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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Reorienting risk to resilience: street-involved youth perspectives on preventing the transition to injection drug use

Authors: Kira Tozer, Despina Tzemis, Ashraf Amlani, Larissa Coser, Darlene Taylor, Natasha Van Borek, Elizabeth Saewyc, Jane A. Buxton

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

The Youth Injection Prevention (YIP) project aimed to identify factors associated with the prevention of transitioning to injection drug use (IDU) among street-involved youth (youth who had spent at least 3 consecutive nights without a fixed address or without their parents/caregivers in the previous six months) aged 16–24 years in Metro Vancouver, British Columbia.

Methods

Ten focus groups were conducted by youth collaborators (peer-researchers) with street-involved youth (n = 47) from November 2009-April 2010. Audio recordings and focus group observational notes were transcribed verbatim and emergent themes identified by open coding and categorizing.

Results

Through ongoing data analysis we identified that youth produced risk and deficiency rather than resiliency-based answers. This enabled the questioning guide to be reframed into a strengths-based guide in a timely manner. Factors youth identified that prevented them from IDU initiation were grouped into three domains loosely derived from the risk environment framework: Individual (fear and self-worth), Social Environment (stigma and group norms – including street-entrenched adults who actively discouraged youth from IDU, support/inclusion, family/friend drug use and responsibilities), and Physical/Economic Environment (safe/engaging spaces). Engaging youth collaborators in the research ensured relevance and validity of the study.

Conclusion

Participants emphasized having personal goals and ties to social networks, supportive family and role models, and the need for safe and stable housing as key to resiliency. Gaining the perspectives of street-involved youth on factors that prevent IDU provides a complementary perspective to risk-based studies and encourages strength-based approaches for coaching and care of at-risk youth and upon which prevention programs should be built.
Literature
1.
Panter-Brick C. Street children, human rights and public health: a critique and future directions. Annu Rev Anthropol. 2002;31(1):147–71.CrossRef
2.
3.
4.
5.
Debeck K, Kerr T, Marshall BDL, Simo A, Montaner J, Wood E. Risk factors for progression to regular injection drug use among street-involved youth in a Canadian setting. Drug Alcohol Depend. 2013;133(2):468–72.CrossRefPubMed
6.
Feng C, DeBeck K, Kerr T, Mathias S, Montaner J, Wood E. Homelessness independently predicts injection drug use initiation among street-involved youth in a Canadian setting. J Adolesc Health. 2013;52(4):499–01.CrossRefPubMed
7.
Dell CA, Duncan CR, Desroches A, Bendig M, Steeves M, Turner H, et al. Back to the basics: identifying positive youth development as a theoretical framework for a youth drug prevention program in rural Saskatchewan, Canada amidst a program evaluation. Subst Abuse Treat Prev Policy. 2013;8(1):36.CrossRefPubMedPubMedCentral
8.
Werb D, Buxton JA, Shoveller J, Richardson C, Rowell G, Wood E. Interventions to prevent the initiation of injection drug use: a systematic review. Drug Alcohol Depend. 2013;133(2):669–76.CrossRefPubMed
9.
10.
11.
12.
Wood E, Stoltz JA, Montaner JSG, Kerr T. Evaluation methamphetamine use and risks of injection initiation among street youth: the ARYS study. Harm Reduction J. 2006;3:18.CrossRef
13.
Kerr T, Marshall BDL, Miller C, Shannon K, Zhang R, Montaner JSG, et al. Injection drug use among street-involved youth in a Canadian setting. BMC Public Health. 2009;9:171.CrossRefPubMedPubMedCentral
14.
Roy E, Haley N, Leclerc P, Cedras L, Blais L, Boivin JF. Drug injection among street youths in Montreal: predictors of initiation. J Urban Health. 2003;80(1):92–105.CrossRefPubMedPubMedCentral
15.
Roy E, Boudreau JF, Leclerc P, Boivin JF, Godin G. Trends in injection drug use behaviors over 10 years among street youth. Drug Alcohol Depend. 2007;89(2–3):170–5.CrossRefPubMed
16.
Small W, Fast D, Krusi A, Wood E, Kerr T. Social influences upon injection initiation among street-involved youth in Vancouver, Canada: a qualitative study. Subst Abuse Treat Prev Policy. 2009;4:8.CrossRefPubMedPubMedCentral
17.
Frajzyngier V, Neaigus A, Gyarmathy VA, Miller M, Friedman S. Gender differences in injection risk behaviors at the first injection. Drug Alcohol Depend. 2007;89(2–3):145–52.CrossRefPubMed
18.
19.
Hadland SE, Kerr T, Marshall BDL, Small W, Lai C, Montaner JS, et al. Non-injection drug use patterns and history of injection among street youth. Eur Addict Res. 2010;16(2):91–8.CrossRefPubMedPubMedCentral
20.
Cheng T, Wood E, Feng C, Mathias S, Montaner J, Kerr T, et al. Transitions into and out of homelessness among street-involved youth in a Canadian setting. Health Place. 2013;23:122–7.CrossRefPubMedPubMedCentral
21.
Gossop M, Griffiths P, Strang J. Chasing the dragon: characteristics of heroin chasers. Br J Addict. 1998;83(10):1159–62.CrossRef
22.
Ungar M. A Constructionist Discourse on Resilience: Multiple Contexts, Multiple Realities among At-Risk Children and Youth. Youth & Society. 2004;35(3):341–65.CrossRef
23.
Ungar M, Brown M, Liebenberg L, Cheung M, Levine K. Distinguishing differences in pathways to resilience among Canadian youth. Can J Commun Ment Health. 2008;27(1):1–13.CrossRef
24.
Sandelowski M. What’s in a name? Qualitative description revisited. Res Nurs Health. 2010;33(1):77–84.PubMed
25.
Funk A, Van Borek N, Taylor D, Grewal P, Tzemis D, Buxton JA. Climbing the “ladder of participation”: engaging experiential youth in a participatory research project. Can J Public Health. 2012;103(4):e228–92.
26.
Coser L, Tozer K, Van Borek N, Tzemis D, Taylor D, Saewyc E, et al. Finding a Voice: Participatory Research with Street-Involved Youth in the Youth Injection Prevention (YIP) Project. Health Promot Pract. 2014;15(5):732–8.CrossRefPubMed
27.
28.
Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L, et al. Generating the best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health. 2007;31(6):54–0.CrossRef
29.
30.
Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee S. The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005;61(5):1026–44.CrossRefPubMed
31.
Rhodes T. The “risk environment”: a framework for understanding and reducing drug-related harm. Int J Drug Policy. 2002;13(2):85–94.CrossRef
32.
Rhodes T. Risk environments and drug harms: a social science for harm reduction approach. Int J Drug Policy. 2009;20(3):193–201.CrossRefPubMed
33.
34.
Ungar M, Brown M, Liebenberg L, Othman R, Kwong WM, Armstrong M, et al. Unique pathways to resilience across cultures. Adolescence. 2008;42(166):287–310.
35.
Roy E, Haley N, Leclerc P, Cedras L, Boivin JF. Drug injection among street youth: the first time. Addiction. 2002;97(8):1003–9.CrossRefPubMed
36.
Ungar M, Liebenberg L, Boothroyd R, Kwong WM, Lee TY, Leblanc J, et al. The Study of Youth Resilience Across Cultures: Lessons from a Pilot Study of Measurement Development. Res Hum Dev. 2008;5(3):166–80.CrossRef
37.
Kidd SA. Street youth: coping and interventions. Child Adolesc Soc Work J. 2003;20(4):235–61.CrossRef
38.
Fergusson DM, Boden JM, Horwood LJ. The developmental antecedents of illicit drug use: evidence from a 25-year longitudinal study. Drug Alcohol Depend. 2008;96(1–2):165–77.CrossRefPubMed
39.
Lubman DI, Hides L, Yucel M, Toumbourou JW. Intervening early to reduce developmental harmful substance use among youth populations. Med J Aust. 2007;187(7):1–4.
40.
Moore MJ, Werch CEC. Sport and physical activity participation and substance use among adolescents. J Adolesc Health. 2005;36(6):486–93.CrossRefPubMed
41.
Fraser-Thomas JL, Cote J, Deakin J. Youth sport programs: an avenue to foster positive youth development. Phys Educ Sport Pedagogy. 2005;10(1):19–40.CrossRef
42.
Bungay V, Malchy L, Buxton JA, Johnson J, MacPearson D, Fosenfeld T. Life with jib: A snapshot of street youth’s use of crystal methamphetamine. Addict Res Theory. 2006;14(3):235–51.CrossRef
43.
Levensky ER, Forcehimes A, O’Donohue W, Beitz K. Motivational Interviewing: An evidence-based approach to counseling helps patients follow treatment recommendations. Am J Nurs. 2007;107(10):50–8.CrossRefPubMed
44.
Ti L, Tzemis D, Buxton JA. Engaging people who use drugs in policy and program development: a review of the literature. Subst Abuse Treat Prev Policy. 2012;7(1):47.CrossRefPubMedPubMedCentral
45.
Hunt N, Stillwell G, Taylor C, Griffiths P. Evaluation of a Brief Intervention to Prevention Initiation into Injecting. Drugs: Education, Prev Policy. 1998;52(2):185–94.
46.
Strike C, Rotondi M, Kolla G, Roy E, Rotondi NK, Rudzinski K, et al. Interrupting the social processes linked with initiation of injection drug use: Results from a pilot study. Drug Alcohol Depend. 2014;137:48–54.CrossRefPubMed
47.
Johnson KD, Whitbeck LB, Hoyt DR. Predictors of social network composition among homeless and runaway adolescents. J Adolesc. 2005;28:231–48.CrossRefPubMed
48.
Milburn NG, Rotheram-Borus MJ, Batterham P, Brumback B, Rosenthal D, Mallett S. Predictors of close family relationships over one year among homeless young people. J Adolesc. 2005;28:263–79.CrossRefPubMed
49.
Kipke MD, Montgomery SB, Simon TR, Unger JB, Johnson CJ. Homeless Youth: Drug Use Patterns and HIV Risk Profiles According to Group Affiliation. AIDS & Behavior. 1997;1(4):247–59.CrossRef
50.
De Rosa CJ, Montgomery SB, Kipke MD, Iverson E, Ma JL, Unger JB. Service utilization among homeless and runaway youth in Los Angeles, California: rates and reasons. J Adolesc Health. 1999;24(6):449–58.CrossRefPubMed
51.
52.
Krusi A, Fast D, Small W, Wood E, Kerr T. Social and structural barriers to housing among street-involved youth who use illicit drugs. Health Soc Care Community. 2010;18(3):282–8.PubMedPubMedCentral
53.
Draus PJ, Carlson RG. Needles in the haystack: the social context of initiation to heroin injection in rural Ohio. Subst Use Misuse. 2006;41(8):1111–24.CrossRefPubMed
Metadata
Title
Reorienting risk to resilience: street-involved youth perspectives on preventing the transition to injection drug use
Authors
Kira Tozer
Despina Tzemis
Ashraf Amlani
Larissa Coser
Darlene Taylor
Natasha Van Borek
Elizabeth Saewyc
Jane A. Buxton
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2153-z

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