Transitioning youth out of homelessness 2.0: A pilot randomized controlled trial of a rent subsidy and identity capital intervention for youth exiting homelessness

Complete

Child and Youth Health

Homelessness and Housing

This study builds on our first Transitioning Youth Out of Homelessness (TYOH) project––a 2.5-year pilot study (2019 – 2022) that provided portable rent subsidies (young people could choose where they lived) and mentors for 24 months to young people who had experienced homelessness. In that study, we found that identity capital––a sense of purpose, control, self-efficacy, and self-esteem––and “coach-like” relationships (informal mentors outside our study) seemed to play important roles in facilitating social and economic inclusion.

Can bolstering identity capital help mediate meaningful socioeconomic inclusion?

In TYOH 2.0, we worked with the same community partners from our last project to design a similar study, but with one difference: this time, we focused on enhancing identity capital.

We started the project in June 2022 by co-developing a 78-page leadership guide with 12 young people who had experienced homelessness. The guide contained 12 chapters, with topics ranging from understanding core values to establishing daily routines. Several of the youth who took part in the co-design process were participants in our last study.

In collaboration with three youth advisors (participants from our last study), we hired two individuals with their own coaching practices outside the homelessness sector to be our study coaches. Each coach was assigned a caseload of 10 youth and instructed to try and meet one-on-one with study participants (virtually or in-person) every other week for 12 months. We enlisted the support of Dr. Haesun Moon of the Canadian Centre for Brief Coaching to help mentor the study coaches.

In March 2023, we began enrolling our first study participants. Each participant remained in the study for one year. In total, 40 young people received portable rent subsidies; 20 were randomly assigned to also receive coaching and the co-designed leadership guide.

All participants completed quantitative questionnaires every four months for one year. The questionnaires were selected to assess proxy indicators of socioeconomic inclusion (education, employment and training; housing security; identity capital). Additionally, Dr. Naomi Thulien and research team member Mardi Daley—a peer engagement specialist with lived expertise of homelessness—conducted focus groups every four month with participants assigned to coaching and leadership guide engagement. Data collection concluded in June 2024.

Key Findings

Our main objective was to assess the feasibility and acceptability of the pilot intervention (rent subsidies + coaching/leadership guide). The intervention was deemed feasible with minimal recruitment-related challenges and a 90% (18 of 20) retention rate.

Acceptability was mixed but in favor of the coaching aspect of the intervention. Overall, 60% of intervention participants attended at least 50% of the bi-weekly coaching sessions over the course of 12 months. Of those, 92% attended 70% or more of the sessions. On the flip side, 40% of participants showed minimal interest, attending only 30% or less of the coaching sessions (attendance records from the two youth who dropped out are also included in this calculation). In terms of leadership guide engagement, young people told us early on that, while they thought the guide was a good idea, it was hard to engage with independently due to multiple factors, including competing demands on their time.

We found no differences between the intervention group and the control group (rent subsidies only) in any of the proxy indicators of socioeconomic inclusion at 12 months. It is important to note that we used the gold standard “intention-to-treat” analysis, meaning data from all 40 participants—even those who dropped out/participated very little in the intervention—was included. This type of analysis can sometimes make it challenging to show improvement, especially with a small number of participants.

Exploratory analysis with the intervention group data showed there were positive correlations between coaching engagement and identity capital at 12 months, with the strongest correlation noted in the self-efficacy sub-scale. In other words, as coaching engagement went up, so did identity capital (especially self-efficacy). Interestingly, participants who scored higher on the control sub-scale of identity capital at the start of the study were less likely to engage in coaching.

Young people who attended the focus group sessions were mostly those quite engaged in coaching, and they helped provide context and nuance to our quantitative data. Youth highlighted the demanding realities of navigating housing insecurity, financial responsibilities, and mental health challenges, alongside the complex expectations of entering adulthood. They also described how coaching and rent subsidies helped create space for self-improvement and self-compassion, boosting their confidence in their ability to (re)imagine and achieve their goals.

Next Steps

With each pilot study, our team is learning important lessons on how to help young people transitioning out of homelessness achieve socioeconomic inclusion.

Portable rent subsidies have been a consistent feature in our studies and are significantly less costly than the average cost of a shelter bed or transitional housing. They also promote youth choice and agency. Our goal is to bolster these economic supports through an intervention that also incorporates employment.

Because of the limited uptake on the leadership guide, we began working with our youth advisors and study coaches in April 2024 to adapt the guide and create a four-week, in-person leadership program to determine whether this new format would be more effective. We also adapted the content to align with the Ontario Ministry of Education high school learning competencies for consideration of high school credits. The program ran from July – August 2024 with a new group of young people, and we intended to use these findings to help design our next study.

Given promising signals from the correlation data on coaching engagement and positive feedback from the focus groups, we believe coaching holds promise as a way to enhance identity capital (especially self-efficacy) and socioeconomic inclusion. We have learned a lot from study participants about how to better assess coaching readiness and fit for our next study.

Since September 2024, our team has been in the early stages of developing a comprehensive initiative that incorporates economic supports (e.g., portable rent subsidies and meaningful employment), social supports (e.g., community case worker with focus on connecting youth to supports outside the homelessness sector), and identity capital supports (e.g., coaching and leadership program) for youth transitioning out of homelessness.

This new project is titled SEED CHANGE: Supporting Social & Economic Equity, Disrupting Cycles of Homelessness, And Nurturing Growth & Empowerment. The aim of this five-year initiative is to work with our youth advisors and community partners to develop and test a model that can be scaled-up across Canada.

Child and Youth Health

Homelessness and Housing

Dr. Naomi Thulien

Dr. Naomi Thulien is a nurse practitioner and researcher committed to working with the community – especially young people with lived expertise – to tackle the social and structural inequities that cause and perpetuate youth homelessness. She has a keen interest in critical qualitative research and community-based participatory action research methodology.

Investigators

  • Cheryl Pedersen
  • Dr. Alex Abramovich (Centre for Addiction and Mental Health)
  • Dr. Bernice Downey (McMaster University)
  • Dr. Tyler Frederick (Ontario Tech University)
  • Dr. Nicole Kozloff (Centre for Addiction and Mental Health)
  • Dr. Amanda Noble (Covenant House Toronto)
  • Dr. Marsha Rampersaud (York University)
  • Dr. Ruth Rodney (York University)

Staff

  • Alex Akdikmen (Research Assistant)
  • Alexandra Amiri (Research Coordinator)
  • Alexandra Carasco (Research Coordinator)
  • Pruthuvie Chandradhas (Research Assistant)
  • Mardi Daley (Research Coordinator)
  • Oluwapelumi (Pukky) Fambegbe (Research Assistant)
  • Giulia Puinean (Research Coordinator)
  • Rowen Stark (Research Coordinator)
  • Tadios Tibebu (Research Coordinator)

Funders

  • Canadian Institutes of Health Research
  • Home Depot Canada Foundation
  • Making the Shift (funded by the Government of Canada’s Networks of Centres of Excellence program)
  • St. Michael’s Hospital Foundation
  • Staples Canada

Collaborators

  • Covenant House (Toronto)
  • Living Rock (Hamilton)
  • RAFT (St. Catharines)
  • StepStones for Youth (Toronto)

Contact Info

Dr. Naomi Thulien

Principal Investigator

MAP's Survey Research Unit supported this project.

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