YouthREX Research Summaries ask Just Six Questions of research publications on key youth issues. These summaries get at what the youth sector needs to know in two pages or less!

1. What was this research about?
This systematic review of research examines the effectiveness of harm reduction and reintegration programs for street-connected children and youth.

It is estimated that 100 million children and youth live on the street worldwide. Street-connected children and youth experience significant and multi-faceted hardships. Interventions designed to ease these hardships are diverse and include one-off services, drop-in programs, shelters, health and nutrition programs, and vocational and education programs. Interventions can be associated with a longer standing institution (like a school or hospital) or they can be independent and community-based.

Programs are often designed for the specific needs of particular youth. For example, programs may be designed with ethnicity, religion, gender, disability, and citizenship status in mind. Issues that these programs strive to address may include those related to literacy, migration, violence, addiction, poverty, and crime. Some interventions build on the strengths of youth and take a participatory approach while other interventions reproduce a clinical model of service that give young people little agency.

Youth who become street-involved often experience multiple overlapping risk factors which complicates the design, delivery, and effectiveness of interventions. Moreover, researchers recognize that pathways to reintegration are non-linear and may take many years. In order to account for this complexity, the authors of this review created a model for thematizing the interventions.

The purpose of this study is to systematically review, evaluate, and summarize available evidence on harm reduction and reintegration interventions with street-involved youth. The study also reveals where additional research is needed.

2. Where did the research take place?
Researchers from the UK, Canada, and Australia conducted a secondary analysis of international studies about the effects of harm reduction and reintegration interventions on street-involved youth.

3. Who is this research about?
This research is about street-involved children and youth between 0-24 years of age who live in high-income countries. No studies from low and middle-income countries fulfilled the inclusion criteria for this research.

“There are millions of children and young people estimated to be living and working on the streets around the world. Many have become resilient but continue to be vulnerable to risks. To promote their best chances in life, services are needed to reduce risks and prevent marginalization from mainstream society” (p. 2).

4. How was this research done?
Researchers compiled and assessed studies on the effects of harm reduction and reintegration interventions for street-involved youth. The study results were combined and analyzed in order to make conclusions about what kinds of interventions are most effective.

Reintegration and inclusion were the primary outcomes that were measured. Better mental-health, increased opportunities for access to education and employment, reduced harm from substance misuse, and reduced harm from early sexual activity were the secondary outcomes that were measured.

5. What are the key findings?
As significant as the problem of street-involved youth is, it is extremely difficult to generalize across research contexts, interventions, and youth involved in the harm reduction and reintegration studies. This research suggests that assessments of intervention effectiveness should start with an examination of the specific context of the youth served, including process factors, rather than with the theoretical construct of the intervention. Additionally this review found that ‘service as usual’ has not been robustly evaluated. There is also a need to better understand the process and contextual conditions of the interventions under study. The authors suggest that involving ‘the research population in question’, in other words the young people, will improve the quality of the research. The researchers also suggest that the evaluation of interventions should include a rationale for the selection of standardized measures and outcomes that are measured.

6. Why does it matter for youth work?
Intervention programs that are contextualized to meet the needs of street-involved youth, which are unique to the situation they find themselves in, are more effective than interventions built around a theoretical construct.

Programs and services based around participatory models of engagement would help youth workers design interventions that are grounded in the needs of the youth they are working with.

The study pointed to a gap in knowledge that youth workers can begin to fill. Many youth are not served by existing programs and services. Therefore, youth workers could develop intervention programs to assist these youth and document the results of their interventions.