Rozycki Victoria, Bryce Cal, Douglin Margaret, Kirst Maritt
Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada.
Canadian Mental Health Association Kelowna Branch, Kelowna, BC, Canada.
J Prev Interv Community. 2025;53(2):324-360. doi: 10.1080/10852352.2025.2474908. Epub 2025 Mar 6.
Housing First for Youth (HF4Y) is a youth-focused adaptation of the well-established Housing First (HF) approach to housing and service provision for individuals experiencing homelessness. Given that youth homelessness is associated with an increased likelihood of substance use issues, a central tenet of the HF4Y framework is the use of a harm reduction approach to substance use. However, research on HF4Y has yet to examine how harm reduction is specifically being implemented in these settings. This study addresses this gap by examining how the principles and philosophies of harm reduction were operationalized and implemented in an HF4Y program for youth experiencing homelessness and concurrent disorders. This study was part of a larger evaluation of a 5-year HF4Y research demonstration project - the Restart Project in Kelowna, British Columbia, and Toronto, Ontario, Canada. Eight program leaders and service providers at the Kelowna site were interviewed to gather their perspectives on harm reduction delivery within the HF4Y program. Additionally, program documents and case management materials were analyzed to examine how harm reduction was operationalized and implemented through the guiding tools and resources available to staff for program delivery. Findings highlighted several ways in which harm reduction was being delivered within the HF4Y program, including working with youth to ensure safe substance use; connecting youth to services in the community; providing youth with individualized support; reducing stigma around substance use; and empowering youth who use substances. Barriers to harm reduction delivery were also identified, including a lack of low-barrier housing for youth who actively use substances and the expectations of some landlords. These findings emphasize the need for increased advocacy for housing options for youth experiencing homelessness and substance use issues and further research to address other contextual factors promoting and limiting harm reduction delivery in HF programming.
青年优先住房（HF4Y）是一种针对青年群体的住房和服务提供方式，它改编自成熟的优先住房（HF）方法，旨在为无家可归者提供住房和服务。鉴于青年无家可归与物质使用问题增加的可能性相关，HF4Y框架的一个核心原则是采用减少伤害的方法来应对物质使用问题。然而，关于HF4Y的研究尚未考察在这些环境中减少伤害是如何具体实施的。本研究通过考察减少伤害的原则和理念如何在一个针对无家可归且并发疾病的青年的HF4Y项目中得以实施和执行，填补了这一空白。本研究是对一个为期5年的HF4Y研究示范项目——加拿大不列颠哥伦比亚省基洛纳市和安大略省多伦多市的重启项目进行的更大规模评估的一部分。对基洛纳市项目点的8名项目负责人和服务提供者进行了访谈，以收集他们对HF4Y项目中减少伤害服务提供的看法。此外，还分析了项目文件和案例管理材料，以考察如何通过工作人员可用于项目实施的指导工具和资源来实施和执行减少伤害措施。研究结果突出了HF4Y项目中实施减少伤害措施的几种方式，包括与青年合作以确保安全使用物质；将青年与社区服务联系起来；为青年提供个性化支持；减少对物质使用的污名化；以及增强使用物质的青年的权能。还确定了减少伤害服务提供的障碍，包括缺乏供积极使用物质的青年居住的低门槛住房以及一些房东的期望。这些研究结果强调，需要加大对为无家可归且有物质使用问题的青年提供住房选择的宣传力度，并开展进一步研究，以解决促进和限制HF项目中减少伤害服务提供的其他背景因素。
