Electronic Case Management with Homeless Youth

Background: Case management, a widely-practiced form of service brokerage, is associated with numerous positive outcomes for homeless youth. However, homeless youth are often transient and face logistical barriers that may disrupt their participation in in-person meetings. Technology (e.g., cell phones, internet) offers means by which staff may more effectively engage homeless youth in case management, particularly as this population uses technology at surprisingly high rates. The use of technology to engage homeless youth in services is under-researched, and as such, the current study investigated the feasibility of engaging homeless youth through the use of electronic case management (ECM).

Methods: As part of a larger clinical trial, data were collected from youth ages 18-21 (n=48) accessing services in a homeless youth shelter in a midsized city in the Southwestern United States. Youth receiving ECM were interviewed at baseline, 1-week, 6-week, and 3-month intervals, and were given prepaid cell-phones, and a case manager provided 4 ECM sessions every 2-3 weeks over the 3-month period. The electronic case manager first attempted to contact youth using cell-phones, followed by texts, email, and Facebook. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths’ preferred technology methods. Descriptive statistics were used to assess feasibility, perception, and acceptability of ECM among youth, as well as frequency and preferred method of contact.

Results: Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority (76%) responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. Longitudinally, more contact attempts were necessary to elicit a response.

Implications: Findings suggest that technology may hold promising implications for engaging and retaining homeless youth in case management services. While many youth engaged in ECM, some required frequent attempts at contact before responding, suggesting the importance of case manager persistence, rapport-development, and youths’ commitment to stay in touch. Cell phones demonstrated great promise in engaging youth, as more responded to missed calls via calling back and texting, than by Facebook and e-mail. Very small attrition occurred between the third and final ECM sessions, suggesting that if youth engage in at least a few ECM sessions, their perceptions of ECM as a valuable resource solidifies. Even when researchers attempted contact through phone calls, youth more frequently responded via text, suggesting that text messaging could be better adapted to suit the needs of homeless youth, who may otherwise find it difficult to incorporate more conventional contact methods into the instability of shelter life.