De Rosa C J, Montgomery S B, Kipke M D, Iverson E, Ma J L, Unger J B
Division of Adolescent Medicine, Childrens Hospital Los Angeles, California, USA.
J Adolesc Health. 1999 Jun;24(6):449-58. doi: 10.1016/s1054-139x(99)00040-3.
To describe the service utilization patterns of homeless and runaway youth in a "service-rich" area of Los Angeles, California; identify demographic and other correlates of utilization; and contextualize the findings with qualitative data.
During Phase 1 of this study, survey data were collected from an ethnically diverse sample of 296 youth aged 13-23 years, recruited from both service and natural "hang-out" sites using systematic sampling methods. During Phase 2, qualitative data were collected from 46 youth of varying ethnicities and lengths of time homeless.
Drop-in centers and shelters were the most commonly used services (reported by 78% and 40%, respectively). Other services were used less frequently [e.g., medical services (28%), substance abuse treatment (10%) and mental health services (9%)]. Utilization rates differed by ethnicity, length of time in Los Angeles, and city of first homeless episode (Los Angeles versus all others). Shelter use was strongly associated with use of all other services. Despite youths' generally positive reactions to services, barriers were described including rules perceived to be restrictive, and concerns youth had about confidentiality and mandated reporting. Youth suggested improvements including more targeted services, more long-term services, revised age restrictions, and more and/or better job training and transitional services to get them off the streets.
Because shelters and drop-in centers act as gateways to other services and offer intervention potential for these hard-to-reach youth, it is vital that we understand the perceived barriers to service utilization.
描述加利福尼亚州洛杉矶一个“服务丰富”地区无家可归和离家出走青少年的服务利用模式；确定利用情况的人口统计学及其他相关因素；并用定性数据对研究结果进行背景分析。
在本研究的第一阶段，采用系统抽样方法，从296名年龄在13至23岁、种族各异的青少年样本中收集调查数据，这些青少年是从服务场所和自然“聚集”地点招募而来的。在第二阶段，从46名不同种族、无家可归时间长短不一的青少年中收集定性数据。
临时接待中心和庇护所是最常用的服务（分别有78%和40%的人报告使用过）。其他服务的使用频率较低[例如，医疗服务（28%）、药物滥用治疗（10%）和心理健康服务（9%）]。利用率因种族、在洛杉矶的时间长短以及首次无家可归事件发生的城市（洛杉矶与其他所有城市）而异。使用庇护所与使用所有其他服务密切相关。尽管青少年对服务总体反应积极，但也提到了一些障碍，包括认为限制过多的规定，以及青少年对保密和强制报告的担忧。青少年提出了改进建议，包括更有针对性的服务、更多长期服务、修订年龄限制，以及更多和/或更好的职业培训和过渡服务，以使他们脱离街头生活。
由于庇护所和临时接待中心是获取其他服务的途径，并且为这些难以接触到的青少年提供了干预潜力，因此了解服务利用中存在的明显障碍至关重要。
