Table 3 Characteristics of Included Systematic Reviews
Study | Design and Quality | Objective | Included Studies | Population | Interventions | Results/Outcomes |
|---|---|---|---|---|---|---|
Altena 2010 | Systematic Review AMSTAR 5/13 Critically low quality review | “To provide a summary of effective interventions for homeless youth by collecting, summarizing, categorizing, and evaluating quantitative studies.” | n = 11 Cauce (1998) [RCT, 150, USA] Slesnick (2007) [RCT, 180, USA] Peterson (2006) [RCT, 285, USA] Baer (2007) [RCT, 117, USA] Hyun (2005) [RCT, 32, South Korea] Upshur (1985) [Quasi-experimental, 57, USA] Upshur (1986) [Quasi-experimental, 22, USA] Ferguson (2008) [Quasi-experimental, 28, USA] Fors (1995) [Quasi-experimental, 221, USA] Kisely (2008) [Quasi-experimental, 45, Canada] Slesnick (2008) [Uncontrolled pre- post-, 172, USA] | Youth experiencing homelessness between the ages of 10 and 24 years, regardless of location or subgroup, whether living on the street or in service accommodations. This typically included more males than females. The proportion of youth with mental health or substance use issues varied greatly. | • Intensive case management • Independent living programs • Brief motivational intervention • Intensive case management, • cognitive behavioral intervention • living skills/vocational intervention • peer-based intervention • supportive housing. | The authors found that there was insufficient evidence to claim any clinical effectiveness in any of the interventions. |
Coren 2016 | Meta-analysis AMSTAR 14/16 Low quality review | “To evaluate and summarize the effectiveness of interventions for street-connected children and young people that aim to promote inclusion and reintegration, increase literacy and numeracy, facilitate access to education and employment, promote mental health, including self-esteem, reduce harms associated with early sexual activity and substance misuse” | n = 13 Baer (2007) [RCT, 127, USA] Carmona (2014)/Slesnick (2015) [RCT, 270, USA] Cauce (1994) [RCT, 115, USA] Hyun (2005) [RCT, 27, South Korea] Milburn (2012) [RCT, 151, USA] Nyamathi (2012/13) [RCT, 100,USA] Peterson (2006) [RCT, 285, USA] Rew (2007) [Quasi-RCT, 572, USA] Rotheram-Borus (2003) [CBA, USA, 311] Slesnick (2005) [RCT, 124, USA] Slesnick (2007/08) [RCT, 580, USA] Slesnick (2009) [RCT, 129, USA] Slesnick (2013)/Guo (2014) [RCT, 179, USA] | Street-connected children and young people between birth and 24 years of age regardless of location, reason for street connectedness or gender, including those living or working on the street or in public places, and returning to the family home at different times. | • harm-reduction • inclusion programs • reintegration programs • shelter • housing • drop in support • any type of intervention interventions explicitly aimed at reducing risky sexual activity and substance misuse • Individual • Family • Small groups • Entire communities. • Multi-faceted interventions that incorporate a range of approaches, including housing, education, training and health.” | There appeared to be no difference in effect between focused therapies and standard services for street-connected children and young people. |
Noh 2018 | Meta-analysis AMSTAR 8/13 Critically low quality review | “To examine the literature for psychological interventions directed toward runaway and homeless youth and to evaluate the effectiveness of these interventions in terms of mental health outcomes.” | n = 11 Baer (2007) [RCT, 127, USA] Brillantes-Evangelista (2013) [non-RCT, 29, Philippines] Hyun (2005) [RCT, 27, South Korea] McCay (2011) [non-RCT, 15, Canada] McCay (2015) [non-RCT, 89, Canada] Milburn (2012) [RCT, 151, USA] Peterson (2006) [RCT, 285, USA] Rew (2017) [non-RCT, 80, USA] Slesnick (2005) [RCT, 124, USA] Slesnick (2007) [RCT, 180, USA] Slesnick (2009) [RCT, 119, USA] | Youth experiencing housing instability that are 12–24 years of age. Most of the included studies included both males and females. Two of the studies included only females or males. | • Art therapy • Cognitive behavioral therapy (CBT) umbrella • Family therapy • Motivational interviewing • Strengths-based interventions | None of the psychological interventions appeared to have any effect on mental health outcomes. However, substance use appeared positively affected by Family Therapy, and depression appeared positively affected by CBT. |
Xiang 2013 | Systematic Review AMSTAR 7/13 Critically low quality review | “Primary: to summarize evidence on interventions for substance use among homeless youth Secondary: to draw implications for practice, to provide a critical appraisal of the methodologies in existing literature, and to suggest avenues for future research.” | n = 15 Peterson et al. (2006) [RCT, 185, USA] Baer et al. (2007) [RCT, 127, USA] Slesnick, Prestopnik, Meyers, et al. (2007) [RCT, 180, USA] Slesnick, Kang et al. (2008) [Longitudinal, 172, USA] Booth et al. (2008) [Crossover, 147, USA] Ferguson & Xie (2008) [Prospective, 28, USA] Cauce et al. (1994, 1998) [RCT, 304, USA] Souza et al. (2011) [Longitudinal, 400, Honduras] Stewart et al. (2009) [Prospective, 70, Canada] Slesnick, Bartle-Haring, et al. (2006)/Slesnick & Prestopnik (2005, 2009) [RCT, 243, USA] Milburn et al. (2012) [RCT, 151, USA] Steele & O’Keefe (2001) [Longitudinal, 106, USA] Rotheram-Borus (2003) [Prospective, 187, USA] Pollio et al. (2006) [Longitudinal, 371, USA] Kisely et al. (2008) [Retrospective, 45, Canada] | Youth experiencing homelessness between the ages of 12 and 24 | • Brief motivational intervention • Community reinforcement approach • Knowledge and skills training • Case management • Peer support interventions • Family therapy • Shelter services • Supportive housing | Most studies showed improvements in substance use outcomes, however, improvements rarely varied between the treatment group and the control group. The only treatment shown to have greater relative efficacy was family therapy. |