title: Adverse outcomes among homeless adolescents and young adults who report a history of traumatic brain injury.
abstract: OBJECTIVE
  We examined the prevalence of self-reported traumatic brain injury (TBI) among homeless young people and explored whether sociodemographic characteristics, mental health diagnoses, substance use, exposure to violence, or difficulties with activities of daily living (ADLs) were associated with TBI.
  
  
  METHODS
  We analyzed data from the Wilder Homelessness Study, in which participants were recruited in 2006 and 2009 from streets, shelters, and locations in Minnesota that provide services to homeless individuals. Participants completed 30-minute interviews to collect information about history of TBI, homelessness, health status, exposure to violence (e.g., childhood abuse, assault), and other aspects of functioning.
  
  
  RESULTS
  Of the 2732 participating adolescents and young adults, 43% reported a history of TBI. Participants with TBI became homeless at a younger age and were more likely to report mental health diagnoses, substance use, suicidality, victimization, and difficulties with ADLs. The majority of participants (51%) reported sustaining their first injury prior to becoming homeless or at the same age of their first homeless episode (10%).
  
  
  CONCLUSIONS
  TBI occurs frequently among homeless young people and is a marker of adverse outcomes such as mental health difficulties, suicidal behavior, substance use, and victimization.
authors.affiliation: Jessica L. Mackelprang is with the Harborview Injury Prevention and Research Center and the Department of Pediatrics, University of Washington School of Medicine, Seattle. Scott B. Harpin is with the College of Nursing, Anschutz Medical Center, University of Colorado, Aurora. Joseph A. Grubenhoff is with the Department of Pediatrics, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora. Frederick P. Rivara is with the Harborview Injury Prevention and Research Center and the Department of Pediatrics, University of Washington School of Medicine.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Mackelprang
authors.forename: Scott B
authors.initials: SB
authors.lastname: Harpin
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Grubenhoff
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D005260:Female; D006304:Health Status; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health; D008910:Minnesota; D015995:Prevalence; D012307:Risk Factors; D019529:Sexuality / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult