Systems Alignment

YouthHealthConnect is a response to young people’s stated need for health services that resonate with their cultures and personal identities. The product of a recent project funded by a Robert Wood Johnson Foundation's Systems for Action Developmental Grant, this digital health resources map is a response to what youth and youth-serving agencies told us about existing gaps and barriers.

We knew when we started this work that metro-area health services for youth experiencing homelessness were siloed and not meeting their needs. We conducted a metro-area Community Needs Assessment and Systems Mapping process in 2023 to better understand what youth experiencing homelessness need and want to support their health.
Youth described the challenges of navigating complex and fragmented healthcare and public health systems. They wanted services that were trauma-informed, affirming of diverse identities, inclusive, culturally sensitive, and familiar with working with youth who have experienced housing instability and homelessness.
Youth-serving agency staff reported struggling to stay up-to-date on appropriate referrals for their young clients. They also wanted more staff training and resources to support health literacy and mental health in youth experiencing homelessness.
Our work now is to expand and evaluate YouthHealthConnect, which evolves continuously based on user feedback and aligns with the increased capacity of youth-serving professionals who access the new YHHL trainings.

Youth Health and Housing Lab works in coalition to align the systems and entities that serve youth experiencing homelessness (YEH). The ways in which stakeholders gather, manage, analyze, and share health and social data needs a more equitable, integrated, and community-driven approach. An equitable data system ensures fair and just treatment of all individuals by accounting for potential biases and disparities in existing data, prioritizing the inclusion of marginalized communities, and distributing the benefits and risks of data use equitably across populations.

This Robert Wood Johnson Foundation’s Systems for Action grant-funded work builds on our earlier pilot project in Hennepin County. We quantified, qualified, and started to fill the youth-identified gaps in healthcare services. Aiming to build better and more integrated systems of support for youth experiencing homelessness, we:

• Tested our new multisector consortium’s capacity to develop, implement, and evaluate system alignment strategies.
• Used formal research methods and analysis to document the barriers to alignment of medical, social, and public health data systems; and identify opportunities to align data systems.
• Showed with a feasibility study the potential to scale up this work statewide.

Read our project summary here. Now, we are planning, implementing, and assessing the long-term feasibility of an integrated system of health services and programs for youth experiencing homelessness statewide. Through consensus building sessions with youth experiencing homelessness and stakeholders from medical, social, and public health systems, we are co-creating new ways to integrate data, share clinical practice guidelines, and co-locate health and social services for youth experiencing homelessness. We use surveys, focus groups, and interviews with key stakeholders to assess the feasibility and effectiveness of proposed system alignment strategies.

Youth Health and Housing Lab works in coalition to align the systems and entities that serve youth experiencing homelessness (YEH). Streamlining the ways in which shelters create and sustain a therapeutic, affirming, and trauma-informed environment and “vibe” is one, low-cost tactic in this strategy.  

We had learned from youth experiencing homelessness and youth-serving agency staff that specific sensory features and cues provided by sites were effective in supporting youth experiencing homelessness mental health. These included things like gender-affirming signage and pronoun pins, sensory rooms and spaces, fidgets, youth-friendly and inclusive art, comfortable and size-inclusive furniture, and inclusive spiritual texts and support. The formal feedback on these small actions also documented and reaffirmed the value of the work that many youth-serving agencies were already doing, such as centering youth voice and experience in site renovations and decorating.

We partnered with four agencies to test-drive these combined interventions and measure their impact on youth emotional well-being and on the site’s general climate. Our evaluation showed that the sensory features did feel supportive to youth. We also learned that having youth input on any of the interventions increased their creativity and chances of being utilized, that low staffing is an ongoing challenge to distributing the interventions (like fidgets), and (not surprisingly) that supportive environments do not preclude the need for accessible mental health care for youth experiencing homelessness.

Youth Health and Housing Lab works in coalition to align the systems and entities that serve youth experiencing homelessness (YEH). Increasing the communication and day-to-day problem-solving between community-based healthcare professionals is one part of this vision.

With funding from the Robert Wood Johnson Foundation’s Systems for Action Development grant (2022-2023), YHHL convened a large metro-area group of youth-serving agencies for the first time, including healthcare providers that work with youth experiencing homelessness, shelters that provide mental health care, representatives from the Minnesota Department of Health and the Department of Human Services, and 5-10 other youth-serving agencies.

Our shared goal was to optimize shelter-based healthcare for youth experiencing homelessness and improve communication between these organizations. In these early meetings, we heard youth perspectives on existing healthcare services and resources and gained a better understanding of the needs that each organization meets. Then, we brainstormed on how to work together to improve care.

As a result of these initial conversations:

• YHHL joined forces with the Youth Law Project (YPL) to help organizations educate young people about minor consent laws. YPL has created two legal briefs on youth’s rights to shelter and youth’s rights to healthcare services, which we disseminated broadly with our partners, including youth. This project still continues through the MN Department of Human Services.
• Our original group of youth-serving entities and individuals meets quarterly to discuss next steps in improving care for youth experiencing homelessness. Topics include how to standardize healthcare services among shelters, improve release of information processes between youth-serving agencies, and improve processes to allow youth to leave shelter with their medications.

Improving and expanding site-based health services for youth experiencing homelessness is one part of our systems alignment plan. To this end, we offer training in health literacy, mental health, and trauma-informed care, meeting a stated need for youth-driven, capacity-building opportunities for youth-serving agency staff and healthcare professionals.

• YHHL’s Health Literacy Trainings, created and presented with youth input, aim to better equip shelters with healthcare resources and information to share with youth. Specifically, they include information on finding insurance, navigating the healthcare system, understanding minor consent laws in Minnesota, and general health literacy education.
• YHHL’s Mental Health and Trauma-Informed Care Trainings, created and presented with youth, introduce the key elements of trauma-informed care to youth-serving agencies and show how staff can use it to improve youth mental health among youth experiencing homelessness. We also provide specific resources to increase staff capacity to connect youth experiencing homelessness to mental health services.

Pilot tests of these trainings in spring 2023 showed a positive impact on staff’s capacity to define health literacy and minor consent laws in Minnesota, articulate the challenges that youth face in navigating the healthcare system, and help youth navigate the healthcare system and insurance. The training sessions also helped participants understand the different ways trauma can present in youth, identify warning signs and symptoms of mental health crises in youth, identify strategies to support youth mental health, apply a trauma-informed framework, and provide mental health resources to youth. We invite youth-serving agencies interested in hosting a training to contact our team.

Youth Health and Housing Lab works in coalition to align the systems and entities that serve youth experiencing homelessness (YEH). Part of this vision is to increase the capacity of youth experiencing homelessness and the communities that serve them to use the available data to identify important research questions and answers that can influence policy and practice.

With funding from the Robert Wood Johnson Foundation's Systems for Action Impact Grant, YHHL is partnering with youth experiencing homelessness and community partners to identify priority youth-driven research and policy questions. Our team of researchers will conduct analyses with existing datasets (Minnesota Student Survey) to answer these youth- and community-driven policy questions. With our Youth Action Board and community partners, we will build consensus (an iterative process) to interpret our research findings with youth experiencing homelessness.

The equitable data system we envision ensures fair and just treatment of all individuals by accounting for potential biases and disparities in existing data, prioritizing the inclusion of marginalized communities, and distributing the benefits and risks of data use equitably across populations. Ultimately, our aim is to translate these equitably analyzed findings into feasible and acceptable policy and systems changes that support youth health and health equity, health care access and agency, and interpret relevant official data in consensus-building dialogue with populations served.