title: Outcomes for street children and youth under multidisciplinary care in a drop-in centre in Tegucigalpa, Honduras.
abstract: BACKGROUND
  There is little evidence to describe the feasibility and outcomes of services for the care of street children and youth in low-income countries.
  
  
  OBJECTIVE
  To describe the outcomes of a multidisciplinary case management approach delivered in a drop-in centre for street children and youth.
  
  
  METHODS
  A longitudinal study of street children and youth followed in an urban drop-in centre. Four hundred (400) street children and youth received a multidisciplinary case management therapeutic package based on the community reinforcement approach. The main outcomes were changes in psychological distress, substance abuse and social situation scores.
  
  
  RESULTS
  The median follow-up time for the cohort was 18 months. There were reductions in the levels of psychological distress (p = 0.0001) and substance abuse (p ≤ 0.0001) in the cohort as well as an improvement in the social situation of street children and youth (p = 0.0001). There was a main effect of gender (p < 0.001) and a significant interaction of gender over time (p < 0.001) on improvements in levels of psychological distress. Survival analysis showed that the probability of remaining on substances at 12 months was 0.76 (95% CI: 0.69-0.81) and 0.51 (95% CI: 0.42-0.59) at 24 months. At 12 months, fewer female patients remained using substances compared to male (p < 0.01).
  
  
  CONCLUSIONS
  To be most effective, programmes and strategies for children and youth in street situations in developing countries should target both their health and social needs.
authors.affiliation: Médecins Sans Frontières, Geneva, Switzerland. renatosouz2002@yahoo.co.uk
authors.forename: Renato
authors.initials: R
authors.lastname: Souza
authors.forename: Klaudia
authors.initials: K
authors.lastname: Porten
authors.forename: Sarala
authors.initials: S
authors.lastname: Nicholas
authors.forename: Rebecca
authors.initials: R
authors.lastname: Grais
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities; D005260:Female; D018453:Homeless Youth / Q000523:psychology*; D006721:Honduras; D006801:Humans; D033183:Interdisciplinary Communication; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D013315:Stress, Psychological; D019966:Substance-Related Disorders