Evaluating the Effects of a Rent Subsidy and Mentoring Intervention for Youth Transitioning Out of Homelessness: Protocol for a Mixed Methods, Community-Based Pilot Randomized Controlled Trial

Naomi S Thulien, Nicole Kozloff, Elizabeth McCay, Rosane Nisenbaum, Andrea Wang, Stephen W Hwang, Naomi S Thulien, Nicole Kozloff, Elizabeth McCay, Rosane Nisenbaum, Andrea Wang, Stephen W Hwang

Abstract

Background: Although the risk factors associated with young people entering and becoming entrenched in street life have been thoroughly investigated, peer-reviewed evidence is scarce to nonexistent for rigorous interventions targeting social integration outcomes for young people who have experienced homelessness. From the limited research that has been done, emerging evidence signals that, although structural supports such as subsidized housing and social service providers are important, these resources alone are insufficient to help young people integrate into the mainstream society.

Objective: The overarching aim of this study is to assess whether and how rent subsidies and mentorship influence social integration outcomes for formerly homeless young people living in market rent housing in 3 Canadian cities. The primary outcome measures for this study are community integration (psychological and physical) and self-esteem at 18 months. Secondary outcomes include social connectedness, hope, and academic and vocational participation at 18 months. Exploratory outcomes include income, perceived housing quality, engulfment, psychiatric symptoms, and participant perspectives of intervention barriers and facilitators.

Methods: This is a convergent mixed methods, open-label, 2-arm parallel randomized controlled trial (RCT) with 1:1 allocation embedded within a community-based participatory action research (CBPAR) framework. The intervention will provide 24 young people (aged 16-26 years), who have transitioned out of homelessness and into market rent housing within the past year, with rent subsidies for 24 months. Half of the young people will also be randomly assigned an adult mentor who has been recruited and screened by 1 of our 3 community partners. Data collection will occur every 6 months, and participants will be followed for 30 months.

Results: Ethical approval for this study has been obtained from the Providence, St Joseph's, and St Michael's Healthcare Research Ethics Board (number 18-251). Enrollment took place from April 2019 to September 2019. Preliminary analysis of the baseline quantitative and qualitative data is underway.

Conclusions: This pilot RCT will be the first to test the impact of economic and social support on meaningful social integration for formerly homeless young people living in market rent housing. We believe that the mixed methods design will illuminate important contextual factors that must be considered if the intervention is to be scaled up and replicated elsewhere. Importantly, the CBPAR framework will incorporate the perspectives of the community, including formerly homeless young people, who are in the best position to determine what might work best in the context of their lives.

Trial registration: Clinicaltrials.gov NCT03779204; https://ichgcp.net/clinical-trials-registry/NCT03779204.

International registered report identifier (irrid): DERR1-10.2196/15557.

Keywords: community integration; homeless youth; housing; mentorship; qualitative research; randomized controlled trial.

Conflict of interest statement

Conflicts of Interest: None declared.

©Naomi S Thulien, Nicole Kozloff, Elizabeth McCay, Rosane Nisenbaum, Andrea Wang, Stephen W Hwang. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.12.2019.

Figures

Figure 1
Figure 1
Consolidated standards of reporting trials’ diagram of ideal flow of participants through the study. The quantitative measures (QT) completed with all participants will comprise 6 standardized measures to assess community integration, self-esteem, social connectedness, hope, engulfment, and psychiatric symptoms. In addition, participants will complete 2 brief questionnaires pertaining to: (1) education (includes skills training), employment, and income and (2) perceived housing quality. The qualitative measures (QL) will comprise one-on-one semistructured interviews with the same 12 participants. The interview questions will explore the participant’s perspectives of the intervention and provide context to the quantitative responses.

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