study as the 1 - proportion of randomized participants who completed the study at 12 months. Exact (Clopper-Pearson) 95% confidence limits will also be calculated.
Feasibility and Acceptability of the Intervention Over 12 Months (Informed by Qualitative Data From Focus Groups)
时间窗: Assessed at 4-months, 8-months, and 12-months.
We conducted focus groups with intervention (rent subsidy + identity capital intervention) participants. Focus group questions explored intervention feasibility and acceptability. Focus group data from all time points was analyzed together.
Feasibility and Acceptability of the Intervention Over 12 Months (Measured by Coaching Session Attendance Over 12 Months)
时间窗: Assessed at 12-months.
Feasibility and acceptability of the coaching component of the identity capital intervention was assessed by coaching session attendance, as recorded by coaches. Overall coaching session attendance was measured as the percentage of total possible coaching sessions attended over the 12-month period (maximum 24 sessions).
Feasibility and Acceptability of the Intervention Over 12 Months (Measured by the Intervention Engagement Questionnaire)
时间窗: Assessed at 4-months, 8-months, and 12-months.
Feasibility and acceptability of the co-designed leadership guide component of the identity capital intervention was assessed using the Intervention Engagement Questionnaire (self-report measure was developed for this study and administered only to intervention participants).
次要结局
- Change From Baseline to 12 Months in Housing Security (Measured by the Housing Security Scale) (Continuous Outcomes)(Assessed at baseline, 4-months, 8-months, and 12-months. Baseline and 12-month scores reported.)
- Change From Baseline to 12 Months in Identity Capital (Measured by the Multi-Measure Agentic Personality Scale)(Assessed at baseline, 4-months, 8-months, and 12-months. Baseline and 12-month data reported.)
- Change in Employment, Education, or Training From Baseline to 12 Months (Assessed by a Questionnaire)(Assessed at baseline and 12-months.)
- Change From Baseline to 12 Months in Housing Security (Measured by the Housing Security Scale) (Binary Outcomes)(Assessed at baseline, 4-months, 8-months, and 12-months. Baseline and 12-month data reported.)