title: High prevalence of exposure to the child welfare system among street-involved youth in a Canadian setting: implications for policy and practice.
abstract: BACKGROUND
  Street-involved youth are more likely to experience trauma and adverse events in childhood; however, little is known about exposure to the child welfare system among this vulnerable population. This study sought to examine the prevalence and correlates of being in government care among street-involved youth in Vancouver, Canada.
  
  
  METHODS
  From September 2005 to November 2012, data were collected from the At-Risk Youth Study, a prospective cohort of street-involved youth aged 14-26 who use illicit drugs. Logistic regression analysis was employed to identify factors associated with a history of being in government care.
  
  
  RESULTS
  Among our sample of 937 street-involved youth, 455 (49%) reported being in government care at some point in their childhood. In a multivariate analysis, Aboriginal ancestry (adjusted odds ratio [AOR] = 2.07; 95% confidence interval [CI]: 1.50-2.85), younger age at first "hard" substance use (AOR = 1.10; 95% CI: 1.05-1.16), high school incompletion (AOR = 1.40; 95% CI: 1.00-1.95), having a parent that drank heavily or used illicit drugs (AOR = 1.48; 95% CI: 1.09-2.01), and experiencing physical abuse (AOR = 1.90; 95% CI: 1.22-2.96) were independently associated with exposure to the child welfare system.
  
  
  CONCLUSIONS
  Youth with a history of being in government care appear to be at high-risk of adverse illicit substance-related behaviours. Evidence-based interventions are required to better support vulnerable children and youth with histories of being in the child welfare system, and prevent problematic substance use and street-involvement among this population.
authors.forename: Brittany
authors.initials: B
authors.lastname: Barker
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Gerald Taiaiake
authors.initials: GT
authors.lastname: Alfred
authors.forename: Michelle
authors.initials: M
authors.lastname: Fortin
authors.forename: Paul
authors.initials: P
authors.lastname: Nguyen
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, Vancouver BC V6Z 1Y6, Canada. uhri-kd@cfenet.ubc.ca.
authors.forename: Kora
authors.initials: K
authors.lastname: DeBeck
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D002170:Canada / Q000453:epidemiology; D002648:Child; D002669:Child Welfare; D003153:Community Health Services; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006291:Health Policy; D018453:Homeless Youth; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult