JMIR Publications

ABSTRACT

Background:

This 12-month pilot randomized controlled trial (RCT) builds on previous community-engaged work and explores whether portable rent subsidies and an intervention targeting identity capital (purpose, control, self-efficacy, and self-esteem) hold promise as a way to facilitate socioeconomic inclusion for youth (age 16-24 years) exiting homelessness and living in market rent housing in Ontario, Canada. All (n = 40) participants received rent subsidies; half were randomly assigned an identity capital intervention (co-designed leadership guide + coach).

Objective:

The objectives of this trial were to: 1. Primary – examine the feasibility and acceptability of a RCT of targeted economic and identity-based supports to foster socioeconomic inclusion. 2. Secondary – estimate the effect of adding identity-based supports to economic supports (intervention group) compared with economic supports alone (control group) at the 12-month endpoint with respect to self-reported proxy indicators of socioeconomic inclusion. 3. Exploratory – among the intervention group, explore whether the estimated effect of the intervention differs by baseline variables or level of engagement with the intervention.

Methods:

This study was a convergent mixed-methods, two-arm parallel RCT, open-label design with 1:1 allocation. The overall study was guided by community-based participatory action research axiology. The qualitative component employed a qualitative descriptive design underpinned by critical social theory. The measures used were: 1. Primary – recruitment/enrolment/dropout metrics; self-report composite checklists regarding intervention engagement; coaching session attendance; qualitative focus groups. 2. Secondary – education, employment and training; housing security; identity capital. 3. Exploratory – impact of baseline variables (e.g., participant demographics such as gender or mental health symptoms as measured by the Global Appraisal of Individual Needs) or level of engagement with intervention (coaching session attendance) on secondary measures.

Results:

Recruitment and enrolment began March 1, 2023, and ended June 19, 2023. Data collection began March 7, 2023 and ended June 17, 2024. Qualitative and quantitative data analyses concluded August 20, 2024.

Conclusions:

This novel intervention could transform the way we conceptualize the types of supports that are necessary to sustain successful exits from homelessness. The intervention was co-designed with youth who have experienced homelessness, and their voices will continue to inform the next iteration of this work. Clinical Trial: ClinicalTrials.gov Identifier: NCT05781503