Publications by authors named "Kimberly Bender"

54 Publications

Revictimization Patterns Among Unhoused Youth.

J Interpers Violence 2021 Jul 1:8862605211028302. Epub 2021 Jul 1.

University of Denver, CO, USA.

Young people experiencing houselessness are at high risk for revictimization. As has been identified in other populations, symptoms of psychological distress may be an indirect pathway by which initial victimization may increase risk for later revictimization among youth experiencing houselessness. The current study used cross-sectional mediation analyses to examine the hypothesis that there would be an indirect effect of interpersonal victimization that occurred before young people left home on subsequent victimization while experiencing houselessness, through posttraumatic stress disorder (PTSD) and depression symptoms. Youth ( = 245) residing in a shelter provided responses during an in-person interview screening prior to participating in a larger clinical study. Relevant to the current study, youth reported victimization experiences before and after leaving home (Childhood Trauma and Juvenile Victimization Questionnaires, respectively), and PTSD and depression symptoms on the Mini International Neuropsychiatric Interview. Results replicated and extended previous findings determining high rates of victimization among houseless young people both before (92%) and after (75%) leaving home. Further, exposure to more types of childhood victimization significantly predicted likelihood of experiencing more types of victimization after leaving home. Significant indirect effects of childhood victimization risk on revictimization after leaving home were found, occurring through both PTSD and depression symptoms. Results are discussed in terms of existing theories of revictimization, with particular emphasis on the state-dependence theory of victimization. These findings have implications for intervention with young people experiencing houselessness, particularly with regard to addressing the consequences of childhood victimization and trauma-informed support systems.
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http://dx.doi.org/10.1177/08862605211028302DOI Listing
July 2021

Understanding the Correlates of Firearm Violence Involvement Among Young Adults Experiencing Homelessness: A 7-City Study.

Am J Prev Med 2021 May 2. Epub 2021 May 2.

USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California.

Introduction: Young adults experiencing homelessness are vulnerable to firearm violence. This study aims to explore the correlates of firearm violence involvement among this vulnerable population, which may inform firearm violence reduction intervention development.

Methods: Between 2016 and 2017, young adults experiencing homelessness aged 18-26 years (N=1,426) were recruited in 7 U.S. cities. Respondents completed a self-administered computer-assisted anonymous survey regarding their homeless experiences and violence involvement. Separate multivariate logistic regression models were conducted in 2020 to explore the correlates of direct firearm violence victimization, witness of firearm violence, and firearm violence perpetration.

Results: A high proportion of young adults experiencing homelessness were involved in firearm violence (witnessing firearm violence: 40%; direct firearm violence victimization: 28%; perpetration: 18%). Stressful experiences, such as childhood trauma and street victimization, were associated with greater odds of firearm violence involvement. Black (OR=2.4, p<0.001) and Latinx (OR=2.0, p<0.05) young adults had greater odds of experiencing direct firearm violence victimization than White young adults. Black (OR=2.0, p<0.01) and Latinx (OR=2.4, p<0.001) young adults were also at greater risk of witnessing firearm violence. Young adults with mental illness had greater odds of being directly victimized by firearm violence (OR=1.7, p<0.01).

Conclusions: Given the inter-related nature of firearm violence involvement and given that risk factors for violence are often embedded in social and structural contexts, multipronged community-based approaches to prevent firearm violence among young adults experiencing homelessness are necessary. Targeted efforts may be indicated to attenuate the risk and promote resilience among subgroups of young adults experiencing homelessness who are disproportionately affected by firearm violence.
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http://dx.doi.org/10.1016/j.amepre.2021.02.016DOI Listing
May 2021

The intersection of housing and mental well-being: Examining the needs of formerly homeless young adults transitioning to stable housing.

SSM Popul Health 2021 Jun 12;14:100775. Epub 2021 Mar 12.

University of Denver, Graduate School of Social Work, 2148 S. High Street Denver, CO, 80208, USA.

We examine the challenges formerly homeless young adults (FHYAs) face after they transition out of homelessness. Considering the adversities FHYAs face, it is unclear how transitioning to stable housing may affect their mental well-being or what types of stressors they may experience once housed. This study investigates the social environment young adults encounter in their transition to stable housing and examines trauma and social coping predictors of mental health symptoms in a sample of FHYAs to generate new knowledge for better intervening to meet their needs. Data were obtained from REALYST, a national research collaborative comprised of interdisciplinary researchers investigating young adults' (ages 18-26) experiences with homelessness. Cross-sectional data for 1426 young adults experiencing homelessness were collected from 2016 to 2017 across seven cities in the United States (i.e., Los Angeles, Phoenix, Denver, Houston, San Jose, St. Louis, and New York City). The analytical sub-sample for this study consisted of 173 FHYAs who were housed in their own apartment (via voucher from Housing and Urban Development or another source) or in transitional living programs during their participation in the study. Ordinary Least Squares regression was used to examine the influence of trauma and social coping strategies on indicators of mental well-being. Findings indicated that higher adversity scores and higher mental health help-seeking intentions were positively associated with higher levels of stress, psychological distress, and depression severity. Higher level of social coping was associated with lower levels of depression severity. Logistic regression results showed that young adults with higher adversity scores had higher odds of reporting clinical levels of post-traumatic symptoms. The study implications suggest that FHYAs who transition to stable housing continue to need support navigating and coping with stressful life events; and interventions that help FHYAs develop strong networks of social supports are needed to promote positive mental well-being.
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http://dx.doi.org/10.1016/j.ssmph.2021.100775DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005844PMC
June 2021

Making power explicit: Using values and power mapping to guide power-diverse Participatory Action Research processes.

J Community Psychol 2021 03 10;49(2):266-282. Epub 2020 Oct 10.

Colorado Coalition for the Homeless, Denver, Colorado, USA.

Aims: Participatory action research (PAR) is a research methodology that uses collective and endemic knowledge to inform action and address social concerns. The aim of this study was to understand how one PAR team (comprised of university and community researchers) navigated power dynamics, especially considering the team's power differentials.

Methods: Drawing upon phenomenological and case study methodologies, this qualitative study used loosely structured interviews and journaling with all members of the PAR team (N = 5) to explore explored how the team navigated power throughout the PAR process.

Findings: This study found that PAR team members navigated the PAR process using values as a constant guide, especially in negotiating power and resource realities and when distinguishing equity from equality.

Conclusion: This paper offers a set of power and values mapping practices which may guide power-diverse PAR teams by addressing power and values realities in their own unique and contextually bound PAR processes.
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http://dx.doi.org/10.1002/jcop.22456DOI Listing
March 2021

Making power explicit: Using values and power mapping to guide power-diverse Participatory Action Research processes.

J Community Psychol 2021 03 10;49(2):266-282. Epub 2020 Oct 10.

Colorado Coalition for the Homeless, Denver, Colorado, USA.

Aims: Participatory action research (PAR) is a research methodology that uses collective and endemic knowledge to inform action and address social concerns. The aim of this study was to understand how one PAR team (comprised of university and community researchers) navigated power dynamics, especially considering the team's power differentials.

Methods: Drawing upon phenomenological and case study methodologies, this qualitative study used loosely structured interviews and journaling with all members of the PAR team (N = 5) to explore explored how the team navigated power throughout the PAR process.

Findings: This study found that PAR team members navigated the PAR process using values as a constant guide, especially in negotiating power and resource realities and when distinguishing equity from equality.

Conclusion: This paper offers a set of power and values mapping practices which may guide power-diverse PAR teams by addressing power and values realities in their own unique and contextually bound PAR processes.
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http://dx.doi.org/10.1002/jcop.22456DOI Listing
March 2021

Making power explicit: Using values and power mapping to guide power-diverse Participatory Action Research processes.

J Community Psychol 2021 03 10;49(2):266-282. Epub 2020 Oct 10.

Colorado Coalition for the Homeless, Denver, Colorado, USA.

Aims: Participatory action research (PAR) is a research methodology that uses collective and endemic knowledge to inform action and address social concerns. The aim of this study was to understand how one PAR team (comprised of university and community researchers) navigated power dynamics, especially considering the team's power differentials.

Methods: Drawing upon phenomenological and case study methodologies, this qualitative study used loosely structured interviews and journaling with all members of the PAR team (N = 5) to explore explored how the team navigated power throughout the PAR process.

Findings: This study found that PAR team members navigated the PAR process using values as a constant guide, especially in negotiating power and resource realities and when distinguishing equity from equality.

Conclusion: This paper offers a set of power and values mapping practices which may guide power-diverse PAR teams by addressing power and values realities in their own unique and contextually bound PAR processes.
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http://dx.doi.org/10.1002/jcop.22456DOI Listing
March 2021

Human Papillomavirus Vaccination Initiation and Completion among Youth Experiencing Homelessness in Seven U.S. Cities.

Prev Sci 2020 10;21(7):937-948

School of Social Work, Arizona State University, Phoenix, AZ, USA.

Little is known about human papillomavirus (HPV) vaccination uptake among youth experiencing homelessness (YEH), who may be at higher risk for HPV than their housed counterparts. We examined the prevalence and associations of HPV vaccination initiation and completion among YEH. Guided by the Behavioral Model for Vulnerable Populations, we analyzed cross-sectional data collected from YEH (N = 1074; ages 18-26) in seven U.S. cities to assess HPV vaccination prevalence and to identify predisposing, enabling, and need factors associated with HPV vaccination status. Due to timing differences in the release of HPV vaccine recommendations, we conducted separate logistic regression analyses for men (n = 673) and women (n = 401). Approximately 19% of men and 37% of women had initiated and completed HPV vaccination. Several factors among men (i.e., older age, Latinx ethnicity, San Jose or St. Louis residence compared with New York City, never having had sex, and not previously being tested for STIs) and women (i.e., lower education level, San Jose or Houston residence compared with New York City, and never having had sex) were associated with lower odds of HPV vaccination initiation, completion, or both. Gay men had higher odds of initiating and completing the vaccination series than their heterosexual counterparts. Our findings reveal that HPV vaccination uptake is low among YEH and that there are vaccination disparities among subgroups of YEH. HPV vaccination strategies and resources that are easy-to-understand, facilitate point-of-care services, and address societal and system-level vaccination barriers encountered by YEH are needed.
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http://dx.doi.org/10.1007/s11121-020-01131-5DOI Listing
October 2020

Human Papillomavirus Vaccination Initiation and Completion among Youth Experiencing Homelessness in Seven U.S. Cities.

Prev Sci 2020 10;21(7):937-948

School of Social Work, Arizona State University, Phoenix, AZ, USA.

Little is known about human papillomavirus (HPV) vaccination uptake among youth experiencing homelessness (YEH), who may be at higher risk for HPV than their housed counterparts. We examined the prevalence and associations of HPV vaccination initiation and completion among YEH. Guided by the Behavioral Model for Vulnerable Populations, we analyzed cross-sectional data collected from YEH (N = 1074; ages 18-26) in seven U.S. cities to assess HPV vaccination prevalence and to identify predisposing, enabling, and need factors associated with HPV vaccination status. Due to timing differences in the release of HPV vaccine recommendations, we conducted separate logistic regression analyses for men (n = 673) and women (n = 401). Approximately 19% of men and 37% of women had initiated and completed HPV vaccination. Several factors among men (i.e., older age, Latinx ethnicity, San Jose or St. Louis residence compared with New York City, never having had sex, and not previously being tested for STIs) and women (i.e., lower education level, San Jose or Houston residence compared with New York City, and never having had sex) were associated with lower odds of HPV vaccination initiation, completion, or both. Gay men had higher odds of initiating and completing the vaccination series than their heterosexual counterparts. Our findings reveal that HPV vaccination uptake is low among YEH and that there are vaccination disparities among subgroups of YEH. HPV vaccination strategies and resources that are easy-to-understand, facilitate point-of-care services, and address societal and system-level vaccination barriers encountered by YEH are needed.
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http://dx.doi.org/10.1007/s11121-020-01131-5DOI Listing
October 2020

Gaps in Sexual Assault Health Care Among Homeless Young Adults.

Am J Prev Med 2020 02 16;58(2):191-198. Epub 2019 Dec 16.

Graduate School of Social Work, University of Denver, Denver, Colorado.

Introduction: Young adults experiencing homelessness are at increased risk for sexual assault. Receiving a post-sexual assault examination has important implications for HIV and unintended pregnancy prevention; yet, utilization is not well understood. In a population at elevated risk for HIV, unintended pregnancy, and sexual violence, identifying barriers and facilitators to post-sexual assault examination is imperative.

Methods: As part of a large, multisite study to assess youth experiencing homelessness across 7 cities in the U.S, a cross-sectional survey was conducted between June 2016 and July 2017. Data were analyzed in 2019 to determine the prevalence and correlates of sexual violence and examine the correlates of post-sexual assault examination utilization.

Results: Respondents (n=1,405), aged 18-26 years, were mainly youth of color (38% black, 17% Latinx) and identified as cisgender male (59%) and lesbian, gay, bisexual, or queer (29%). HIV risks were high: 23% of participants had engaged in trade sex, 32% had experienced sexual assault as a minor, and 39% had experienced sexual exploitation. Young adults reported high rates of sexual assault (22%) and forced sex (24%). Yet, only 29% of participants who were forced to have sex received a post-sexual assault examination. Latinx young adults were more likely than other races/ethnicities to receive post-assault care. Participants frequently said they did not get a post-sexual assault exam because they did not want to involve the legal system and did not think it was important.

Conclusions: Interventions are needed to increase use of preventive care after experiencing sexual assault among young adults experiencing homelessness.
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http://dx.doi.org/10.1016/j.amepre.2019.09.023DOI Listing
February 2020

Prevalence and correlates of nonmedical use of prescription drugs (NMUPD) among Young adults experiencing homelessness in seven cities across the United States.

Drug Alcohol Depend 2019 07 14;200:153-160. Epub 2019 May 14.

School of Social Work, Arizona State University, 411 N. Central Ave. #865, Phoenix, AZ 85004-0689, USA. Electronic address:

Background: Nonmedical use of prescription drugs (NMUPD) is an urgent public health concern facing the United States. Young adults experiencing homelessness (YEH) are at increased risk of NMUPD; however, community estimates of NMUPD among YEH are sparse. This current study sought to understand patterns and correlates of NMUPD in a geographically heterogeneous sample of YEH recruited from seven cities across the United States.

Methods: From June 2016 to July 2017, 1,426 YEH (aged 18-26) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information on substance use, mental health, trauma, and sexual-risk behaviors. Multivariable logistic regression was utilized to assess demographic, psychological, and behavioral correlates of self-reported past-month NMUPD and NMUPD types (i.e., prescription stimulant, sedative, and opioids).

Results: Approximately 20% of participants reported past-month NMUPD. Almost 9% reported misusing prescription opioids, 8.7% misused prescription sedatives, and 6% misused prescription stimulants. Multivariable logistic regressions revealed unmet mental health needs were associated with sedative and stimulant misuse but not opioid misuse. Having suicidal thoughts was associated with opioid misuse but not sedative or stimulant misuse. Although no geographical differences emerged for stimulant and sedative misuse, youth from Denver, Phoenix, and San Jose were more likely to engage in opioid misuse relative to youth in Los Angeles.

Conclusions: These findings indicate that interventions designed to address NMUPD need to be multifaceted, designed to address other risk behaviors correlated with NMUPD, and target unmet mental health needs.
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http://dx.doi.org/10.1016/j.drugalcdep.2019.03.015DOI Listing
July 2019

Adverse childhood experiences and their relationship to complex health profiles among child welfare-involved children: A classification and regression tree analysis.

Health Serv Res 2019 08 10;54(4):902-911. Epub 2019 May 10.

Graduate School of Social Work, University of Denver, Butler Institute for Families, Denver, Colorado.

Objective: To identify the clustering of adverse childhood experiences (ACEs) that best characterize child welfare-involved children with known complex health concerns.

Data Source: Multi-informant data were obtained from Wave I of the National Survey of Child and Adolescent Well-Being (NSCAW II).

Study Design: This study used a cross-sectional design and classification and regression tree (CART) analyses.

Data Collection: Data were collected from families with children, aged birth to 17, investigated for child maltreatment and their child protective services caseworkers, including demographic characteristics of the children, their histories of adversity, and a wide range of health concerns.

Principal Findings: Results indicate that for children between the ages of six and 17, experiences of physical abuse alone, as well as experiences of physical abuse combined with having a caregiver with mental illness, are most strongly associated with complex health concerns. For children aged 2-5 years, results suggest that caregiver mental illness is a key adverse experience associated with complex health concerns.

Conclusions: Identifying specific combinations of ACEs may be a critical next step for child- and youth-serving agencies to allow providers to better calculate risk of health problems among children exposed to adversity.
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http://dx.doi.org/10.1111/1475-6773.13166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606552PMC
August 2019

More than Data Collectors: A Systematic Review of the Environmental Outcomes of Youth Inquiry Approaches in the United States.

Am J Community Psychol 2019 03;63(1-2):208-226

Graduate School of Social Work, University of Denver, Denver, CO, USA.

Over the last twenty years, research on the impact of engaging children and adolescents in the generation of new knowledge about their lives, schools, and communities, has grown tremendously. This systematic review summarizes the findings from empirical studies of youth inquiry approaches in the United States, with a focus on their environmental outcomes. Searches of four interdisciplinary databases retrieved a total of 3,724 relevant articles published between 1995 and 2015. Sixty-three distinct studies met the systematic review inclusion criteria, of which, 36 (57.1%) reported that the youth inquiry approach contributed to positive changes among adults, peers, organizations, and/or institutions. These environmental outcomes were qualitatively recorded, inductively categorized, and then organized into Bronfenbrenner's ecological framework. Youth inquiry approaches led to practitioner growth and changes in peer group norms at the micro-system level, program development or improvement and research benefits at the meso-system level, and school, city, and state level policy adoption at the exo-system level. Qualitative methods, especially case studies, were most commonly used to evaluate the impact of youth inquiry approaches on environmental outcomes. Studies of approaches that utilized advocacy to create change, targeted decision-makers as the audience for the youth's work and convened for a longer duration were more likely to report improved environmental outcomes. This systematic review suggests that youth inquiry approaches are a promising strategy for ecological systems change.
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http://dx.doi.org/10.1002/ajcp.12321DOI Listing
March 2019

Implications for PrEP Uptake in Young Adults Experiencing Homelessness: A Mixed Methods Study.

AIDS Educ Prev 2019 02;31(1):63-81

Graduate School of Social Work, University of Denver.

Youth experiencing homelessness (YEH) have a high risk of contracting HIV; however, they remain relatively unreached by pre-exposure prophylaxis (PrEP)-based HIV prevention initiatives. We used a cross-sectional mixed-methods study to explore PrEP knowledge, interest, facilitators, and barriers among YEH. Young adults were recruited from agencies serving YEH in Houston, TX (n = 30) and Los Angeles, CA (n = 15) to participate in an electronic self-report survey and a semistructured interview. Survey results indicate that 68.2% of YEH had low or no prior knowledge of PrEP, though 63.7% reported interest in taking PrEP. Qualitative results revealed facilitators of PrEP use, including high PrEP acceptability and awareness, and supportive social networks. Several barriers emerged, including medication-related barriers, adherence, cost, access barriers, low perceived HIV risk, perceived stigma of PrEP use, and low PrEP awareness. Despite high PrEP acceptability, PrEP use among YEH remains low partly due to low PrEP awareness, low perceived HIV risk, and medical mistrust.
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http://dx.doi.org/10.1521/aeap.2019.31.1.63DOI Listing
February 2019

On the fringes: How youth experiencing homelessness conceptualize social and economic inequality-A Photovoice study.

J Community Psychol 2019 05 5;47(4):924-942. Epub 2019 Feb 5.

University of Denver, Colorado.

This study used Photovoice methods with young adults experiencing homelessness to collaboratively identify issues that are of greatest importance in an open-ended, exploratory, and inductive manner. Participants selected two concepts to focus their inquiry: freedom and prosperity. Within these concepts, participants discussed nature as a source of inspiration, a desire to better themselves and to change their situations, and passion for contributing to social change by exposing economic inequality and raising awareness about homelessness. These findings demonstrate that young people are keenly aware of the structural and macro-level factors that have contributed to their risks of social exclusion and marginalization.
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http://dx.doi.org/10.1002/jcop.22164DOI Listing
May 2019

Reconciling Adaptation and Fidelity: Implications for Scaling Up High Quality Youth Programs.

J Prim Prev 2019 02;40(1):35-49

Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80208, USA.

In the field of prevention science, some consider fidelity to manualized protocols to be a hallmark of successful implementation. A growing number of scholars agree that high-quality implementation should also include some adaptations to local context, particularly as prevention programs are scaled up, in order to strengthen their relevance and increase participant engagement. From this perspective, fidelity and adaptation can both be seen as necessary, albeit mutually exclusive, dimensions of implementation quality. In this article, we propose that the relationship between these two constructs may be more complex, particularly when adaptations are consistent with the key principles underlying the program model. Our argument draws on examples from the implementation of a manualized youth voice program (YVP) in two different organizations serving six distinct communities. Through a series of retreats, implementers identified examples of modifications made and grouped them into themes. Results suggest that some adaptations were actually indicators of fidelity to the key principles of YVPs: power-sharing, youth ownership, and engagement in social change. We therefore offer suggestions for re-conceptualizing the fidelity-adaptation debate, highlight implications for measurement and assessment, and illustrate that the de facto treatment of adaptation and fidelity as opposing constructs may limit the diffusion or scaling up of these types of youth programs.
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http://dx.doi.org/10.1007/s10935-019-00535-6DOI Listing
February 2019

"It seems kinda like a different language to us": Homeless youths' attitudes and experiences pertaining to condoms and contraceptives.

Soc Work Health Care 2019 03 8;58(3):237-257. Epub 2018 Nov 8.

b Graduate School of Social Work , University of Denver , Denver , CO USA.

Homeless youth become pregnant or involved in pregnancies at high rates. There are many ways by which unintended pregnancies may be prevented, including the use of condoms and other contraceptives. However, there is a dearth of research regarding contraceptive use among this vulnerable youth population, and especially through lenses that consider homeless youths' diverse gender identities, expressions, and sexualities. This study qualitatively explores homeless youths' attitudes and experiences regarding condom and other contraceptive use. Data were obtained from interviews with 30 youth experiencing homelessness, ages 18-21. Youth reported inconsistent use of condoms and other contraceptives, which youth often attributed to their perceptions of contraceptive inaccessibility and exorbitant cost. Most youth also did not know where to obtain contraceptive information and services, and reported transportation barriers and fear of being stigmatized in health care settings, particularly in relation to their gender identities and sexualities. Findings suggest that reproductive and sexual health information and services are urgently needed by all homeless young people, and from low-barrier, non-judgmental, and empathetic sources.
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http://dx.doi.org/10.1080/00981389.2018.1544961DOI Listing
March 2019

Knowledge and Attitudes About Pre-Exposure Prophylaxis Among Young Adults Experiencing Homelessness in Seven U.S. Cities.

J Adolesc Health 2019 05 22;64(5):574-580. Epub 2018 Sep 22.

School of Social Work, Arizona State University, Phoenix, Arizona. Electronic address:

Purpose: Evidence suggests that young adults experiencing homelessness (YEH) are at elevated risk of HIV compared to housed youth. Given the limited research on pre-exposure prophylaxis (PrEP) awareness among YEH, this study examined their PrEP knowledge and attitudes.

Methods: Data from a cross-sectional survey among YEH (ages 18-26) (n = 1,427) in seven U.S. cities were used to assess their knowledge and attitudes regarding PrEP to inform HIV prevention efforts.

Results: Participants were primarily male youth of color. The mean age was 20.9years. While 66% felt at risk for HIV, only 14% strongly agreed that they try to protect themselves from getting infected with HIV. Most (84%) were eligible for PrEP based on risk, yet only 29% had knowledge of PrEP. Despite this, 59% reported they were likely/extremely likely to take PrEP. Access to free PrEP (55%), HIV testing (72%), healthcare (68%), and one-on-one (62%), and text messaging support (57%) were rated as very/extremely important for PrEP uptake and adherence.

Conclusions: The results of this study suggest missed opportunities to prevent new HIV infections among YEH. Efforts to increase PrEP uptake among this population should consider provider- and system-level interventions to increase PrEP awareness, decrease PrEP-associated healthcare costs, improve access to PrEP providers, and provide in-person and text messaging support.
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http://dx.doi.org/10.1016/j.jadohealth.2018.06.023DOI Listing
May 2019

A Systematic Review of Youth Participatory Action Research (YPAR) in the United States: Methodologies, Youth Outcomes, and Future Directions.

Health Educ Behav 2018 12 11;45(6):865-878. Epub 2018 May 11.

1 University of Denver, Denver, CO, USA.

Objectives: To use a systematic review methodology to describe the state of the youth participatory action research (YPAR) literature and synthesize findings about the youth outcomes reported in these studies.

Methods: We screened and coded studies using a process consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Of the 3,724 articles found in the database search, 67 reports of 63 distinct studies were included in the final sample. These reports were coded for reports of YPAR principles and project characteristics, study methods, and reported youth outcomes.

Results: The YPAR literature comprises predominantly qualitative studies, with only two randomized trials. The most common outcomes associated with participation in YPAR were those related to agency and leadership (75.0%), followed by academic or career (55.8%), social (36.5%), interpersonal (34.6%), and cognitive (23.1%) outcomes.

Conclusions: This systematic review provides emerging evidence of the skills and competencies youth may develop through YPAR and offers methodological recommendations for future research that can provide greater evidence of causality.
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http://dx.doi.org/10.1177/1090198118769357DOI Listing
December 2018

Comparing Women's and Men's Sexual Offending Using a Statewide Incarcerated Sample: A Two-Study Design.

J Interpers Violence 2021 04 7;36(7-8):3093-3116. Epub 2018 May 7.

Wayne State University, Detroit, MI, USA.

This study identifies the characteristics that distinguish between women's and men's sexual offending. We compare women and men currently incarcerated for a sex offense in one state using two data sources: administrative data on sex offenders in the state prison ( = 9,235) and subsample surveys ( = 129). Bivariate and logistic regressions were used in these analyses. Women account for a small proportion (1.1%, = 98) of incarcerated sex offenders. In the population, women and men were convicted of similar types of sex offenses. The subsample was demographically similar to the population. In the subsample, women were more likely than men to have a child victim, be the parent/guardian of the victim, have a co-offender, and repeatedly perpetrate against the same victim. Findings suggest that women convicted and sentenced for a sex offense differ from their male counterparts, with predictive factors being dependent upon the age of their victim(s). Sex offender treatment interventions developed for men are poorly suited to and may have limited efficacy for women.
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http://dx.doi.org/10.1177/0886260518772110DOI Listing
April 2021

My Own Best Friend: Homeless Youths' Hesitance to Seek Help and Strategies for Coping Independently after Distressing and Traumatic Experiences.

Soc Work Public Health 2018 29;33(3):149-162. Epub 2018 Jan 29.

a Graduate School of Social Work , University of Denver , Denver , Colorado , USA.

Although homeless youth face extreme adversities, they are often hesitant to seek help from formal and informal supports. The current study qualitatively explored homeless youths' reasons for coping independently and their strategies for doing so. Youth accessing services (N = 145) in three U.S. cities were interviewed about their rationales for not seeking help from others regarding distressing experiences. Analyses illustrated specific barriers to help seeking that prompted homeless youth to cope on their own by utilizing soothing, avoidant, aggressive, and introspective coping strategies. Implications for outreaching to those least likely to seek help are discussed.
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http://dx.doi.org/10.1080/19371918.2018.1424062DOI Listing
December 2018

Social Networking Technology Use and Engagement in HIV-Related Risk and Protective Behaviors Among Homeless Youth.

J Health Commun 2016 07 23;21(7):809-17. Epub 2016 Jun 23.

b School of Social Work , University of Southern California , Los Angeles , California , USA.

Preliminary studies with homeless youth have found surprisingly pervasive social media use and suggest that youth's online interactions may be associated with their HIV-related risk and protective behaviors. As homeless youth are transient and difficult to engage in place-based services, social media may represent a novel venue for intervention. A critical 1st step in intervention development is gaining greater understanding of how homeless youth use social media, especially as it relates to who they connect to and around what topics. Given the salience of social networking sites in the lives of these otherwise difficult-to-reach adolescents, and their potential to disseminate prevention interventions, this study assessed associations between online social networking technology use and HIV risk behaviors among homeless youth in Los Angeles, California. Homeless youth ages 13 through 24 (N = 1,046) were recruited through 3 drop-in centers and surveyed about their social media use and self-reported HIV-related risk behaviors. Results suggest that social media use is widely prevalent among this population, and the content of these online interactions is associated with whether youth engage in risk or protective behaviors. Implications for interventions and further research are discussed.
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http://dx.doi.org/10.1080/10810730.2016.1177139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5158181PMC
July 2016

Enhancing Risk Detection Among Homeless Youth: A Randomized Clinical Trial of a Promising Pilot Intervention.

J Interpers Violence 2018 10 2;33(19):2945-2967. Epub 2016 Mar 2.

1 University of Denver, CO, USA.

Homeless youth frequently experience victimization, and youth with histories of trauma often fail to detect danger risks, making them vulnerable to subsequent victimization. The current study describes a pilot test of a skills-based intervention designed to improve risk detection among homeless youth through focusing attention to internal, interpersonal, and environmental cues. Youth aged 18 to 21 years ( N = 74) were recruited from a shelter and randomly assigned to receive usual case management services or usual services plus a 3-day manualized risk detection intervention. Pretest and posttest interviews assessed youths' risk detection abilities through vignettes describing risky situations and asking youth to identify risk cues present. Separate 2 (intervention vs. control) × 2 (pretest vs. posttest) mixed ANOVAs found significant interaction effects, as intervention youth significantly improved in overall risk detection compared with control youth. Post hoc subgroup analyses found the intervention had a greater effect for youth without previous experiences of indirect victimization than those with previous indirect victimization experiences.
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http://dx.doi.org/10.1177/0886260516633208DOI Listing
October 2018

Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities.

Soc Sci Med 2015 Jun 26;135:47-55. Epub 2015 Apr 26.

University of Texas at Austin, School of Social Work, USA. Electronic address:

This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population.
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http://dx.doi.org/10.1016/j.socscimed.2015.04.028DOI Listing
June 2015

Reentry Programming for High-Risk Offenders: Insights From Participants.

Int J Offender Ther Comp Criminol 2016 Oct 31;60(13):1479-508. Epub 2015 Mar 31.

Michigan State University, East Lansing, USA.

The mass increase in imprisonment of the last two decades has led to an increasing number of adults released from prison. Scholarly accounts of prisoner reentry have demonstrated that incarcerated individuals face barriers on release from prison and that intervention programs are necessary to assist their transition to the community. Here, we build from the insights of previous research by examining how high-risk offenders perceive a reentry program. Using a qualitative approach, our findings suggest that procedural and substantive justice affect their satisfaction and involvement with the program. This study highlights the importance of providing employment opportunities, social support, and fair and respectful delivery of services to assist incarcerated individuals transitioning to the community.
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http://dx.doi.org/10.1177/0306624X15578204DOI Listing
October 2016

An Exploratory Factor Analysis of Coping Styles and Relationship to Depression Among a Sample of Homeless Youth.

Community Ment Health J 2015 Oct 29;51(7):818-27. Epub 2015 Mar 29.

School of Social Work, University of Texas, 1925 San Jacinto Blvd. D3510, Austin, TX, 78712-0358, USA.

The extent to which measures of coping adequately capture the ways that homeless youth cope with challenges, and the influence these coping styles have on mental health outcomes, is largely absent from the literature. This study tests the factor structure of the Coping Scale using Exploratory Factor Analysis (EFA) and then investigates the relationship between coping styles and depression using hierarchical logistic regression with data from 201 homeless youth. Results of the EFA indicate a 3-factor structure of coping, which includes active, avoidant, and social coping styles. Results of the hierarchical logistic regression show that homeless youth who engage in greater avoidant coping are at increased risk of meeting criteria for major depressive disorder. Findings provide insight into the utility of a preliminary tool for assessing homeless youths' coping styles. Such assessment may identify malleable risk factors that could be addressed by service providers to help prevent mental health problems.
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http://dx.doi.org/10.1007/s10597-015-9870-8DOI Listing
October 2015

Electronic case management with homeless youth.

Eval Program Plann 2015 Jun 16;50:36-42. Epub 2015 Feb 16.

2148 S. High Street, Graduate School of Social Work, University of Denver, Denver, CO 80208, United States. Electronic address:

Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth.
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http://dx.doi.org/10.1016/j.evalprogplan.2015.02.002DOI Listing
June 2015

Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth.

Child Maltreat 2015 May 14;20(2):115-24. Epub 2014 Dec 14.

Graduate School of Social Work, University of Denver, Denver, CO, USA.

Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth-a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths' odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths' odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences.
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http://dx.doi.org/10.1177/1077559514562859DOI Listing
May 2015

Utilizing technology for longitudinal communication with homeless youth.

Soc Work Health Care 2014 Oct;53(9):865-82

a Graduate School of Social Work , University of Denver , Denver , Colorado , USA.

The current study investigated forms of technology (phone calls, texts, email and Facebook) for maintaining contact with homeless youth over baseline, 1-week, 6-week, and 3-month follow-up interviews. The study combined quantitative tracking of youths' response patterns and open-ended interviews regarding youths' preferred methods of communication. Results indicate that maintaining communication with homeless youth requires persistence, including frequent contact attempts over several days. Cell phone contacts (calls or texts) were most successful in communicating with youth, with e-mail and Facebook messaging useful when phones were lost or stolen. Youth who maintained contact were strikingly similar to youth who discontinued contact.
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http://dx.doi.org/10.1080/00981389.2014.925532DOI Listing
October 2014

Mental health correlates of victimization classes among homeless youth.

Child Abuse Negl 2014 Oct 13;38(10):1628-35. Epub 2014 Apr 13.

Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO 80208, USA.

Literature reports high rates of street victimization among homeless youth and recognizes psychiatric symptoms associated with such victimization. Few studies have investigated the existence of victimization classes that differ in type and frequency of victimization and how youth in such classes differ in psychiatric profiles. We used latent class analysis (LCA) to examine whether classes of homeless youth, based on both type and frequency of victimization experiences, differ in rates of meeting diagnostic criteria for major depressive episodes and posttraumatic stress disorder (PTSD) in a sample of homeless youth (N=601) from three regions of the United States. Results suggest youth who experience high levels of direct and indirect victimization (high-victimization class) share similarly high rates of depressive episodes and PTSD as youth who experience primarily indirect victimization only (witness class). Rates of meeting criteria for depressive episodes and PTSD were nearly two and three times greater, respectively, among the high victimization and witness classes compared to youth who never or rarely experienced victimization. Findings suggest the need for screening and intervention for homeless youth who report direct and indirect victimization and youth who report indirect victimization only, while prevention efforts may be more relevant for youth who report limited victimization experience.
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http://dx.doi.org/10.1016/j.chiabu.2014.03.001DOI Listing
October 2014
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