Long-term benefits of providing transitional services to youth aging-out of the child welfare system: Evidence from a cohort of young people who use drugs in Vancouver, Canada

Barker, Brittany; Shoveller, Jean; Grant, Cameron; DeBeck, Kora

doi:10.1016/j.drugpo.2020.102912

Cited by 3 publications

(2 citation statements)

References 62 publications

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“…Under these agreements, provinces provide financial, residential, supportive, and rehabilitative services to individuals who can no longer stay at home, through such initiatives as Newfoundland and Labrador's Extension of Youth Services Program (Sukumaran, 2021;Public Health Agency of Canada, 2019). Despite making services available for youth in transition, policymakers are criticized for their overt focus on measurable outcomes, such as education or employment (Antle et al, 2009;Barker et al, 2020;Lee & Berrick, 2014). However, a scoping review of high school outcomes of children in care found that neither researchers nor policymakers are well informed about the high school outcomes of children in care in Anglosphere countries (Sundly et al, 2023).…”

Section: Transitioning Youth In Canadamentioning

confidence: 99%

Neuroscientific Evidence and Care Leaving: A Multidisciplinary Critical Commentary

Sundly

Keating²,

Effiong³

et al. 2023

IJCYFS

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While neuroscientific literature suggests that some parts of the brain are not fully developed until the mid-20s, public discourse is skewed toward early child development (ECD) because of its supposed long-term economic benefits. Some researchers have gone so far as to say that society overinvests in remedial programs for disadvantaged adolescents. Such claims resist advocacy efforts for extended care for children in out-of-home care and discourage policy and legislative concerns regarding investing in early adulthood. In this commentary, we unpack the literature on brain development and critically discuss its selective use by legislators and policymakers for investments in ECD. Despite the availability of neuroscientific and economic evidence, it is not prominent in the discourse surrounding supportive interventions like extending care. Using Bourdieu’s theory of social reproduction, we discuss how preference is given to only the type of knowledge that preserves the social structures that work to ensure the multigenerational flow of capital among dominant groups. Also, social institutions act within the dimensions set by the social structure, constantly shaping and reshaping ways of facilitating capital preservation among the upper classes. We conclude that, in addition to moral argument, the current neuroscientific evidence may support investment in extended care programs.

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Section: Transitioning Youth In Canadamentioning

confidence: 99%

Neuroscientific Evidence and Care Leaving: A Multidisciplinary Critical Commentary

Sundly

Keating²,

Effiong³

et al. 2023

IJCYFS

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“…Previous ARYS studies have described and utilized this approach. [36][37][38] A multivariable extended Cox regression subanalysis was also conducted to identify factors associated with time to potentially "actionable" MMT discontinuation events. This was defined as MMT discontinuation that could be addressed through policy or clinical guideline changes, and the subanalysis was restricted to participants who reported discontinuing MMT due to missing a dose or being taken off by a healthcare provider, having difficulty accessing a pharmacy, or experiencing cost or affordability barriers.…”

Section: Statistical Analysesmentioning

confidence: 99%

Methadone Maintenance Treatment Discontinuation Among Young People who use Opioids in Vancouver, Canada

et al. 2022

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Objective Retaining adolescents and young adults (AYA) in medications for opioid use disorder (MOUD), like methadone maintenance treatment (MMT), is critical to reducing toxic drug fatalities. This analysis sought to identify factors associated with MMT discontinuation among AYA. Method Data were derived from the At-Risk Youth Study, a prospective cohort study of street-involved AYA in Vancouver, Canada, between December 2005 and June 2018. Multivariable extended Cox regression identified factors associated with time to MMT discontinuation among AYA who recently initiated MMT. In subanalysis, multivariable extended Cox regression analysis identified factors associated with time to “actionable” MMT discontinuation, which could be addressed through policy changes. Results A total of 308 participants reported recent MMT during the study period. Participants were excluded if they reported MMT in the past 6 months at baseline and were retained in MMT ( n = 94, 30.5%); were missing MMT status data ( n = 43, 14.0%); or completed an MMT taper ( n = 11, 3.6%). Of the remaining 160 participants who initiated MMT over the study period, 102 (63.8%) discontinued MMT accounting for 119 unique discontinuation events. In multivariable extended Cox regression, MMT discontinuation was positively associated with recent weekly crystal methamphetamine use (adjusted hazard ratio [AHR] = 1.67, 95% confidence interval [CI]: 1.19 to 2.35), but negatively associated with age of first “hard” drug use (per year older) (AHR = 0.95, 95% CI: 0.90 to 1.00) and female sex (AHR = 0.66, 95% CI: 0.44 to 0.99). In subanalysis, recent weekly crystal methamphetamine use (AHR = 4.61, 95% CI: 1.78 to 11.9) and weekly heroin or fentanyl use (AHR = 3.37, 95% CI: 1.21 to 9.38) were positively associated with “actionable” MMT discontinuation, while older age (AHR = 0.87, 95% CI: 0.76 to 0.99) was negatively associated. Conclusions Efforts to revise MMT programming; provide access to a range of MOUD, harm reduction, and treatments; and explore coprescribing stimulants to AYA with concurrent stimulant use may improve treatment retention and reduce toxic drug fatalities.

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Homelessness Is Socially Created: Cluster Analysis of Social Determinants of Homelessness (SODH) in North West England in 2020

Mabhala

Esealuka

Nwufo

et al. 2021

IJERPH

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Poverty creates social conditions that increase the likelihood of homelessness. These include exposure to traumatic life experiences; social disadvantages such as poor educational experiences; being raised in a broken family, care homes or foster care; physical, emotional, and sexual abuse; and neglect at an early age. These conditions reduce people’s ability to negotiate through life challenges. This cross-sectional study documents the clustering and frequency of adverse social conditions among 152 homeless people from four cities in North West England between January and August 2020. Two-step cluster analysis showed that having parents with a criminal record, care history, and child neglect/abuse history was predictive of homelessness. The cluster of indicator variables among homeless people included sexual abuse (χ2 (N = 152) = 220.684, p < 0.001, Cramer’s V = 0.7), inappropriate sexual behaviour (χ2 (N = 152) = 207.737, p < 0.001, Cramer’s V = 0.7), emotional neglect (χ2 (N = 152) = 181.671, p < 0.001, Cramer’s V = 0.7), physical abuse by step-parent (χ2 (N = 152) = 195.882, p < 0.001, Cramer’s V = 0.8), and physical neglect (χ2 (N = 152) = 205.632, p < 0.001, Cramer’s V = 0.8). Poverty and homelessness are intertwined because of the high prevalence of poverty among the homeless. Poverty sets up a chain of interactions between social conditions that increase the likelihood of unfavourable outcomes: homelessness is at the end of the interaction chain. Interventions supporting families to rise out of poverty may also reduce entry into homelessness.

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Long-term benefits of providing transitional services to youth aging-out of the child welfare system: Evidence from a cohort of young people who use drugs in Vancouver, Canada

Cited by 3 publications

References 62 publications

Neuroscientific Evidence and Care Leaving: A Multidisciplinary Critical Commentary

Neuroscientific Evidence and Care Leaving: A Multidisciplinary Critical Commentary

Methadone Maintenance Treatment Discontinuation Among Young People who use Opioids in Vancouver, Canada

Homelessness Is Socially Created: Cluster Analysis of Social Determinants of Homelessness (SODH) in North West England in 2020

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