Abstract
Health-risk behaviors and associated adverse health outcomes in homeless adolescents are well documented. Strengths of these youth that contribute to their health and well-being are seldom acknowledged. The purpose of this secondary analysis of qualitative data was to identify strengths that protect homeless youth. Two types of strengths emerged: resources and self-improvement. Resources served as the foundation for survival whereas self-improvement served as a process that enabled youth to consider a more healthy future. By recognizing the many strengths of homeless youth, nurses may develop community-based programs to help this population reenter society.
HEALTH RISKS for homeless individuals are well documented, ranging from acute and chronic respiratory diseases to various psychiatric disorders.1,2 The health risks for homeless adolescents are compounded by their engagement in high-risk behaviors such as using alcohol and intravenous drugs, exchanging sex for money or food, and having multiple sex partners.1,3,4 Moreover, homeless youth are particularly vulnerable to sexually transmitted infections (STI) and the human immunodeficiency virus (HIV) because they often combine using drugs with engaging in sexual activities with multiple partners.5-9
The preponderance of research on adolescents who are homeless has focused on their deficits and problem behaviors.10-18 However, a few nurse researchers have begun to identify strengths in homeless individuals. For example, Montgomery19 interviewed 7 women between the ages of 35 and 53 years who had overcome homelessness and found that they had personal, interpersonal, and transpersonal strengths such as pride, moral principles, determination, and commitment to personal relationships. These strengths served to protect them from adverse health outcomes associated with being homeless. Similarly, McCormack and MacIntosh20 conducted a grounded theory study with 11 homeless males and females between the ages of 17 and 56 years and found that there were numerous pathways to health for these individuals. In particular they found that participants exhibited self-confidence and considered themselves to be the primary resource for health promotion. Rew21 conducted a secondary analysis of data from a convenience sample of 32 homeless youth and identified positive strategies of coping with loneliness. These strategies included making friends with other homeless youth and having a dog for a companion. Rew stated that such positive coping strategies could enable homeless youth to develop in a healthy manner and attenuate their vulnerability. Pender22 asserted that the motivation for engaging in health-promotive behaviors stems more from positive factors or strengths such as the desire for growth and human potential than from negative factors. The purpose of this study was to synthesize findings from 3 qualitative studies of homeless adolescents and identify strengths that might serve as motivators for health-promoting behaviors in this vulnerable population.