Premier’s Youth Initiative — Service Improvement Study

The Premier’s Youth Initiative aims to prevent homelessness among at risk young people leaving care and divert them from the homelessness service system altogether. The Initiative service model has been designed to provide a combination of
- mentoring-like support through personal advisor, who can co-ordinate adolescents transition from care to adulthood,
- education and employment mentoring,
- transitional accommodation support and long-term accommodation.

The initiative was designed by FACS and will be further developed using a Continuous Quality Improvement (CQI) process.

2017-11-27

2020-06-30

Homelessness, reduction or delay of risk factors and consequences for homelessness

Homelessness:
• Whether or the participant was homeless at any time during the trial period
• The number of days that the participant was homeless during the trial period (0 to total number of days in the trial)

Prevention or delay of risk factors and consequences of homelessness:
• Number of contacts with Specialist Homelessness Services
• The Personal Wellbeing Index (aggregated score across 7 items)
• DSM 5 cross-cutting symptom measure (aggregated score across 23 items)

Secondary outcomes will be measured along the domains home, health, education, economic outcomes, safety and empowerment.
Service use and intensity as well as academic achievement will be assessed using administrative data.

The secondary outcomes will be tracked using validated measures:
• Home: Housing Instability Questionnaire from the California Youth Transitions to Adulthood Study
• Social and Community: Warwick-Edinburgh Mental Wellbeing Scale; Duke-UNC Functional Social Support Questionnaire
• Empowerment: General Self Efficacy Scale
• Health: DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure - Adult

Participants will be young people leaving out of home care in New South Wales (NSW) regions Central Coast, Hunter New England, Illawarra Shoalhaven, Nepean Blue Mountains, South Western Sydney, Southern NSW and Western NSW.
In addition to location, participation criteria are:
- the young person is between 16.5 and 18 years old,
- the young person is leaving Statutory out-of-home care
- the young person is at risk or likely to be homeless upon leaving care.

All youth in the target locations who are, or will turn, age 17 during the study recruitment period (FY 2017-2019) and who meet one or more of the four inclusion criteria above will be eligible to participate. All young people who meet these criteria will be invited to participate in the trial and join the evaluation.

Participating young people will be randomly assigned to the intervention or control group. Immediately after consent has been received but latest within 30 days, a baseline assessment will be conducted by a dedicated consent worker.

Outcomes will be tracked using validated measures. The measures will be taken at a minimum of three time points that correspond to the age of the young person:
1. Initial assessment: Within 6 months of their 17th birthday
2. Second assessment: Within 2 months prior to their 18th birthday or 2 months prior to exiting out-of-home care
3. Third assessment: Within 2 months prior to their 19th birthday or 12 months after transitioning from out-of-home care

These time points were chosen as they correspond to the beginning of the intervention (Initial assessment), when the young person is still in OOHC (Second assessment), and when the anticipated effect of the intervention is most likely to be felt (Third assessment and admin data).

To augment the information collected through surveys the evaluation will also employ administrative data collected continuously for the duration of the study.

Since all potential participants will be residing in out-of-home care, eligible youth can be identified using administrative data provided by FACS. In order to avoid delays in case management processes and unnecessary burden for participants, young people will be randomly assigned to intervention or control group prior to their consent. However, the participants’ case worker (and anyone involved in the allocation process) will not know the allocation result for the participant prior to consent and administration of the baseline assessment. After the client's case worker has completed the consent process and baseline assessment, FACS and providers will be informed about whether a youth was allocated PYI or BAU so they can begin delivering each of these services.

Randomization done in office by a computer

Randomization will be conducted at the individual level, i.e. young people will be randomly assigned to the intervention or control group.

No

Minimum of 250 young people leaving statutory out-of-home care. Based on preliminary analyses, we anticipate approximately 1000 youth to participate in this study over the duration of two years.

Minimum of 250 young people leaving statutory out-of-home care. Based on preliminary analyses, we anticipate approximately 1000 youth to participate in this study over the duration of two years.

Minimum sample size:
Treatment condition: 125 young people.
Control condition: 125 young people

Expected sample size:
Treatment condition: 500 young people
Control condition: 500 young people

We estimate the power for our key outcome variable, the proportion of those leaving out-of-home-care that become homeless within the first year of leaving out-of-home-care using the following assumptions: • The baseline rate of those leaving out-of-home-care becoming homeless within the first year is 30 per cent • We will have 1,000 individuals in the trial • Our analysis will be clustered at the region level, and include controls for the region • Conservative assumptions on the variation in outcomes and between regions (standard deviation of 10 per cent at both levels) Based on these assumptions, we estimate that we will be able to detect a treatment effect of approximately 8 percentage points at 80% power. This shows that we are powered to detect a difference if the treatment group has a homelessness rate of 22 per cent or less after the first year.