EMPOWERING PARENTS FOR WELLNESS IN SHELTER (EMPOWER): DEVELOPMENT AND IMPLEMENTATION OF A HEALTH EMPOWERMENT PROGRAM FOR PARENTING HOMELESS YOUTH

Purpose: Approximately 700,000 U.S. adolescents (aged 13-17) face homelessness annually. Among them, 10% of females and 3% of males are either pregnant or parenting, posing a multi-generational threat to health. Yet, there are few programs to improve health among parenting homeless youth and their children. To address this gap, an urban youth shelter launched a new transitional housing program for parenting youth with programming to improve parent and child health, and reduce unplanned subsequent pregnancies. The purpose of this community-engaged study was to adapt and implement an evidence-supported health empowerment program for pregnant and parenting youth living in shelter, and assess the program's feasibility and acceptability. Methods: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework for implementation research, we conducted a mixed-methods community needs assessment employing key informant interviews, focus groups, and/or questionnaires with three stakeholder groups: previously or currently homeless youth (n=17), shelter staff (n=20), and community experts (n=5). The needs assessment focused on program content and design. We analyzed data using content analysis (qualitative data) and descriptive statistics (quantitative data). A community-based team, including youth, staff, clinicians and researchers, selected an existing evidence-informed curriculum for a unified group-based intervention and tailored the intervention to address stakeholder-identified content areas and elements of program design. We further adapted the program using interviews, informal focus groups and surveys with youth participants (n=5) and program staff (n=5). All youth were female and pregnant or parenting, with children ages 0-3. Results: Our needs assessment identified several content areas of importance, including sexual health (e.g., healthy sexuality, relationships), mental health (e.g., post-partum mood concerns, trauma), and child health. Youth and staff identified several priorities for the program's design including that it should: be adaptable; incorporate a strengths-based, culturally-competent, and traumainformed approach; develop skills around both health and health care; leverage the key role of staff in promoting youth health; and integrate youth voice. Preliminary implementation data revealed that the program was acceptable to youth and staff, and aligned with the mission of the housing program. During implementation, group f