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Youth Wellness Project (YWP) Vancouver, Canada. Program Introduction and Description. Angela Sanchez-Pope. Vancouver Street Youth Wellness Program. Presentation Overview. Joseph. Angela. Abby. Anthony. Carlotta. Oliva. Health Promotion Program for Inner-City Street Youth .

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Presentation Transcript
presentation overview
Presentation Overview

Joseph

Angela

Abby

Anthony

Carlotta

Oliva

Angela Sanchez-Pope

health promotion program for inner city street youth
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

risk factors
Risk Factors

Angela Sanchez-Pope

risk factors concluded
Risk Factors (Concluded)

Angela Sanchez-Pope

demographics
Demographics

Angela Sanchez-Pope

services needed by youth
Services Needed By Youth

Angela Sanchez-Pope

transitioning off the streets
Transitioning off the Streets
  • Skills Required
    • Service Access
    • Consequences of Street
    • Problem Solving
    • Communication/Advocacy
    • Mentorship/Empowerment
rationale
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

collaborators
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

slide16

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

areas of coverage
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

youth wellness project assumptions
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

desired results
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

logic model
Logic Model

Joseph Harris

impact
Impact

Improve the health and quality of life of street-involved youth

Joseph Harris

contributors to the program
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

an evaluation grounded in theory
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

a front line perspective on participatory evaluatin
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

focus groups participants
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

procedures and ethics
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

analysis
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

results
Results

Carlotta Archuleta

three groups the youth the vyvc youth instructors the health science student instructors
Three Groups

The Youth

The VYVC Youth Instructors

The Health Science Student Instructors

Results of Participants

Carlotta Archuleta

2008 recruitment of evaluative focus groups
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

program and individual level
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

1 impact 2 internal external factors
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

internal external factors three themes emerged
Internal/External Factors: Three Themes Emerged
  • Access to Shelters and Drop in Centers
  • Access to Health Care
  • Access to Nutrition

Carlotta Archuleta

feedback on the youth wellness project
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

workshop specific feedback
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

results cont
Results Cont.

Anthony Barajas

chapter five results
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

focus groups
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

motivators of focus groups
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

presence factors for focus groups
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

program facilitation styles for focus groups
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

vyvc youth instructors
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

vyvc youth instructors cont
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

implications for continued participation by chuis students
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

challenges going forward for focus groups
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

chuis students final report
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

chuis students final report cont
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

reasons for participating
Reasons for Participating
  • Multilayered problem requiring multiple support services
  • Services: shelter, clothing, food, medical
  • Availability of harm reduction oriented programs and health promotion programs
  • Motivators: help youth, improve health and quality of life to make a difference

Oliva Lopez

program facilitation
Program Facilitation
  • Teach youth to identify signs and symptoms of illness and drug addiction
  • Promote sharing of knowledge, discuss health issues, find solutions
  • Dialogues, interactive methodology
  • Peer trust effects

Oliva Lopez

impacts
Impacts
  • Collaborators on the YWP: contributions from youth, more support for youth and community based org., increased credibility and legitimacy
  • YWP on Collaborators: lower youth fear, gain skills in public speaking, source of income, build reputation and connections, service learning

Oliva Lopez

challenges
Challenges
  • Intra-personal, interpersonal, organizational and structural
  • Different life structures
  • Monetary compensation
  • Disagreement on target

Oliva Lopez

participatory evaluation with street youth
Participatory Evaluation with Street Youth
  • Apply knowledge to benefit both sides
  • Learning opportunity
  • Collaborative health promotion model to break barriers to health among youth
  • Academics and PE partners
  • Community
  • Youth in PE

Oliva Lopez

research time in p e
Research Time in P.E.
  • Collaborates with community members
  • Takes into consideration individual capacity; interest and life stability
  • Determines how to use interest, abilities
  • Develops focus group to address priorities of academics and community members
  • Academics: role of initiator, consultant
  • Community and academic level of participation

Oliva Lopez

participatory evaluation
Participatory Evaluation
  • Indicators of success
  • Community members and academics interests
  • PCHR learners concerns
  • Ensure success= relationship at the onset of PE

Oliva Lopez

differences
Differences

Conventional Research

Participatory Evaluation

  • Distances evaluator and participants
  • Ensures accountability of program
  • Methods adapted to local culture
  • Intends to empower local people to: initiatecontrol, take action

Oliva Lopez

other observations
Other Observations
  • Street-involved youth input
  • PCHR gains
  • Sense of ownership
  • Journals
  • Main approach
  • Fundamental characteristic

Oliva Lopez

chapter seven
Chapter Seven

LIMITATIONS AND CONCLUSIONS

Oliva Lopez

limitations
Limitations
  • Informal structure of peer education presents a challenge in identifying program strength and outputs making sustainability difficult
  • Results are not good enough to measure impact of participation on health/quality of life
  • No longitudinal data to aid in determining if participation will influence future practice
  • Self bias: program facilitated by youth leaders participating in focus groups to evaluate program

Oliva Lopez

conclusions
Conclusions
  • Collaboration: university and community based = effectiveness
  • Engaging
  • A building tool
  • Interactive approach
  • Participatory evaluation steps w/ street youth
  • Future research is needed

Oliva Lopez