Tackling exclusion: A pilot mixed method quasi-experimental identity capital intervention for young people exiting homelessness

Stephen W Hwang,Ri Wang,Caitlin Mathewson,Naomi S Thulien,Matthew Morton,Andrea Wang

doi:10.1371/journal.pone.0256288

Abstract

BackgroundLongitudinal studies examining the life trajectories of young people after they have exited homelessness have identified concerns with persistent social and economic exclusion, struggles to shake off identities of homelessness, and housing instability. This pilot study sought to explore the feasibility of improving socioeconomic inclusion outcomes by bolstering identity capital (sense of purpose and control, self-efficacy and self-esteem) among young people who had experienced homelessness.MethodsNineteen individuals (aged 18–26) who had transitioned out of homelessness within the past three years participated in a six-week, six-session program focused on building identity capital. The study employed a mixed method prospective cohort hybrid design with an intervention group (Group One) and a delayed intervention comparison group (Group Two). Participants were interviewed every three months until nine months post-intervention.ResultsNone of the youth who began the intervention dropped out of the program, with the exception of one participant who moved across the country and was unable to continue. Immediately after participating in the intervention, Group One had statistically significant improvements (p < .05) and large to very large effect sizes in self-esteem (d = 1.16) and physical community integration (d = 1.79) compared to changes in Group Two over the same period, which had not yet begun the intervention. In the pooled analysis, small to moderate effect sizes in hopelessness, physical community integration, and self-esteem were observed at all post-intervention time points. Notably, at six- and nine-months post-intervention, statistically significant improvements (p < .05) and moderate effect sizes in hopelessness (d = -0.73 and d = -0.60 respectively) and self-esteem (d = 0.71 and d = 0.53 respectively) were observed. Youth shared they appreciated the normalizing (vs. pathologizing) of strategies they needed to learn and spoke of the importance of framing new skills as something one needs “to have a better life” vs. “to get better.”ConclusionsThese early findings signal that targeting identity capital is feasible and may be a promising approach to incorporate into a more complex intervention that includes housing, education, and employment supports to help youth transition out of homelessness. Future research could build on these findings through a sufficiently powered randomized controlled trial.

Highlights

A great deal is known about the social structural inequities associated with young people entering and remaining entrenched in homelessness, but much less about how to sustain transitions off the streets and facilitate meaningful socioeconomic inclusion [1,2,3,4]
None of the youth who began the intervention dropped out of the program, with the exception of one participant who moved across the country and was unable to continue
At six- and nine-months postintervention, statistically significant improvements (p < .05) and moderate effect sizes in hopelessness (d = -0.73 and d = -0.60 respectively) and self-esteem (d = 0.71 and d = 0.53 respectively) were observed. Youth shared they appreciated the normalizing of strategies they needed to learn and spoke of the importance of framing new skills as something one needs “to have a better life” vs. “to get better.”. These early findings signal that targeting identity capital is feasible and may be a promising approach to incorporate into a more complex intervention that includes housing, education, and employment supports to help youth transition out of homelessness

Summary

Introduction

A great deal is known about the social structural inequities associated with young people entering and remaining entrenched in homelessness (e.g., intergenerational poverty, childhood abuse, inadequate education, and limited employment opportunities), but much less about how to sustain transitions off the streets and facilitate meaningful socioeconomic inclusion [1,2,3,4]. Key principles of the recovery-oriented approach embedded in Housing First include fostering a sense of hope, focusing on strengths, affirming self-determination, supporting social inclusion and advocacy on the social determinants of health, respect for diversity (e.g., racial and gender identity), and workforce development and planning [15]. In keeping with these concerns, the authors of the aforementioned Housing First study with six-year outcome data, suggest a more targeted recovery-oriented approach may be warranted [12]. This pilot study sought to explore the feasibility of improving socioeconomic inclusion outcomes by bolstering identity capital (sense of purpose and control, self-efficacy and self-esteem) among young people who had experienced homelessness

Objectives

Results

Conclusion