Youth Wellness Project (YWP) Vancouver, Canada

1. Youth Wellness Project (YWP) Vancouver, Canada

2. Program Introduction and Description Angela Sanchez-Pope

3. Vancouver Street Youth Wellness Program Angela Sanchez-Pope

4. Presentation Overview Joseph Angela Abby Anthony Carlotta Oliva Angela Sanchez-Pope

5. Health Promotion Program for Inner-City Street Youth • MISSION : To improve the wellbeing of inner city street youth. • Research: Evaluation of Program • Education: Health Program • Advocacy: Expose Health Science Students to Street-involved youth Angela Sanchez-Pope

6. Stakeholders and Participants Angela Sanchez-Pope

7. Risk Factors Angela Sanchez-Pope

8. Risk Factors (Concluded) Angela Sanchez-Pope

9. Street-Involved Youth Categories Angela Sanchez-Pope

10. Demographics Angela Sanchez-Pope

11. Services Needed By Youth Angela Sanchez-Pope

12. Transitioning off the Streets • Skills Required • Service Access • Consequences of Street • Problem Solving • Communication/Advocacy • Mentorship/Empowerment

13. Program Development and Promotion Joseph Harris

14. Rationale The Youth Wellness Project was initiated with the primary goal of providing effective and culturally sensitive health promotion for street-involved youth in Vancouver. Once these youth leave the home, they lack basic necessities: Shelter Proper Clothing Nutrition Access to Health Care Safety Social Aptitude Basic Survival THE PROJECT EVOLVED… Joseph Harris

15. Collaborators Because of the awareness and necessity, organizations committed themselves to the Youth Wellness Project in an attempt to blanket all the needs of Street-Involved Youth. Joseph Harris

16. Improve the health status Community Health Initiative by University Students Focused on bridging the gap (5 principles): service, learning, inter-professionalism, reflection, and student leadership Division of Inner City Medicine, Faculty of Medicine Vancouver Youth Visions Coalition Prevention of homeless and sexually exploited youth Crystal Clear Support for youth addicted to drugs – specifically meth Covenant House 24-hour youth shelter Directions Youth Services Center Helps youth reclaim their lives Center for Population and Public Health Health Promotion Joseph Harris

17. Areas of Coverage • Easier access to health care; • Mentoring and friendship; • Street education (avoidance); • Addiction support; • 24-hour shelter; • Goal setting • First-Aid education Not only did these opportunities become available, but it because easier for the youth to access these programs through collaborative effort. Joseph Harris

18. Youth Wellness Project Assumptions • Health literacy is a barrier to health and quality of life among street-involved youth • Many different interest groups (e.g., Health-Science Students; Volunteers, and Community Members) would be willing and able to participate in a health-literacy education program • Financial support from different organizations would be willing and available to fund a health-literacy program. Joseph Harris

19. Proposal and Promotion Joseph Harris

20. Desired Results • Provide 150 hours of health literacy education to 120 street-involved youth • Engage street-involved youth in project planning and implementation • Empower and improve health literacy among street-involved youth • Provide health-science students with experience working with marginalized youth • Increase health and quality of life among street-involved youth Joseph Harris

21. Logic Model Joseph Harris

22. Impact Improve the health and quality of life of street-involved youth Joseph Harris

23. Contributors to the Program • Paulo Friere – Participatory Education Theory • The full participation and empowerment of the people affected by a problem is essential in order to enact change • Albert Bandura – Social Learning Theory • People learn through direct experience as well as through the observation of role models. Joseph Harris

24. Program Methodology and Evaluation Abby Maestas

25. An Evaluation Grounded in Theory • The process of creating and managing a collaborative research project that includes parties such as: academics, physicians, community based organizations, and other street-involved youth partners. • Collaborative research with communities increases the collective research capacity of the group and contributes to the overall functioning of the evaluation process. Abby Maestas

26. A Front Line Perspective on Participatory Evaluatin • September of 2007, Partnership in Community Health Research (PCHR) learners identified an opportunity to conduct an evaluation of the YWP in partnership with the YWP’s street-involved youth partners. • YWP’s reputation as a youth operated organization allowed us to take advantage of facilitating factors. Abby Maestas

27. Focus Groups Participants • Two major collaborators in development and facilitation of the YWP, VYVC and CHIUS, both participated as subjects in focus groups. • Street-involved youth who participated in the YWP workshop series at Covenant House, the Directions Youth Services Centre were also invited to participate in focus groups. Abby Maestas

28. Procedures and Ethics • Focus group participants were eligible to participate in the evaluation process only if they had self-selected into the program as a youth participant, VYVC member or as a UBC health science student. • Participants were assured anonymity, informed that they were free to withdraw from the interview at any time and were asked to sign a consent form. Abby Maestas

29. Analysis • Focus groups were audio recorded and transcribed after which a discourse analysis was performed. • Reviewing the transcripts allowed for identification of common themes within single focus groups and across focus groups with each of the three populations; that is health science students, VYVC members and youth participants. Abby Maestas

30. Results Carlotta Archuleta

31. Three Groups The Youth The VYVC Youth Instructors The Health Science Student Instructors Results of Participants Carlotta Archuleta

32. 2008 Recruitment of Evaluative Focus Groups • Coded Categories and Themes • February Group March Group • April Group May Group • 7 Participants each month • Total of 22 • 41% Male and 59% Female • Average Age 17.5 Carlotta Archuleta

33. Program and Individual Level All Groups Divided into Coded Categories and Themes Survey is composed of two sections 1. Health Experiences 2. Feedback Categories Identified • General Feedback • Workshop Specific Feedback Carlotta Archuleta

34. 1. Impact2. Internal/External Factors Health Experience Living On The Streets Impact: Five Themes Emerged • Networking and Social Skills • Health Literacy Skills • Feelings of Helplessness • Rejection of Mainstream Culture Carlotta Archuleta

35. Internal/External Factors: Three Themes Emerged • Access to Shelters and Drop in Centers • Access to Health Care • Access to Nutrition Carlotta Archuleta

36. Feedback on the Youth Wellness Project: General Feedback: Six Themes Emerged • Reasons for participating • Impact of VYVC presence • Impact of student presence • Impact for participants • Facilitation style • Curriculum Carlotta Archuleta

37. Workshop Specific Feedback Topics are as follows: • Mental Health • Substance Use • Reproduction Health • Nutrition • First Aid (Fitness workshop was not available at time of evaluation) Carlotta Archuleta

38. Results Cont. Anthony Barajas

39. Chapter Five: Results Recruitment of VYVC Youth Recruitment of Health Science Students Youth Group Demographics • Four Youth Recruited • Two Female • Two Male • Avg. 24 years of age Student Group Demographics • Three Students Recruited • One Male • Two Female • Avg. 25 years of age Anthony Barajas

40. Focus Groups VYVC Youth Identified 7 Themes CHIUS Students Identified Five Themes • Reason being involved • VYVC Presence • Facilitation Style • Curriculum • Impact for Participates • Program Structure • Challenges • Reason being involved • VYVC Presence • Program Facilitation • Implications for Future Practice • Challenges Anthony Barajas

41. Motivators of Focus Groups Reasons YVVC Youth being Involved Reasons CHUIS Students being Involved • Supporting VYVC • Supporting Street-Involved youth Youth reported that they needed to be more productive and main reason is to support youth. This is street-youths opportunity to make a difference in their Life. • Insufficient Exposure to marginalized populations • Opportunity to provided services and learn about marginalized populations • Prospect of improving health of street-youth Anthony Barajas

42. Presence Factors for Focus Groups VYVC Impact on Development of YWP Perceived Impact of VYVC on YWP by CHUIS Students • Positive effect on youth lives • Gained Valuable knowledge through facilitation • Addressed Self-Stigmatization among YVCV youth • VYVC play a vital role in facilitating workshops • VYVC ability to communicate with street-involved youth • VYVC act as ‘bridge’ or liaison for CHUIS students with street-involved youth • VYVC help build relationships Anthony Barajas

43. Program Facilitation Styles for Focus Groups Facilitation Styles for VYVC Program Facilitation for CHUIS Students • Youth react negatively to top down approach • Due to having little control over life choices • Positive reactions when co-learning is employed • Youth tend to learn from each other • Increased learning when interactive discussion takes place • Lecture style found in inappropriate for street-involved youth • Students out of comfort zone • Students changed style to suit street-involved youth • Discussion based style more effective • Information sharing very effective as a learning tool Anthony Barajas

44. VYVC Youth Instructors Impact for Participants • Important step to begin improving health • Learning to effectively utilize knowledge to benefit health • Important step to build trust between adults and street-youth • Promotes respect between street-youth and health science students Anthony Barajas

45. VYVC Youth Instructors Cont. Program Structure feedback by Youth Instructors • Diversity of Youth Involvement • Synergistic Relationship Developed between YVYC and CHIUS • Ensure Long Term Sustainability of YWP • VYVC need to develop trust in others long term Anthony Barajas

46. Implications for Continued Participation by CHUIS Students • Provides valuable knowledge to provide medical care to street-involved youth • Opportunity to acquaint students with street-involved youth • Acquaints students with needs of street-involved youth • Prevents assumptions and stereotyping of street-involved youth and their needs • Better informed decisions in terms of health care of this population • Students realized difficulties working with a marginalized population Anthony Barajas

47. Challenges going forward for Focus Groups Challenges for VYVC Instructors Challenges for CHUIS Students • Open Lines of Communication between VYVC and Health Students • More Opportunities to know each other • VYVC youth feel unappreciated by Health Science Students • Acknowledgement of VYVC youth life skills and experiences • Lack of stability of VYVC youth frustrating • Lack of commitment outside meetings by VYVC youth • Students unable to convey more information during workshops Anthony Barajas

48. CHUIS Students Final Report Street Youth Perceptions of Health Care System Perceptions of Street Youth • Trust issues- youth simply do not trust Health Care system • Judgment- youth feel that they are judged by the way they live and not understood well • Students learned important not to be judgmental in terms of life style of street youth • Heavy drug and alcohol users • Lack basic hygiene • Negative attitudes • Students surprised- • Youth respectful and polite • Level of education • Engaged in discussions • Types of question asked Anthony Barajas

49. CHUIS Students Final Report cont. Working with Street Youth Implication for the Future • Diverse population • Different stages of recovery • Some youth open and outgoing, some shy • Lack of stability in terms of living condition • Lack of concept of time • Thinking outside the ‘box’ in delivery of health care to street-youth • Working with street-youth is a niche • Feared burn out working with marginalized populations • Despite reservations expressed willingness to continue working with street-youth Anthony Barajas

50. Program Conclusion/Limitations Oliva Lopez