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read the following article the answer in 600 words make sure each point is addresso Instrumentation or data collection methods (including data collection time points, reliability, and validity) o Proposed data analyses o Descriptive statistics lgbtq.pdf Unformatted Attachment Preview Out of the System and onto the Streets: LGBTQ-Identified Youth Experiencing Homelessness with Past Child Welfare System Involvement Youth who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) are over-represented in the child welfare system and Robin Hartinger-Saunders School of Social Work, Georgia State also among people experiencing University homelessness. This article reports on the experiences of youth who Eric Wright identify as LGBTQ and also Department of Sociology, Georgia State University have previous child welfare system involvement—as compared Erin Ruel to youth identifying as heteroDepartment of Sociology, Georgia State sexual, cisgender—as a subsample University of youth experiencing homelessness in a southeastern metropolitan area. The study sample was comprised of primarily black males who reported an average age of 21. Approximately one third of youth identified as LGBTQ. Over half of the youth in the sample had been in foster care, while 43\% indicated some other form of child welfare system involvement. Of those who had been in the foster care system, 11\% were eligible to return to care based on their age. When compared to their heterosexual, cisgender counterparts, a greater percentage of youth who are LGBTQ had been kicked out of their homes, had been homeless for more than one year, reported being abused as a child, were victimized while they were homeless, indicated a mental health problem, and identified adult friends or a professional contact (rather than family members) Nicholas Forge School of Social Work, Georgia State University 47 Child Welfare Vol. 96, No. 2 as a source of support. Fully 95\% of both groups in the sample reported some form of trauma. Findings support the need for child welfare system workers to adopt identity affirming, trauma-informed practices with youth who are in care and highlight the challenges in preparing youth for successful, independent living. The child welfare system and homeless providers should deliver a coordinated response to both prevent pathways to system involvement and intervene when necessary. 48 Forge et al. Child Welfare I n 2015, approximately 21,000 youth in the United States became emancipated—commonly referred to as “aged out”—from the foster care system; neither being adopted nor reunified with their family of origin, and were therefore expected to live independent lives (U.S. Department of Health and Human Services, 2016). In addition to the youth who aged out, nearly 1,000 youth ran away from foster care (U.S. Department of Health and Human Services, 2016). Over the past two decades, studies have consistently indicated a strong association between experiencing homelessness and having prior placement in the foster care system (Zlotnick, 2009). Youth who age out of foster care are among the populations at the greatest risk of becoming homeless (Dworsky, Dillman, Dion, Coffee-Borden & Rosenau, 2012) with as many as half of youth experiencing homelessness or housing instability within 18 months of their exit from the foster care system (Kushel, Yen, Gee, & Courtney, 2007). While precise population statistics on the number of youth experiencing homelessness are difficult to ascertain, it is estimated that approximately 1.24 million will face an episode of homelessness in a given year (National Center for Homeless Education, 2014), representing approximately seven percent of the total population who are homeless (Henry, Watt, Rosenthal, & Shivji, 2016). For youth who identify as lesbian, gay, bisexual, transgender, questioning (LGBTQ), or as non-heterosexual, or gender expansive, the risk of becoming homeless or facing housing instability is greater than that faced by their cisgender, heterosexual counterparts. Youth who identify as LGBTQ are less likely to be adopted or reunited with their family than heterosexual, cisgender youth, with those who identify as transgender or gender-expansive having the least success achieving permanency (Child Welfare Information Gateway, 2013; Jacobs & Freundlich, 2006), contributing to less security and greater risk for becoming homeless. Studies indicate that between 20 and 40\% of youth experiencing homelessness identify as LGBTQ (Cochran, Stewart, Ginzler, & Cauce, 2002; Durso & Gates, 2012; Quintana, Rosenthal, & Kehely, 2010; Van Leeuwen et al., 2006; Wright et al., 2016), which is 49 Child Welfare Vol. 96, No. 2 a significant overrepresentation when compared to general population estimates. Furthermore, youth of color are overrepresented among youth who are LGBTQ and experiencing homelessness (Choi, Wilson, Shelton, & Gates, 2015). To date, there is a significant dearth of published research available to understand, draw attention to, provide appropriate services to, and effectively advocate for a population who, although demonstrate large levels of resilience, face significant risks to their well-being. For youth who identify as LGBTQ and have previously been in the foster care system, or have some other form of child welfare system involvement, even more limited attention has been paid to their experience and well-being (McCormick, Schmidt, & Terrazas, 2017). While these youth share common experiences with their heterosexual, cisgender child welfare system-involved (CWS-I) counterparts (i.e., histories of trauma, poor relationships with parents/caregivers), they also have distinctive experiences related to their sexual orientation, gender identity and expression. While some research does exist on the experiences of youth who were previously CWS-I and who are experiencing homelessness, we are not aware of any studies that focus on sexual orientation and gender identity. This study aims to describe characteristics and experiences of youth who are LGBTQ who have previous child welfare system-involvement and are currently experiencing homelessness. Literature Review Children and youth with previous child welfare system-involvement are one of the most vulnerable populations in the United States. (American Academy of Pediatrics, 2005). A large body of literature highlights the increased risk for homelessness and subsequently poor social, educational, health, and financial outcomes among youth who age out of the foster care system (Bender, Yang, Ferguson, &Thompson, 2015). This section synthesizes some of these key issues in the literature. 50 Forge et al. Child Welfare Homelessness Youth report becoming homeless for a variety of reasons, including social, economic, and environmental influences, but youth who identify as LGBTQ most often report experiencing homelessness due to running away or being ejected from their home of origin because of their sexual orientation or gender identity (Durso & Gates, 2012; Rosario, Scrimshaw, & Hunter, 2012). For youth with histories of foster care system involvement, experiencing physical abuse, engaging in delinquent behaviors, and having symptoms of a mental illness are predictors of homelessness (Dworsky, Napolitano, & Courtney, 2013). Furthermore, research indicates that for emancipated youth aged 17 or 18, 14\% had experienced homelessness and 39\% were unstably housed (Kushel, Yen, Gee, & Courtney, 2007). Additionally, in a study of former foster youth, 31 to 46\% had experienced homelessness at least once by the time they turned 26 years old (Dworsky, Napolitano, & Courtney, 2013). Trauma and Violence The process of becoming, experiencing, and identifying as homeless is often traumatic for youth. This trauma is often confounded by previous occurrences of trauma and abuse experienced by youth who have had some form of child welfare system involvement; moreover, youth who are in care have often experienced sexual trauma, making them more likely to engage in risky sexual behaviors (Homma, Wang, Saewyc, & Kishor, 2012; Ramseyer Winter, Brandon-Friedman, & Ely, 2016). Youth experiencing homelessness with a history of foster care are more vulnerable to being recruited into sex trafficking (Fong & Cordosa, 2010). Furthermore, youth who identify as LGBTQ experience higher rates of rejection, abuse and victimization from their families of origin than their heterosexual, cisgender counterparts (Liu & Mustanski, 2012; Marshal et al., 2011; Wilson & Kastanis, 2015). For example, youth who are LGBTQ are 1.2 times more likely to be physically abused and 3.8 times more likely to experience sexual abuse at the hands of a parent or caregiver 51 Child Welfare Vol. 96, No. 2 than their peers who are heterosexual and cisgender (Friedman et al., 2011). For those who are in foster care, approximately one third report experiencing violence after revealing their identity to their family members (Laver & Khoury, 2008). Also, after becoming homeless, youth who identify as LGBTQ are more likely than youth who are heterosexual, cisgenderto experience additional trauma through physical and sexual victimization (Cochran, Stewart, Ginzler, & Cauce, 2002; Gattis, 2011). Mental Health and Risk Behaviors Experiences of heterosexism, transgender bias and stress, and distal stress associated with sexual and gender identity are significant threats to the mental health of youth (Steever, Francis, Gordon, & Lee, 2014). Youth who are lesbian, gay, and bisexual report high rates of depression (Marshal et al., 2012), and feelings of sadness or hopelessness that are greater than their heterosexual counterparts (Kann, Olsen, & McManus, 2016). They are also at increased risk for self-harm and suicidal ideation (Liu & Mustanski, 2012; Marshal et al., 2012), with one study reporting youth who are lesbian, gay, and bisexual were four times more likely to attempt suicide (Kann, Olsen, & McManus, 2016). Youth who are transgender face a similar trend in reports of mental health; they are at two to three times greater risk for depression, anxiety, suicidal ideation and attempts, and self-harm (Reisner, Vetters, Leclerc, Zaslow, Wolfrum, Shumer, & Mimiaga, 2015). Homelessness is related to high levels of daily stressors (Ecker, 2016) and mental health symptoms (Cauce et al., 2000; Yoder, Hoyt, & Whitbeck, 1998). Lack of permanency and feelings of insecurity, together with decreased levels of sleep, nutritional needs, combined with loneliness and a decreased sense of self-worth, serve to induce and exacerbate depressive symptoms (De Rosa, Montomery, Hyde, Iverson, & Kipke, 2001; Whitbeck & Hoyt, 2000). Youth who are LGBT and experiencing homelessness also experience increased levels of posttraumatic stress disorder (PTSD) and depressive symptoms, including feelings of sadness or hopelessness (Cochran, Stewart, Ginzler, & 52 Forge et al. Child Welfare Cauce, 2002; Gangamma, Slesnick, Toviessi, & Serovich, 2008; Walls, Hancock, & Wisneski, 2007; Whitbeck, Chen, Hoyt, Tyler, & Johnson, 2004). When a young person experiences homeless, their risk for substance use and abuse increases (Cauce et al., 2000; De Rosa, Montgomery, Hyde, Iverson, & Kipke, 2001; Whitbeck, Hoyt, Yoder, Cauce, & Paradise, 2001), although, the prevalence of use is similar irrespective of previous child welfare system-involvement (Hudson & Nandy, 2012). Substance use and abuse among youth who are LGBTQ has been reported at higher rates when compared to their heterosexual, cisgender counterparts (Cochran, Stewart, Ginzler, & Cauce, 2002; Salomonsen-Sautel et al., 2008; Unger et al., 1998; Unger, Kipke, Simon, Montgomery, & Johnson, 1997). Although there are conflicting findings when examining use of specific substances, youth who are LGBTQ and experiencing homelessness are more likely to use marijuana (Walls, Hancock, & Wisneski, 2007). Unstable housing also places youth at risk for contracting HIV and other sexually transmitted infections, including hepatitis C (Moon et al., 2000; Rew, Whittaker, Taylor-Seehafer, & Smith, 2005; Walls, Hancock, & Wisneski, 2007). Young males who are gay and experiencing homelessness are less likely to say they intend to use condoms and show lower levels of self-efficacy in using condoms when compared to heterosexual males (Taylor-Seehafer et al., 2007). Regarding actual usage, one study found, among 13–21 year olds experiencing homelessness, youth who are LGBTQ report high rates of unprotected intercourse (Cochran et al., 2002). Additionally, youth who are lesbian-identified and experiencing homelessness have higher rates of unprotected vaginal and anal sex than lesbians who were housed (Walls, Hancock, & Wisneski, 2007). Furthermore, there is an established body of research that posits that many youth experiencing homelessness engage in “survival sex” (Clatts & Davis, 1999; Ennett, Bailey, & Federman, 1999; Gaetz & O’Grady, 2002; Haley et al., 2000; Kipke, O’Connor, Palmer, & MacKenzie, 1995). Survival sex refers to the exchange of sexual behaviors for resources such as food, shelter, and money. For those young adults who 53 Child Welfare Vol. 96, No. 2 are LGBTQ-identified, the rate of engagement in survival sex has been reported to be greater (44\%) compared to 32\% of their heterosexual and cisgender counterparts (VanLeeuwen, et al., 2006). Social Support Young people experiencing homelessness often have few social resources and low levels of social support ( Johnson, Whitbeck, & Hoyt, 2005). Social support is an important protective factor that safeguards against negative experiences (Cohen, 2004) and predicts episodes of homelessness for youth who were previously in foster care; the more perceived social support, the less likely a youth is to experience homelessness (Dworsky & Courtney, 2009). Among the general population, youth who are lesbian, gay, and bisexual report low levels of social support (Marshal, et al., 2011). While on the street, youth seek support from their street based peers which is a relationship associated with more risky behaviors (Wenzel, Tuckers, Golinelli, Green, & Zhou, 2010). However, these peer networks are integral for both support and survival among youth (Garrett, Higo, Phares, Peterson, Wells, & Baer, 2008). For example, Smith (2008) found that youth often create “street families” that mirror the roles of family life which often alleviates stressors associated with homelessness. Methods Data This descriptive study used data from the 2015 Atlanta Youth Count (AYC) collected between May 15 and July 31, 2015. The full sample was comprised of 693 homeless and runaway youth between the ages of 14 and 25, who were experiencing homelessness in metro Atlanta at the time of the survey. The survey collected important demographic information about youth experiencing homelessness including age, race, gender, sexual orientation, gender identity, personal and family 54 Forge et al. Child Welfare background, trauma exposure, educational status, financial and employment status, health and mental health status, health risk behaviors, involvement with the child welfare, and criminal justice systems and contact with health and outreach organizations. The study was approved and overseen by Georgia State University’s Institutional Review Board (IRB, study number H15427). A waiver of parental consent was obtained for the initial study as the IRB determined that the population would likely include youth who had run away from home or were otherwise unaccompanied. A ‘minor response protocol’ was developed and followed each time researchers encountered a youth under the age of 18. This protocol included following state mandated reporting requirements and alerting a local police liaison if the youth was in imminent danger. Recruitment The AYC study used a sophisticated capture-recapture field sampling method to obtain a sample representative of the current population of youth experiencing homelessness in metro Atlanta. While originating in the biological sciences, capture-recapture methodologies have been successfully implemented in social science research (Bloor, Leyland, & McKeganey, 1991; Rossmo & Routledge, 1990; Smit, Toet, & van der Heijden, 1997). In the initial study, during the first wave of data collection respondents received a token. During two separate, two-week periods, additional waves of data collection followed, where respondents were asked if they had in their possession, or had seen, the token. This enabled the researchers to determine the number of respondents who were “unique” to each wave of data collection, and enabled the researchers to calculate a population estimate (for further description of the methodology used, see Wright et al., 2016). Teams of trained outreach workers, service providers, students and youth conducted the sweeps of metro area shelters, streets and known locations where youth experiencing homelessness routinely spend their time. 55 Child Welfare Vol. 96, No. 2 Study Participants Youth who were homeless or runaway between the ages of 14 and 25, who were (1) living independently (i.e., no consistent support from parents or other family members) and (2) without a permanent stable residence at the time of the survey, were eligible to participate in the full AYC study. Eligible participants were incentivized to take a brief 15-minute survey. At the completion of the survey, participants received a $10 Visa gift card and a list of community resources to access a wide array of services if necessary. Study Measures The survey instrument contained measures that indicated whether participants had been in the foster care system due to abuse and /or neglect, had been in foster care due to juvenile delinquency or had received any child welfare services other than foster care. Demographic information that included age, race, ethnicity, sexual orientation, and gender identity were included. Participants were asked to indicate the reason for and length of time they had been homeless. To explore each participant’s exposure to trauma, a series of questions were asked related to abuse and victimization, exposure to violence, and commercial sexual exploitation. The instrument included measures of mental health problems, indicators of serious mental health challenges and health-risk behaviors such as substance use and risky sexual behavior. Aspects of social support measures included the number of family, friends or professionals that participants felt they could rely on, as well as membership in a street family or crew. A detailed description of all study measures used on the survey instrument can be found in Appendix A. Statistical Analysis IBM SPSS 24 software was used for data screening, variable transformation, and analyses. Since the current study focused on youth experiencing homelessness who had previous child welfare system involvement, only participants who answered affirmative to one or more of the child 56 Forge et al. Child Welfare welfare system-involvement variables were included in the analyses for this study (n = 295). Other respondents were excluded. Results Descriptive Statistics Youth with prior CWS-I comprised 43\% of the full AYC sample. Within the CWS-I sample, 60\% indicated they had been in foster care because of previous abuse and/or neglect, 38\% had been in care because of juvenile delinquency or criminal behavior and 43.2\% reported receiving services from the child welfare system, other than foster care. Of youth who had been in the foster care system, 11\% were under the age of 21 and eligible to return to care. A large percentage (56.3\%) of the youth in the CWS-I sample experienced a parent going to jail or prison. The CWS-I sample was comprised of respondents who were primarily Black (65\%) and male (65.6\%), with a mean age of 21.4. Within the CSW-I sample, 29.8\% of youth self-identified as LGBQ and 8.8\% identified as transgender. There were no significant age, race or ethnicity differences between LGBTQ and heterosexual, cisgender participants (See Table 1.). Most CWS-I study participants (61.8\%) reported living in Georgia when they first bec ... Purchase answer to see full attachment