Effect of a Rent Subsidy and Mentoring on Youth Transitioning Out of Homelessness

NCT03779204 | Completed Results

• 1 other identifier: 18-251
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

Compared to the vast amount of literature about the risk factors associated with young people entering and becoming entrenched in homelessness, much less is known about how to facilitate and sustain transitions off the streets. Current evidence indicates that while structural supports such as subsidized housing and social service providers are important, these things alone are insufficient to help young people integrate into mainstream society. Connecting these young people with an adult who exhibits the relationship-based components of mentoring that young people value most (e.g., genuine interest in their well-being and belief in their ability to succeed, a non-judgmental attitude and a willingness to listen, the provision of advice, guidance, affirmation and encouragement) may be key to helping them move forward and integrate into the mainstream. This intervention will provide 24 young people (ages 18-26) 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 be randomized to receive regular mentorship from an adult mentor, tasked with helping their mentee bridge the gap between homelessness and mainstream living. It is hypothesized that, for the primary outcome measures of community integration and self-esteem: 1\. Better mean scores (community integration and self-esteem) in the participants who receive rent subsidies plus mentorship (intervention group) will be observed compared to the participants who receive rent subsidies only (control group) by the primary endpoint of 18 months of study participation. It is hypothesized that, for the secondary outcome measures of social connectedness, hope, and academic and vocational participation:

1. 1.Better mean scores (social connectedness and hope) in the intervention group relative to participants in the control group will be observed by 18 months of study participation.
2. 2.Participants in the intervention group will be more likely than the control group to demonstrate sustained engagement in academic and vocational activities (education, employment, and/or skills training) by 18 months of study participation.

Conditions

Homeless Persons

Keywords

Social Isolation; Self-Esteem; Hope; Psychiatric Problem; Education; Employment; Income; Housing Problems; Identity, Social; Youth; Rent Subsidy; Mentorship

Outcome Measures

Primary Outcomes (2)

• Community Integration Scale Score at 18 Months

  This outcome is a measure of behavioural (e.g., participation in activities) and psychological (e.g., sense of belonging) aspects of community integration. This will be measured using the Community Integration Scale (CIS), an 11-item scale. The CIS includes a psychological subscale (possible score range is from 4-20, 4 being low psychological community integration and 20 being high integration), and a physical subscale (total score range is 0-7, 0 being low physical community integration, and 7 being high integration). Only the psychological subscale has been reported here.

  Change from baseline to 18 months

• Rosenberg Self-Esteem Scale Score at 18 Months

  This outcome is a measure of global self-worth and will be measured using the Rosenberg Self-Esteem Scale, a 10-item scale, internal consistency α = .77 - .88. The total scoring range is 0-30, a score of \<15 is categorized as low self-esteem, and 15-30 is categorized as normal self-esteem.

  Change from baseline to 18 months.

Secondary Outcomes (3)

• Social Connectedness Scale Score at 18 Months

  Change from baseline to 18 months.

• Beck Hopelessness Scale Score at 18 Months

  Change from baseline to 18 months.

• Academic/Vocational Participation as Assessed by a Questionnaire at 18 Months

  Change from baseline to 18 months.

Other Outcomes (6)

• Modified Engulfment Scale Score at 18 Months

  Change from baseline to 18 months.

• Modified Colorado Symptom Index Score at 18 Months

  Change from baseline to 18 months.

• Income as Assessed by a Questionnaire at 18 Months

  Change from baseline to 18 months.

Study Arms (2)

Rent subsidies + Mentorship

EXPERIMENTAL

Participants in this arm (n = 13) will receive rent subsidies (ranging from $400 - $500/month) for 24 months as part of the intervention and be matched with an adult mentor recruited by one of the community partners.

Behavioral: Mentorship; Behavioral: Rent Subsidies

Rent subsidies only

ACTIVE COMPARATOR

Participants in this arm (n = 11) will receive rent subsidies only (ranging from $400 - $500/month) for 24 months as part of the comparator group intervention. This group will not receive mentorship.

Behavioral: Rent Subsidies

Interventions

Mentorship BEHAVIORAL

The mentors will be encouraged to incorporate the key relationship-based components of natural mentors (e.g., a 'coach' or 'cheerleader' role) to assist with mainstream integration. The mentors will have more flexibility than a typical formal mentorship program in the types of activities they pursue with their mentees. They will not be mandated to attend shelter-based social events, but rather engage in activities that direct their mentees away from the shelter system (and their old identities as homeless youth) and toward the mainstream (e.g., meeting for coffee at a local university campus). All of the mentors will meet monthly with their mentees for two years. In addition, the mentor will be encouraged to touch base with their mentee via phone or text message every week. If a mentor is unable to continue their role and there are at least six months left in the study, the study participant will be matched with a new mentor.

Rent subsidies + Mentorship

Rent Subsidies BEHAVIORAL

Participants will receive rent subsidies ($500 for those living in Toronto, $400 for those living in Hamilton or St. Catherine's due to differences in cost of living) for 24 months.

Rent subsidies + Mentorship; Rent subsidies only

Eligibility Criteria

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

You may qualify if:

• Be between ages 18-26
• Left homelessness within the past year
• Living in market rent housing
• Plan on staying in or nearby the community in which they were recruited (Toronto, Hamilton, or St. Catharines) for the duration of the 24-month study
• Be willing to be matched with an adult mentor who has been screened and chosen by one of the community partners

You may not qualify if:

• In imminent danger of losing their housing (e.g., facing jail time or impending eviction)
• Enrolled in another study with enhanced financial and social supports
• Unable to provide free and informed consent
• Unable to communicate fluently in English

Sponsors & Collaborators

• Unity Health Toronto: lead
• Covenant House Toronto: collaborator
• Living Rock Ministries: collaborator
• Resource Association for Teens: collaborator

Study Sites (1)

St. Michael's Hospital

Toronto, Ontario, Canada

Location

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• Thulien NS, Amiri A, Hwang SW, Kozloff N, Wang A, Akdikmen A, Roglich J, Nisenbaum R. Effect of Portable Rent Subsidies and Mentorship on Socioeconomic Inclusion for Young People Exiting Homelessness: A Community-Based Pilot Randomized Clinical Trial. JAMA Netw Open. 2022 Oct 3;5(10):e2238670. doi: 10.1001/jamanetworkopen.2022.38670.

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  PMID: 37462842 RESULT

• Thulien NS, Kozloff N, McCay E, Nisenbaum R, Wang A, Hwang SW. 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. JMIR Res Protoc. 2019 Dec 20;8(12):e15557. doi: 10.2196/15557.

  PMID: 31859688 DERIVED

MeSH Terms

Conditions

Social Isolation; Social Identification

Condition Hierarchy (Ancestors)

Social Behavior; Behavior

Results Point of Contact

• Title: Dr. Naomi Thulien
• Organization: Unity Health Toronto

naomi.thulien@unityhealth.to

647-460-0781

Study Officials

• Naomi S Thulien, RN, PhD

  Unity Health Toronto

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

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

Model Details: This study will employ a convergent mixed methods design (i.e., quantitative and qualitative data are collected concurrently, and the findings combined) embedded within a RCT and a CBPAR framework. 24 participants will be assessed for eligibility, and then randomized into 1 of 2 arms using covariate adaptive randomization. 12 are allocated to the intervention group (rent subsidies + mentoring), while 12 are allocated to the control group (rent subsidies only). Participants in the intervention group (n = 12) will be matched with an adult mentor recruited by one of the community partners. Mentors are selected and matched through one-on-one interviews with someone in a leadership role within the organization. A common mentoring guide will be used for all sites; these booklets cover information ranging from ideal mentor characteristics to mentor code of conduct.

Study Record Dates

• First Submitted: September 23, 2018
• First Posted: December 19, 2018
• Study Start: February 28, 2019
• Primary Completion: March 31, 2022
• Study Completion: March 31, 2022
• Last Updated: January 13, 2025
• Results First Posted: January 13, 2025

Record last verified: 2024-09

Locations

CA (1)