title: The impact of drop-in centers on the health of street children in New Delhi, India: A cross-sectional study.
abstract: (1) To determine whether street children who visit drop-in centers experience better physical and mental health, and engage in less substance use than street children who do not visit centers. (2) To determine whether the duration of attendance at a center has an impact on the above outcomes.
  
  
  
  We conducted a cross-sectional study with 69 street children from two drop-in centers in New Delhi, India (attenders) and a comparison group of 65 street children who did not visit drop-in centers (non-attenders). We used pretested questionnaires to assess their physical health, substance use status and mental health.
  
  
  
  Attenders experienced fewer ill health outcomes, engaged in less substance use, and had better mental health outcomes than non-attenders (p<0.01). For every month of attendance at a drop-in center, street children experienced 2.1% (95% CI 0% to 4.1%, p=0.05) fewer ill health outcomes per month and used 4.6% (95% CI 1.3% to 8%, p=0.01) fewer substances. Street children were also less likely to have been a current substance user than a never substance user for every additional month of attendance at a center (OR: 0.79, 95% CI: 0.66-0.96, p=0.02). Duration of drop-in center attendance was not a significant factor in predicting mental health problems.
  
  
  
  Drop-in centers may improve the physical health of street children and reduce their substance abuse. Rigorous longitudinal studies are needed to better determine if drop-in centers impact the health and substance use status of street children in LMICs.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada. Electronic address: nathra@mcmaster.ca.
authors.forename: Ronita
authors.initials: R
authors.lastname: Nath
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada. Electronic address: shannonh@mcmaster.ca.
authors.forename: Harry
authors.initials: H
authors.lastname: Shannon
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada. Electronic address: georgik@mcmaster.ca.
authors.forename: Kathy
authors.initials: K
authors.lastname: Georgiades
authors.affiliation: School of Nursing, University of Ottawa, Canada. Electronic address: Wendy.Sword@uottawa.ca.
authors.forename: Wendy
authors.initials: W
authors.lastname: Sword
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Canada. Electronic address: praina@mcmaster.ca.
authors.forename: Parminder
authors.initials: P
authors.lastname: Raina
mesh_terms: D000293:Adolescent; D002648:Child; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D018453:Homeless Youth / Q000523:psychology*; D006801:Humans; D007194:India; D008297:Male; D001523:Mental Disorders / Q000517:prevention & control / Q000523:psychology; D008603:Mental Health; D019966:Substance-Related Disorders / Q000517:prevention & control / Q000523:psychology; D011795:Surveys and Questionnaires; D014505:Urban Population
keywords: Drop-in centers; Health status; India; Street children; Substance abuse