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The Identity Project (TIP)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03772522
Recruitment Status : Completed
First Posted : December 11, 2018
Results First Posted : May 12, 2020
Last Update Posted : May 12, 2020
Sponsor:
Collaborators:
dk Leadership
Covenant House Toronto
Ontario Trillium Foundation
Information provided by (Responsible Party):
St. Michael's Hospital, Toronto

Brief Summary:

Understanding how to create successful pathways out of homelessness is crucial. Thirty young people (aged 18 - 26 years) who have transitioned out of homelessness within the past three years will be offered scholarships to participate in a six week intervention that focuses on building identity capital (sense of purpose and control, self-efficacy and self-esteem) and providing career direction. The intervention will be designed and carried out by dk Leadership - an established, highly successful leadership and counseling centre in Toronto with a track record of significantly improving the life trajectories of teens and adults. Importantly, study participants will be incorporated into the centre's current programming, meaning the intervention will be held at a location not associated with homelessness. Study participants will be collaboratively recruited by dk Leadership and Covenant House Toronto - Canada's largest agency for street-involved and homeless youth.

This impact and process evaluation aims to address critical gaps in knowledge about transition-related supports by asking whether and how an identity capital intervention delivered outside the social service sector impacts the life-trajectories of formerly homeless young people. Particular attention will be paid to whether this intervention shows promise as an unconventional way to tackle poverty and improve social inclusion.

It is hypothesize that, for the primary quantitative outcome measures of hope, community integration, social connectedness, and self-esteem:

  1. Significant improvements in the mean scores of the intervention group compared to the delayed intervention comparison group immediately post-intervention will be observed.
  2. Significant improvements in the mean scores of both groups (intervention and delayed intervention) immediately post-intervention will be observed.
  3. These significant improvements will be sustained in both groups for at least three months post-intervention.

Condition or disease Intervention/treatment Phase
Youth Homelessness Behavioral: dk Leadership Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 27 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Thirty young people (aged 18 - 26 years) who have transitioned out of homelessness within the past three years will be offered scholarships to participate in a six-week intervention that focuses on building identity capital and providing career direction. The intervention will be designed and carried out by dk Leadership - an established, highly successful leadership and counseling centre in Toronto with a track record of significantly improving the life trajectories of teens and adults. Importantly, study participants will be incorporated into the centre's current programming, meaning the intervention will be held at a location not associated with homelessness. All of the participants will be invited to attend two focus groups, which will be conducted immediately post-intervention and at six months post-intervention. Each focus group will contain approximately 8 - 10 youth. Participants in the intervention and delayed intervention will be in separate focus groups.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Identity Project: An Evaluation of an Identity Capital Intervention for Young People Transitioning Out of Homelessness
Actual Study Start Date : April 1, 2018
Actual Primary Completion Date : August 6, 2019
Actual Study Completion Date : August 6, 2019

Arm Intervention/treatment
Experimental: Immediate dk Leadership Intervention

Participants allocated to the immediate intervention group are assessed for study outcomes immediately prior to the 6-week dk Leadership intervention and immediately after the intervention.

Outcomes measured immediately post-intervention are compared with participants who have not received the intervention during the 6 weeks.

After the delayed intervention group takes the intervention, the two groups are joined into a single arm.

Behavioral: dk Leadership
Participants will attend two full-day workshops and four half-day group coaching sessions over the course of six weeks. The workshops and coaching sessions will be supplemented by on-line (e.g., podcasts) and print (e.g., workbooks) material. The full-day workshops will focus on identity-enhancing topics such as self-understanding, creating a life of meaning and purpose, and strategic career development. The half-day group coaching sessions will focus on workshop debriefing and on exploring solutions to transition-related challenges faced by study participants. The program was designed and carried out by dk Leadership - an established leadership and executive coaching centre in Toronto, Canada.

Placebo Comparator: Delayed dk Leadership Intervention

Participants allocated to this arm receive 6 weeks of no intervention. Outcomes are measured immediately before and immediately after the 6 week period. The change in outcomes are compared with participants who have received the intervention during the 6 week period.

This group then receives the same dk Leadership intervention; after this point, the two groups are joined into a single arm for subsequent analyses.

Behavioral: dk Leadership
Participants will attend two full-day workshops and four half-day group coaching sessions over the course of six weeks. The workshops and coaching sessions will be supplemented by on-line (e.g., podcasts) and print (e.g., workbooks) material. The full-day workshops will focus on identity-enhancing topics such as self-understanding, creating a life of meaning and purpose, and strategic career development. The half-day group coaching sessions will focus on workshop debriefing and on exploring solutions to transition-related challenges faced by study participants. The program was designed and carried out by dk Leadership - an established leadership and executive coaching centre in Toronto, Canada.




Primary Outcome Measures :
  1. Mean Change From Baseline in Hopelessness as Measured by the Beck Hopelessness Scale [ Time Frame: Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]

    Assessed using Beck's Hopelessness Scale, a 20-item scale which measures motivation, expectations, and feelings about the future (internal consistency α = .93). The total scoring range is 0-20, with 0-3 = no or minimal hopelessness, 4-8 = mild hopelessness, 9-14 = moderate hopelessness- requires monitoring, and 15+ = severe hopelessness- suicide risk.

    Participants' scores at baseline will be compared with their scores post-intervention to detect changes in levels of hopelessness. The change in scores over time will describe the general trajectory of hopelessness.


  2. Mean Change From Baseline in Community Integration (Psychological and Physical) Scores as Measured by the Community Integration Scale (CIS) [ Time Frame: Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]

    Assessed using the Community Integration Scale, an 11-item scale which measures behavioural (e.g., participation in activities) and psychological (e.g., sense of belonging) aspects of community integration. The CIS includes a physical subscale (with scores ranging from 0-7) and a psychological subscale (with scores ranging from 4-20). Higher scores indicate greater community integration. This scale was used extensively in the Chez Soi/At Home study, but psychometric properties have yet to be reported.

    Participants' scores at baseline will be compared with their scores post-intervention to detect changes in levels of community integration. The change in scores over time will describe the general trajectory of community integration.


  3. Mean Change From Baseline in Social Connectedness Scores as Measured by the Social Connectedness Scale (SCS) [ Time Frame: Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]

    Measured using the Social Connected Scale, a 20-item scale which measures belongingness - the degree to which people feel connected to others (internal consistency α = .92). Scores range from 20-120, with higher scores indicating greater social connectedness.

    Participants' scores at baseline will be compared with their scores post-intervention to detect changes in social connectedness. The change in scores over time will describe the general trajectory of social connectedness.


  4. Mean Change From Baseline in Self-esteem Scores as Measured by the Rosenberg Self-Esteem Scale (RSS) [ Time Frame: Assessed at 6 weeks pre-baseline (for the delayed intervention group only), at baseline (immediately pre-intervention), immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]

    Assessed using the Rosenberg Self-Esteem Scale, a 10-item scale which measures of global self-worth (internal consistency α = .77 - .88). Scores range from 0-30. A score of <15 is categorized as low self-esteem, and 15-30 is categorized as normal self-esteem.

    Participants' scores at baseline will be compared with their scores post-intervention to detect changes in self-esteem. The change in scores over time will describe the general trajectory of self-esteem.



Secondary Outcome Measures :
  1. Change in Vocational Participation/Employment as Assessed by a Questionnaire From Baseline to 9-Months [ Time Frame: Assessed at baseline (immediately pre-intervention) and 9 months post-intervention ]
    Acquirement of meaningful employment will be assessed. Participants will be prompted to answer questions about their current employment status, intensity of employment, and type of employment in the questionnaire. The change in the number of participants engaging in employment over time at the aggregate level will be assessed.

  2. Change in Academic Participation/Educational Attainment as Assessed by a Questionnaire From Baseline to 9-Months [ Time Frame: Assessed at baseline (immediately pre-intervention) and 9 months post-intervention ]
    Participants will be prompted to answer questions about their current educational pursuit, and type of schooling or training program in a questionnaire. The change in the number of participants engaging in education over time on the aggregate will be assessed.

  3. Number of Themes Related to Change in Career Awareness Informed by Focus Groups With Participants [ Time Frame: 60 - 90 minute focus groups at each of the following timepoints: immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]
    This outcome will describe the general trajectory of career awareness. Self-awareness, confidence, ability to articulate career goals, and understanding of how to achieve career goals will be assessed in focus groups. The questions posed during the focus groups will be guided by the evaluation objectives, but will be conversational and exploratory in nature with particular attention to identity capital, life-trajectories, and social inclusion. All will be conducted by the co-investigator at locations most convenient for the study participants, and will be audio recorded and transcribed verbatim. All focus groups will be analyzed together; the themes identified from the analysis will be presented as one data entry.

  4. Number of Themes Related to Change in Knowledge and Use of Soft Skills Informed by Focus Groups With Participants [ Time Frame: 60 - 90 minute focus groups at each of the following timepoints: immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]
    Acquirement of soft skills such as motivation, goal setting, self-discipline, and organization will be assessed in focus groups. The questions posed during the focus groups will be guided by the evaluation objectives, but will be conversational and exploratory in nature with particular attention to identity capital, life-trajectories, and social inclusion. All will be conducted by the co-investigator at locations most convenient for the study participants, and will be audio recorded and transcribed verbatim. All focus groups will be analyzed together; the themes identified from the analysis will be presented as one data entry.

  5. Number of Themes Related to Participant Perspectives of Intervention Barriers and Facilitators, as Informed by Focus Groups With Participants [ Time Frame: 60 - 90 minute focus groups at each of the following timepoints: immediately post-intervention, 3 months post-intervention, 6 months post-intervention, and 9 months post-intervention ]
    In focus groups, youth will be prompted to discuss the strengths and drawbacks of conventional programs for youth transitioning out of homelessness. These evaluations will be compared to this intervention to determine what aspects of programs youth find most helpful, and which could be improved upon. The questions posed during the focus groups will be guided by the evaluation objectives, but will be conversational and exploratory in nature with particular attention to identity capital, life-trajectories, and social inclusion.All will be conducted by the co-investigator at locations most convenient for the study participants, and will be audio recorded and transcribed verbatim. All focus groups will be analyzed together; the themes identified from the analysis will be presented as one data entry.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 26 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Between 18-26 years of age
  • Left homelessness within the last 3 years (youth living in supportive housing contexts (e.g., transitional housing) will be considered to have left homelessness)
  • Currently not homeless (youth in supportive or transitional housing are eligible)
  • A concerted effort will be made to recruit young people facing additional identity-related challenges like newcomer and racialized youth, Indigenous youth, and youth who belong to the LGBTQ2S community.

Exclusion Criteria:

  • Not fluent in English
  • Cannot provide informed consent
  • Cannot commit to attending two full-day workshops and four half-day group coaching sessions over the course of six weeks (missing more than one workshop and two coaching sessions will disqualify participants from the study)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03772522


Locations
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Canada, Ontario
St. Michael's Hospital
Toronto, Ontario, Canada
Sponsors and Collaborators
St. Michael's Hospital, Toronto
dk Leadership
Covenant House Toronto
Ontario Trillium Foundation
Investigators
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Principal Investigator: Naomi S Thulien St. Michael's Hospital, Toronto
  Study Documents (Full-Text)

Documents provided by St. Michael's Hospital, Toronto:
Publications:
Gaetz, S., Dej, E., Richter, T., & Redman, M. (2016) The state of homelessness in Canada 2016. Toronto, ON: Canadian Observatory on Homelessness Press. Retrieved from http://www.homelesshub.ca/SOHC2016
Gaetz, S., & Redman, M. (2016). Federal investment in youth homelessness: Comparing Canada and the United States and a proposal for reinvestment. Canadian observatory on homelessness policy brief. Toronto, ON: The Homeless Hub Press. Retrieved from http://homelesshub.ca/sites/default/files/Policy_Brief.pdf
Karabanow, J. (2008). Getting off the street: Exploring the process of young people's street exits. American Behavioral Scientist, 51(6), 772-788. doi:10.1177/0002764207311987
Covenant House Toronto. (2016). Facts and stats. Retrieved from http://www.covenanthousetoronto.ca/homeless-youth/Facts-and-Stats
Kidd, S.A., Frederick, T., Karabanow, J., Hughes, J., Naylor, T., & Barbic, S. (2016). A mixed methods study of recently homeless youth efforts to sustain housing and stability. Child and Adolescent Social Work Journal, 33(3), 207-218. doi:10.1007/s10560-015-0424-2
Mayock, P., O'Sullivan, E., & Corr, M.L. (2011). Young people exiting homelessness: An exploration of process, meaning and definition. Housing Studies, 26(6), 803-826. doi:10.1080/02673037.2011.593131
Brueckner, M., Green, M., & Saggers, S. (2011). The trappings of home: Young homeless people's transitions towards independent living. Housing Studies, 26(1), 1-16. doi:10.1080/02673037.2010.512751
Gaetz, S. (2014). Coming of age: Reimagining the response to youth homelessness in Canada. Toronto, ON: The Canadian Homelessness Research Network Press. Retrieved from http://www.homelesshub.ca/comingofage
Karabanow, J., Carson, A., & Clement, P. (2010). Leaving the streets: Stories of Canadian youth. Halifax, NS: Fernwood Publishing.
Public Interest. (2009). Changing patterns for street involved youth. Toronto, ON: Author. Retrieved from http://www.worldvision.ca/Programs-and- Projects/Canadian Programs/Documents/ChangingPatternsForStreetInvolvedYouth.pdf
Karabanow, J., Kidd, S., Frederick, T., & Hughes, J. (2016). Toward housing stability: Exiting homelessness as an emerging adult. Journal of Sociology & Social Welfare, 43(1), 121- 148. Retrieved from https://wmich.edu/socialworkjournal
Frederick, T., Chwalek, M., Hughes, J., Karabanow, J., & Kidd, S. (2014). How stable is stable? Defining and measuring housing stability. Journal of Community Psychology, 42(8), 964- 979. doi:10.1002/jcop.21665
Thulien, N.S. (2017). Chronic precarity: A critical examination of homeless youth transitions to independent housing (Doctoral dissertation). University of Toronto: Toronto, ON. Retrieved from https://tspace.library.utoronto.ca/bitstream/1807/78804/3/Thulien_Naomi_201706_PhD_thesis.pdf
Côté, J.E. (2016). The identity capital model: A handbook of theory, methods, and findings. Unpublished manuscript, Department of Sociology, The University of Western Ontario, London, Ontario, Canada. Retrieved from https://www.researchgate.net/publication/305698905_The_Identity_Capital_Model_A_Handbook_Of_Theory_Methods_And_Findings
Lee, C., & Berrick, J.D. (2014). Experiences of youth who transition to adulthood out of care: Developing a theoretical framework. Children and Youth Services Review, 46, 78-84. Retrieved from http://dx.doi.org/10.1016/j.childyouth.2014.08.005
Kidd, S., Frederick, T., Morales, S., Daley, M., & Vitopoulos, N. (2016, November). The Toronto housing outreach program collaborative (HOP-C): Stabilizing housing for recently homeless youth. Oral presentation at the Canadian Alliance to End Homelessness National Conference, Montreal, QC. Retrieved from http://conference.caeh.ca/wp-content/uploads/AWH5_The-Toronto-Housing-Outreach-Program-Collaborative-TFrederick-et-al.pdf
dkLeadership. (2017). Dream it. Do it. Retrieved from http://www.dkleadership.org Urbaniak, G.C., & Plous,S. (2013). Research Randomizer (Version 4.0) [Computer software]. Retrieved from https://www.randomizer.org
Lee, R. M., & Robbins S. B. (1995). Measuring belongingness: The social connectedness and the social assurance scales. Journal of Counseling Psychology, 42, 232-241
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.
Hammersley, M., & Atkinson, P. (2007). Ethnography: Principles in Practice (3rd ed.). London, UK: Routledge.
Kusenbach, M. (2003). Street phenomenology: The go-along as ethnographic research tool. Ethnography, 4(3), 455-485. Retrieved from http://eth.sagepub.com
Creswell, J.W. (2014). Research design: Qualitative, quantitative, and mixed method approaches (4th ed.). Thousand Oaks, CA: Sage.
Kawabata, M., & Gastaldo, D. (2015). The less said, the better: Interpreting silence in qualitative research. International Journal of Qualitative Research Methods, 14(4), 1-9. doi:10.1177/1609406915618123
Loiselle, C.G., Profetto-McGrath, J., Polit, D.F., & Tatano Beck, C.T. (2004). Canadian essentials of nursing research. Philadelphia, PA: Lippincott Williams & Wilkins.
SocioCultural Research Consultants, LLC. (2016). Dedoose (Version 7.0.23) [web application]. Retrieved from http://www.dedoose.com

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Responsible Party: St. Michael's Hospital, Toronto
ClinicalTrials.gov Identifier: NCT03772522    
Other Study ID Numbers: 18-002
First Posted: December 11, 2018    Key Record Dates
Results First Posted: May 12, 2020
Last Update Posted: May 12, 2020
Last Verified: May 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by St. Michael's Hospital, Toronto:
Hopelessness
Self Esteem
Social Isolation
Employment Status
Education
Housing Problems
Identity, Social
Self Efficacy
Control Locus
Poverty
Youth
Homelessness
Homeless Youth