Transitioning Youth Out of Homelessness 2.0 (TYOH 2.0)

NCT05781503 | Completed

• 1 other identifier: 22-230
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Introduction: This 12-month pilot randomized controlled trial (RCT) built on previous community-engaged work and explored whether portable rent subsidies and an intervention targeting identity capital (purpose, control, self-efficacy, and self-esteem) hold promise as a way to facilitate socioeconomic inclusion for youth (age 16 - 24 years) exiting homelessness and living in market rent housing in Ontario, Canada. All (n = 40) participants received rent subsidies; half were randomly assigned an identity capital intervention (co-designed leadership guide + coach). Methods and analysis: This study employed a convergent mixed methods, two-arm parallel RCT, open-label design with 1:1 allocation embedded within a Community Based Participatory Action Research framework and underpinned by Critical Social Theory. Specifically, the objectives and measures were:

1. 1.Primary - to examine whether targeted economic and identity-based supports are a feasible and acceptable way to foster socioeconomic inclusion. Measures: recruitment/enrolment/dropout metrics; self-report composite checklists regarding intervention engagement; coaching session attendance; qualitative focus groups.
2. 2.Secondary - to assess differences between targeted economic and identity-based supports (intervention group) and economic supports only (control group) at the 12-month primary endpoint with respect to self-reported socioeconomic inclusion measures of: 1) education, employment and training (EET); 2) housing security; and 3) identity capital. Measures: self-report composite EET checklist; self-report measures of housing security and identity capital.
3. 3.Exploratory - to explore whether the estimated effect of the intervention differed by baseline variables or level of engagement with the intervention. Measures: select variables from the baseline demographic questionnaire; GAIN-Short Screener questionnaire for those in the intervention group.

Conditions

Homelessness; Youth

Keywords

Identity Capital; Youth; Rent Subsidy; Coach; Self-Efficacy; Self-Esteem; Control; Purpose; Socioeconomic Inclusion; Homelessness; Transition

Outcome Measures

Primary Outcomes (3)

• Change in intervention feasibility and acceptability as assessed by recruitment/enrolment/dropout metrics from baseline to 12-months.

  To examine intervention feasibility and acceptability, quantitative measures consisting of recruitment/enrolment/dropout metrics will be utilized. Recruitment rate will be estimated as the proportion of contacted individuals who express interest in participating in the study. The enrollment rate will be calculated as the proportion of recruited individuals who are eligible and consent to participate in the study. Dropout rates will be separately calculated for intervention and control groups at the end of the study as the 1 - proportion of randomized participants who completed the study at 12 months. Exact (Clopper-Pearson) 95% confidence limits will also be calculated.

  Assessed at baseline and 12-months.

• Change in intervention feasibility and acceptability as assessed by the Intervention Engagement Questionnaire from 4-months to 12-months, and coaching session attendance measured across the entire 12-month period.

  Initially, the study was designed to assess changes in intervention feasibility and acceptability using the Intervention Engagement Questionnaire. This five-item self-report measure was developed for this study and explores engagement with the co-designed leadership guide and coaching (administered only to intervention participants). Higher scores indicate greater engagement. However, as the study progressed, we shifted focus to coaching session attendance, as recorded by coaches. Among those in the intervention group, acceptability was measured as the percentage of coaching sessions attended over the 12-month period, out of a maximum of 24 sessions. This provides an objective measure of participant engagement, as self-reported engagement data is not included in the analysis.

  Assessed at 4-months, 8-months, and 12-months.

• Intervention feasibility and acceptability as informed by focus groups from 4-months to 12-months.

  Focus group questions explored intervention feasibility and acceptability.

  Assessed at 4-months, 8-months, and 12-months.

Secondary Outcomes (3)

• Mean change from baseline in housing security as measured by the Housing Security Scale at 12-months.

  Assessed at baseline, 4-months, 8-months, and 12-months.

• Mean change from baseline in identity capital as measured by the Multi-Measure Agentic Personal Scale (MAPS20) at 12-months.

  Assessed at baseline, 4-months, 8-months, and 12-months.

• Change in employment, education, and training as assessed by a questionnaire from baseline to 12-months.

  Assessed at baseline and 12-months.

Other Outcomes (3)

• Subgroup feasibility and acceptability as measured by the Baseline Demographic Questionnaire.

  Assessed at baseline.

• Subgroup feasibility and acceptability as measured by the GAIN Short Screener (GAIN-SS).

  Assessed at baseline.

• Correlation between secondary outcomes and engagement with the intervention.

  Assessed at 12-months.

Study Arms (2)

Portable Rent Subsidies + Identity Capital Intervention

EXPERIMENTAL

Young people randomized to the intervention group will receive 12 months of: portable rent subsidies, engage in a co-designed leadership guide, and be assigned a coach (one coach/10 youth).

Behavioral: Identity Capital Intervention (Coach + Co-designed Leadership Guide); Other: Monthly Rent Subsidies

Portable Rent Subsidies Only

ACTIVE COMPARATOR

The control group will be offered 12 months of portable rent subsidies.

Other: Monthly Rent Subsidies

Interventions

Identity Capital Intervention (Coach + Co-designed Leadership Guide) BEHAVIORAL

Young people randomized to the intervention group will engage in a co-designed leadership guide with their assigned coach. The co-designed leadership guide contains 12 chapters with the overarching aim of enhancing identity capital along with providing strategies to achieve participant-identified goals. Each chapter contains four activities (e.g., self-reflection exercise or listening to a podcast). Ideally, youth will complete one chapter every month. Each young person in this group will meet individually with their coach every two weeks and with a larger group of 10 youth participants and their coach every month.

Portable Rent Subsidies + Identity Capital Intervention

Monthly Rent Subsidies OTHER

All study participants will receive a monthly rent subsidy ($800 for those living in Toronto; $700 for those living in St. Catharine's or Hamilton due to differences in cost of living) for 12 months.

Portable Rent Subsidies + Identity Capital Intervention; Portable Rent Subsidies Only

Eligibility Criteria

• Age: 16 Years - 24 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Be able to provide free and informed consent.
• Be able to understand English (intervention and data collection will be conducted in English).
• Have experienced homelessness (e.g., all non-parental and unstable housing arrangements including shelter stays, couch surfing, and time-limited housing) in the past 12 months.
• Be willing to actively participate in the intervention (co-designed leadership program + coach) if randomized to this arm.

You may not qualify if:

• In imminent danger of losing their housing and not able to utilize the rent subsidy to sustain market rent housing.
• Currently receiving rent subsidies.
• Enrolled in a program or study with similar features to the TYOH 2.0 intervention.

Sponsors & Collaborators

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

Study Sites (1)

Unity Health Toronto

Toronto, Ontario, Canada

Location

Related Publications (1)

• Thulien NS, Stark RK, Amiri A, Abramovich A, Akdikmen A, Carasco A, Daley M, Downey B, Fambegbe OP, Frederick T, Hwang SW, Kozloff N, Noble A, Pedersen C, Rampersaud M, Rodney R, Tibebu T, Nisenbaum R. A Rent Subsidy and Identity Capital Intervention for Youth Exiting Homelessness: Protocol for the Transitioning Youth Out of Homelessness 2.0 Pilot Randomized Controlled Trial. JMIR Res Protoc. 2025 Apr 25;14:e66210. doi: 10.2196/66210.

  PMID: 40279147 DERIVED

Related Links

• TYOH 1.0 study website (includes short documentary and animation of study findings).

Study Officials

• Naomi S Thulien, NP-PHC, PhD

  Unity Health Toronto

  PRINCIPAL INVESTIGATOR

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 pilot study will employ a convergent mixed methods (quantitative and qualitative data collected concurrently and the findings combined), two-arm parallel RCT (participants randomly assigned to either one intervention or control group), open-label (participants and research team aware of random assignment) design with 1:1 allocation (roughly equal number of participants in each study arm) embedded within a Community Based Participatory Action Research framework. Twenty young people will be allocated to the intervention group (portable rent subsidies + identity capital intervention), while 20 will be allocated to the control group (portable rent subsidies only). Participants in the intervention group (n = 20) will receive 12 months of: portable rent subsidies, engage in a co-designed (with youth who have experienced homelessness) leadership guide, and be assigned a coach (one coach/10 youth).

Study Record Dates

• First Submitted: February 27, 2023
• First Posted: March 23, 2023
• Study Start: March 1, 2023
• Primary Completion: June 17, 2024
• Study Completion: June 17, 2024
• Last Updated: October 16, 2024

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)