NIH grant funds research with youth experiencing homelessness

Young adults living on the streets face a daily struggle to find food and shelter, many after having fled unsupportive homes. This trauma and chronic stress often lead to risky behaviors with serious health consequences.

“Youth experiencing homelessness are 10 times more likely than their stably housed counterparts to die from causes such as suicide and drug overdoses, and they are more likely to engage in sexual risk behaviors and substance use,” said Diane Santa Maria, DrPH, MSN, ACRN, PHNA-BC, FSAHM, FAAN, dean of Cizik School of Nursing at UTHealth Houston. “By developing coping skills such as stress management and emotion regulation, they become better equipped to make health-promoting decisions.”

Santa Maria has long worked with youth experiencing homelessness, and her most recent federal grant will expand feasibility testing of a mindfulness-based intervention to improve coping skills. She will use a $1.66 million award from the National Center for Complementary and Integrative Health of the National Institutes of Health for her study, “Assessing the Feasibility of a Multi-Site .b4me Mindfulness Intervention with Sheltered Homeless Youth (R01AT013946).”

“This program of research is particularly important because, while mindfulness programs are being used with youth experiencing homelessness, they have not been subject to rigorous research to prove efficacy,” Santa Maria said.

In previous studies, her team worked with the .b curriculum developed by the UK-based Mindfulness in Schools Project. They adapted it as the .b4me program for use with young adults who live in a temporary youth emergency shelter in Houston. A small-scale study proved the feasibility and acceptability of .b4me, and the new grant will fund a randomized control trial with 180 participants ages 18-25 at shelters in Houston, Atlanta, and New Orleans.

Youth will be randomized into a control group who participate in health education sessions, and an intervention group who will be offered five mindfulness sessions over a two-week period. Participants will be interviewed at baseline, three months, and six months. Mobile phones and public transportation passes will be provided as needed to support follow-up engagement.

“Keeping in contact with youth experiencing homeless can be difficult, but we exceeded our retention goals in our earlier pilot projects,” Santa Maria said. “With our multisite project, we will assess the feasibility of recruitment, retention, and follow-up at multiple locations and lay the groundwork for a fully powered randomized control trial of .b4me.”

Co-investigators on the study are Paula Cuccaro, PhD, an assistant professor at the School of Public Health at UTHealth Houston; Erica Sibinga, MD, MHS, a professor of pediatrics at Johns Hopkins Medicine; and Kimberly Bender, PhD, MSW, a professor in the Graduate School of Social Work at the University of Denver.

Santa Maria serves on the Science Advisory Council of the American Academy of Nursing and on the Society for Adolescent Health and Medicine Board of Directors. She is the Jane and Robert Cizik Distinguished Chair and the Huffington Foundation Endowed Chair in Nursing Education Leadership.