The Identity Project

NCT03772522 | Completed Results

• 1 other identifier: 18-002
• Study Type: interventional
• Target: 27
• Locations: 1 country
• Sites: 1

Brief Summary

Understanding how to create successful pathways out of homelessness is crucial. Thirty young people (aged 18 - 26 years) who have transitioned out of homelessness within the past three years will be offered scholarships to participate in a six week intervention that focuses on building identity capital (sense of purpose and control, self-efficacy and self-esteem) and providing career direction. The intervention will be designed and carried out by dk Leadership - an established, highly successful leadership and counseling centre in Toronto with a track record of significantly improving the life trajectories of teens and adults. Importantly, study participants will be incorporated into the centre's current programming, meaning the intervention will be held at a location not associated with homelessness. Study participants will be collaboratively recruited by dk Leadership and Covenant House Toronto - Canada's largest agency for street-involved and homeless youth. This impact and process evaluation aims to address critical gaps in knowledge about transition-related supports by asking whether and how an identity capital intervention delivered outside the social service sector impacts the life-trajectories of formerly homeless young people. Particular attention will be paid to whether this intervention shows promise as an unconventional way to tackle poverty and improve social inclusion. It is hypothesize that, for the primary quantitative outcome measures of hope, community integration, social connectedness, and self-esteem:

1. 1.Significant improvements in the mean scores of the intervention group compared to the delayed intervention comparison group immediately post-intervention will be observed.
2. 2.Significant improvements in the mean scores of both groups (intervention and delayed intervention) immediately post-intervention will be observed.
3. 3.These significant improvements will be sustained in both groups for at least three months post-intervention.

Conditions

Youth; Homelessness

Keywords

Hopelessness; Self Esteem; Social Isolation; Employment Status; Education; Housing Problems; Identity, Social; Self Efficacy; Control Locus; Poverty; Youth; Homelessness; Homeless Youth

Outcome Measures

Primary Outcomes (4)

• Mean Change From Baseline in Hopelessness as Measured by the Beck Hopelessness Scale

  Assessed using Beck's Hopelessness Scale, a 20-item scale which measures motivation, expectations, and feelings about the future (internal consistency α = .93). The total scoring range is 0-20, with 0-3 = no or minimal hopelessness, 4-8 = mild hopelessness, 9-14 = moderate hopelessness- requires monitoring, and 15+ = severe hopelessness- suicide risk. Participants' scores at baseline will be compared with their scores post-intervention to detect changes in levels of hopelessness. The change in scores over time will describe the general trajectory of hopelessness.

  Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

• Mean Change From Baseline in Community Integration (Psychological and Physical) Scores as Measured by the Community Integration Scale (CIS)

  Assessed using the Community Integration Scale, an 11-item scale which measures behavioural (e.g., participation in activities) and psychological (e.g., sense of belonging) aspects of community integration. The CIS includes a physical subscale (with scores ranging from 0-7) and a psychological subscale (with scores ranging from 4-20). Higher scores indicate greater community integration. This scale was used extensively in the Chez Soi/At Home study, but psychometric properties have yet to be reported. Participants' scores at baseline will be compared with their scores post-intervention to detect changes in levels of community integration. The change in scores over time will describe the general trajectory of community integration.

  Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

• Mean Change From Baseline in Social Connectedness Scores as Measured by the Social Connectedness Scale (SCS)

  Measured using the Social Connected Scale, a 20-item scale which measures belongingness - the degree to which people feel connected to others (internal consistency α = .92). Scores range from 20-120, with higher scores indicating greater social connectedness. Participants' scores at baseline will be compared with their scores post-intervention to detect changes in social connectedness. The change in scores over time will describe the general trajectory of social connectedness.

  Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

• Mean Change From Baseline in Self-esteem Scores as Measured by the Rosenberg Self-Esteem Scale (RSS)

  Assessed using the Rosenberg Self-Esteem Scale, a 10-item scale which measures of global self-worth (internal consistency α = .77 - .88). Scores range from 0-30. A score of \<15 is categorized as low self-esteem, and 15-30 is categorized as normal self-esteem. Participants' scores at baseline will be compared with their scores post-intervention to detect changes in self-esteem. The change in scores over time will describe the general trajectory of self-esteem.

  Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

Secondary Outcomes (5)

• Change in Vocational Participation/Employment as Assessed by a Questionnaire From Baseline to 9-Months

  Assessed at baseline (immediately pre-intervention) and 9 months post-intervention

• Change in Academic Participation/Educational Attainment as Assessed by a Questionnaire From Baseline to 9-Months

  Assessed at baseline (immediately pre-intervention) and 9 months post-intervention

• Number of Themes Related to Change in Career Awareness Informed by Focus Groups With Participants

  60 - 90 minute focus groups at each of the following timepoints: immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

• Number of Themes Related to Change in Knowledge and Use of Soft Skills Informed by Focus Groups With Participants

  60 - 90 minute focus groups at each of the following timepoints: immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

• Number of Themes Related to Participant Perspectives of Intervention Barriers and Facilitators, as Informed by Focus Groups With Participants

  60 - 90 minute focus groups at each of the following timepoints: immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention

Study Arms (2)

Immediate dk Leadership Intervention

EXPERIMENTAL

Participants allocated to the immediate intervention group are assessed for study outcomes immediately prior to the 6-week dk Leadership intervention and immediately after the intervention. Outcomes measured immediately post-intervention are compared with participants who have not received the intervention during the 6 weeks. After the delayed intervention group takes the intervention, the two groups are joined into a single arm.

Behavioral: dk Leadership

Delayed dk Leadership Intervention

PLACEBO COMPARATOR

Participants allocated to this arm receive 6 weeks of no intervention. Outcomes are measured immediately before and immediately after the 6 week period. The change in outcomes are compared with participants who have received the intervention during the 6 week period. This group then receives the same dk Leadership intervention; after this point, the two groups are joined into a single arm for subsequent analyses.

Behavioral: dk Leadership

Interventions

dk Leadership BEHAVIORAL

Participants will attend two full-day workshops and four half-day group coaching sessions over the course of six weeks. The workshops and coaching sessions will be supplemented by on-line (e.g., podcasts) and print (e.g., workbooks) material. The full-day workshops will focus on identity-enhancing topics such as self-understanding, creating a life of meaning and purpose, and strategic career development. The half-day group coaching sessions will focus on workshop debriefing and on exploring solutions to transition-related challenges faced by study participants. The program was designed and carried out by dk Leadership - an established leadership and executive coaching centre in Toronto, Canada.

Delayed dk Leadership Intervention; Immediate dk Leadership Intervention

Eligibility Criteria

• Age: 18 Years - 26 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Between 18-26 years of age
• Left homelessness within the last 3 years (youth living in supportive housing contexts (e.g., transitional housing) will be considered to have left homelessness)
• Currently not homeless (youth in supportive or transitional housing are eligible)
• A concerted effort will be made to recruit young people facing additional identity-related challenges like newcomer and racialized youth, Indigenous youth, and youth who belong to the LGBTQ2S community.

You may not qualify if:

• Not fluent in English
• Cannot provide informed consent
• Cannot commit to attending two full-day workshops and four half-day group coaching sessions over the course of six weeks (missing more than one workshop and two coaching sessions will disqualify participants from the study)

Sponsors & Collaborators

• Unity Health Toronto: lead
• dk Leadership: collaborator
• Covenant House Toronto: collaborator
• Ontario Trillium Foundation: collaborator

Study Sites (1)

St. Michael's Hospital

Toronto, Ontario, Canada

Location

Related Publications (37)

• Gaetz, S., Dej, E., Richter, T., & Redman, M. (2016) The state of homelessness in Canada 2016. Toronto, ON: Canadian Observatory on Homelessness Press. Retrieved from http://www.homelesshub.ca/SOHC2016

  BACKGROUND

• Gaetz, S., & Redman, M. (2016). Federal investment in youth homelessness: Comparing Canada and the United States and a proposal for reinvestment. Canadian observatory on homelessness policy brief. Toronto, ON: The Homeless Hub Press. Retrieved from http://homelesshub.ca/sites/default/files/Policy_Brief.pdf

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• Karabanow, J. (2008). Getting off the street: Exploring the process of young people's street exits. American Behavioral Scientist, 51(6), 772-788. doi:10.1177/0002764207311987

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• Covenant House Toronto. (2016). Facts and stats. Retrieved from http://www.covenanthousetoronto.ca/homeless-youth/Facts-and-Stats

  BACKGROUND

• Kidd, S.A., Frederick, T., Karabanow, J., Hughes, J., Naylor, T., & Barbic, S. (2016). A mixed methods study of recently homeless youth efforts to sustain housing and stability. Child and Adolescent Social Work Journal, 33(3), 207-218. doi:10.1007/s10560-015-0424-2

  BACKGROUND

• Mayock, P., O'Sullivan, E., & Corr, M.L. (2011). Young people exiting homelessness: An exploration of process, meaning and definition. Housing Studies, 26(6), 803-826. doi:10.1080/02673037.2011.593131

  BACKGROUND

• Brueckner, M., Green, M., & Saggers, S. (2011). The trappings of home: Young homeless people's transitions towards independent living. Housing Studies, 26(1), 1-16. doi:10.1080/02673037.2010.512751

  BACKGROUND

• Thulien NS, Gastaldo D, Hwang SW, McCay E. The elusive goal of social integration: A critical examination of the socio-economic and psychosocial consequences experienced by homeless young people who obtain housing. Can J Public Health. 2018 Feb;109(1):89-98. doi: 10.17269/s41997-018-0029-6.

  PMID: 29981071 BACKGROUND

• Altena AM, Brilleslijper-Kater SN, Wolf JL. Effective interventions for homeless youth: a systematic review. Am J Prev Med. 2010 Jun;38(6):637-45. doi: 10.1016/j.amepre.2010.02.017.

  PMID: 20494240 BACKGROUND

• Coren E, Hossain R, Pardo JP, Veras MM, Chakraborty K, Harris H, Martin AJ. Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young people. Evid Based Child Health. 2013 Jul;8(4):1140-272. doi: 10.1002/ebch.1923.

  PMID: 23877940 BACKGROUND

• Hwang SW, Burns T. Health interventions for people who are homeless. Lancet. 2014 Oct 25;384(9953):1541-7. doi: 10.1016/S0140-6736(14)61133-8.

  PMID: 25390579 BACKGROUND

• Gaetz, S. (2014). Coming of age: Reimagining the response to youth homelessness in Canada. Toronto, ON: The Canadian Homelessness Research Network Press. Retrieved from http://www.homelesshub.ca/comingofage

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• Karabanow, J., Carson, A., & Clement, P. (2010). Leaving the streets: Stories of Canadian youth. Halifax, NS: Fernwood Publishing.

  BACKGROUND

• Public Interest. (2009). Changing patterns for street involved youth. Toronto, ON: Author. Retrieved from http://www.worldvision.ca/Programs-and- Projects/Canadian Programs/Documents/ChangingPatternsForStreetInvolvedYouth.pdf

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• Milburn NG, Rice E, Rotheram-Borus MJ, Mallett S, Rosenthal D, Batterham P, May SJ, Witkin A, Duan N. Adolescents Exiting Homelessness Over Two Years: The Risk Amplification and Abatement Model. J Res Adolesc. 2009 Dec 1;19(4):762-785. doi: 10.1111/j.1532-7795.2009.00610.x.

  PMID: 25067896 BACKGROUND

• Karabanow, J., Kidd, S., Frederick, T., & Hughes, J. (2016). Toward housing stability: Exiting homelessness as an emerging adult. Journal of Sociology & Social Welfare, 43(1), 121- 148. Retrieved from https://wmich.edu/socialworkjournal

  BACKGROUND

• Frederick, T., Chwalek, M., Hughes, J., Karabanow, J., & Kidd, S. (2014). How stable is stable? Defining and measuring housing stability. Journal of Community Psychology, 42(8), 964- 979. doi:10.1002/jcop.21665

  BACKGROUND

• Thulien, N.S. (2017). Chronic precarity: A critical examination of homeless youth transitions to independent housing (Doctoral dissertation). University of Toronto: Toronto, ON. Retrieved from https://tspace.library.utoronto.ca/bitstream/1807/78804/3/Thulien_Naomi_201706_PhD_thesis.pdf

  BACKGROUND

• Côté, J.E. (2016). The identity capital model: A handbook of theory, methods, and findings. Unpublished manuscript, Department of Sociology, The University of Western Ontario, London, Ontario, Canada. Retrieved from https://www.researchgate.net/publication/305698905_The_Identity_Capital_Model_A_Handbook_Of_Theory_Methods_And_Findings

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• Oyserman D, Bybee D, Terry K. Possible selves and academic outcomes: How and when possible selves impel action. J Pers Soc Psychol. 2006 Jul;91(1):188-204. doi: 10.1037/0022-3514.91.1.188.

  PMID: 16834488 BACKGROUND

• Lee, C., & Berrick, J.D. (2014). Experiences of youth who transition to adulthood out of care: Developing a theoretical framework. Children and Youth Services Review, 46, 78-84. Retrieved from http://dx.doi.org/10.1016/j.childyouth.2014.08.005

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• Kidd, S., Frederick, T., Morales, S., Daley, M., & Vitopoulos, N. (2016, November). The Toronto housing outreach program collaborative (HOP-C): Stabilizing housing for recently homeless youth. Oral presentation at the Canadian Alliance to End Homelessness National Conference, Montreal, QC. Retrieved from http://conference.caeh.ca/wp-content/uploads/AWH5_The-Toronto-Housing-Outreach-Program-Collaborative-TFrederick-et-al.pdf

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• Oyserman D, Destin M. Identity-based motivation: Implications for intervention. Couns Psychol. 2010 Oct;38(7):1001-1043. doi: 10.1177/0011000010374775.

  PMID: 21516204 BACKGROUND

• Cote JE, Schwartz SJ. Comparing psychological and sociological approaches to identity: identity status, identity capital, and the individualization process. J Adolesc. 2002 Dec;25(6):571-86. doi: 10.1006/jado.2002.0511.

  PMID: 12490176 BACKGROUND

• dkLeadership. (2017). Dream it. Do it. Retrieved from http://www.dkleadership.org Urbaniak, G.C., & Plous,S. (2013). Research Randomizer (Version 4.0) [Computer software]. Retrieved from https://www.randomizer.org

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• Thulien NS, Wang A, Mathewson C, Wang R, Hwang SW. Tackling exclusion: A pilot mixed method quasi-experimental identity capital intervention for young people exiting homelessness. PLoS One. 2021 Aug 20;16(8):e0256288. doi: 10.1371/journal.pone.0256288. eCollection 2021.

  PMID: 34415951 RESULT

MeSH Terms

Conditions

Social Isolation; Social Identification

Condition Hierarchy (Ancestors)

Social Behavior; Behavior

Limitations and Caveats

A limitation is that the small sample size means the findings are unable to be generalized to young people in other contexts.

Results Point of Contact

• Title: Dr. Naomi Thulien
• Organization: MAP Centre for Urban Health Solutions, Unity Health Toronto

ThulienN@mcmaster.ca

647-460-0781

Study Officials

• Naomi S Thulien

  Unity Health Toronto

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Thirty young people (aged 18 - 26 years) who have transitioned out of homelessness within the past three years will be offered scholarships to participate in a six-week intervention that focuses on building identity capital and providing career direction. The intervention will be designed and carried out by dk Leadership - an established, highly successful leadership and counseling centre in Toronto with a track record of significantly improving the life trajectories of teens and adults. Importantly, study participants will be incorporated into the centre's current programming, meaning the intervention will be held at a location not associated with homelessness. All of the participants will be invited to attend two focus groups, which will be conducted immediately post-intervention and at six months post-intervention. Each focus group will contain approximately 8 - 10 youth. Participants in the intervention and delayed intervention will be in separate focus groups.

Study Record Dates

• First Submitted: September 23, 2018
• First Posted: December 11, 2018
• Study Start: April 1, 2018
• Primary Completion: August 6, 2019
• Study Completion: August 6, 2019
• Last Updated: June 22, 2023
• Results First Posted: May 12, 2020

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)