Facilitators and Barriers of Drop-In Center Use Among Homeless Youth

Published in: Journal of Adolescent Health, 2016

Posted on RAND.org on July 05, 2016

by Eric R. Pedersen, Joan S. Tucker, Stephanie Ann Kovalchik

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Research Questions

  1. What are the facilitators and barriers of drop-in center use among homeless youth?
  2. What models of drop-in service use exist in the research literature?

Drop-in centers for homeless youth address basic needs for food, hygiene, and clothing but can also provide critical services that address youth's "higher level" needs (e.g., substance use treatment, mental health care, HIV-related programs). Unlike other services that have restrictive rules, drop-in centers typically try to break down barriers and take a "come as you are" approach to engaging youth in services. Given their popularity, drop-in centers represent a promising location to deliver higher level services to youth that may not seek services elsewhere. A better understanding of the individual-level factors (e.g., characteristics of homeless youth) and agency-level factors (e.g., characteristics of staff and environment) that facilitate and impede youth engagement in drop-in centers will help inform research and outreach efforts designed to engage these at-risk youth in services. Thus, the goal of this review was to develop a preliminary conceptual model of drop-in center use by homeless youth. Toward this goal, we reviewed 20 available peer-reviewed articles and reports on the facilitators and barriers of drop-in center usage and consulted broader models of service utilization from both youth and adult studies to inform model development.

Key Findings

  • Homeless youth prefer drop-in centers to other types of services such as shelters.
  • Individual-level barriers and facilitators of center use include demographics, access to care and referral sources, the role of peers, and risk behaviors.
  • Staff and service-level barriers and facilitators of using drop-in centers include staff characteristics and structural barriers (such as inconvenient location, long waiting lists, and inconvenient operating hours).
  • Researchers developed a conceptual model that was specific to drop-in center use. It included predisposing factors that might motivate youth to use a drop-in center; enabling factors, such as the desire for change and peer support; and the need for care, including substance use and mental health status.

Recommendation

Research and outreach efforts designed to engage at-risk youth in services may be improved by considering the individual-level factors (e.g., characteristics of homeless youth) and agency-level factors (e.g., characteristics of staff and environment) that facilitate and impede youth engagement in drop-in centers.

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