Facilitating risk reduction among homeless and street-involved youth.
OBJECTIVE
The purposes of this evaluation project were to describe a group of homeless adolescents and street-involved youth who utilized a mobile unit that provided medical and mental healthcare services and to assess the efficacy of the services provided in reducing their health risk behaviors.


METHODS
The records of 95 youth aged 15-25 years who used the medical mobile unit for an average of 14 months were examined and evaluated according to the national health indicators related to risk reduction. Current literature related to health risk behavior among homeless youth was reviewed, synthesized, and provided the background for this article.


CONCLUSIONS
Data were obtained from the records of mostly heterosexual youth with a mean age of 20.5 years. Approximately one third of the participants were high school graduates and most were without health insurance. Living situations were transient including friends, shelters, crash pads, or the streets. Abuse accounted for the majority leaving home. Psychiatric conditions and substance abuse were common. Medical conditions were related to transient living situations, substance abuse, and sexual activity. Success of the program was associated with sustained counseling, stabilizing youth on psychotropic medications, decreasing substance use, providing birth control and immunizations, and treating medical conditions.


CONCLUSIONS
Homeless youth are one of the most underserved vulnerable populations in the United States with limited access and utilization of appropriate healthcare services. Nurse practitioners often serve as care providers but are also in a position to effectively lobby to improve health care for homeless youth through professional organizations and community activism. Furthermore, when designing and evaluating healthcare services, multidisciplinary teams need to consider risk reduction for homeless youth in the context of their environment.
Busen
Nancy H
NH
Department of Integrative Nursing Care, School of Nursing, The University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. nancy.h.busen@uth.tmc.edu
Engebretson
Joan C
JC
D000293:Adolescent; D002649:Child Abuse / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D054624:Health Status Disparities; D006305:Health Status Indicators; D054625:Healthcare Disparities; D018453:Homeless Youth / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008952:Mobile Health Units / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000458:organization & administration*; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D015397:Program Evaluation; D012111:Residence Characteristics; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D013781:Texas; D055815:Young Adult