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

Abstract

Background: Longitudinal 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.

Methods: Nineteen 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.

Results: 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. 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."

Conclusions: 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. Future research could build on these findings through a sufficiently powered randomized controlled trial.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow of participation and analysis: The Identity Project.

1 Assessment of eligibility and enrollment continued while Group One began the intervention (no randomized assignment). 2 To compare six weeks of intervention (Group One) with six weeks of no intervention (Group Two), we conducted two baseline interviews with Group Two: one at initial study enrollment (T0a; mid-June–mid-July 2018 [rolling recruitment/enrolment]), and one six weeks later (T0b; late July–late August 2018 [second interview date dependent on date of initial enrolment/interview to ensure a six-week span between T0a and T0b]). 3 After Group Two received the same six-week, six-session intervention, Group One and Group Two participants (n = 19) were pooled and a single-arm study design was chosen to examine pre-post intervention changes during follow-up.

Fig 2. Equitable socioeconomic inclusion framework for youth experiencing homelessness.

(Framework modified from the World Health Organization conceptual framework for action on the social determinants of health [23]).