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
- Change in intervention feasibility and acceptability as assessed by recruitment/enrolment/dropout metrics from baseline to 12-months.
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
- •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.
结局指标
主要结局
Change in intervention feasibility and acceptability as assessed by recruitment/enrolment/dropout metrics from baseline to 12-months.
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.
Change in intervention feasibility and acceptability as assessed by the Intervention Engagement Questionnaire from 4-months to 12-months, and coaching session attendance measured across the entire 12-month period.
时间窗: Assessed at 4-months, 8-months, and 12-months.
Initially, the study was designed to assess changes in intervention feasibility and acceptability using the Intervention Engagement Questionnaire. This five-item self-report measure was developed for this study and explores engagement with the co-designed leadership guide and coaching (administered only to intervention participants). Higher scores indicate greater engagement. However, as the study progressed, we shifted focus to coaching session attendance, as recorded by coaches. Among those in the intervention group, acceptability was measured as the percentage of coaching sessions attended over the 12-month period, out of a maximum of 24 sessions. This provides an objective measure of participant engagement, as self-reported engagement data is not included in the analysis.
Intervention feasibility and acceptability as informed by focus groups from 4-months to 12-months.
时间窗: Assessed at 4-months, 8-months, and 12-months.
Focus group questions explored intervention feasibility and acceptability.
次要结局
- Mean change from baseline in housing security as measured by the Housing Security Scale at 12-months.(Assessed at baseline, 4-months, 8-months, and 12-months.)
- Mean change from baseline in identity capital as measured by the Multi-Measure Agentic Personal Scale (MAPS20) at 12-months.(Assessed at baseline, 4-months, 8-months, and 12-months.)
- Change in employment, education, and training as assessed by a questionnaire from baseline to 12-months.(Assessed at baseline and 12-months.)