Doorway Project Plan, Year One

Below is an abbreviated version of the grant proposal for the Doorway Project that was submitted to Washington State funders and legislators in July, 2017. It was originally written by Lisa Kelly and Josephine Ensign.

+ Background

In 2015, the city of Seattle declared a State of Emergency regarding homelessness.[i] Despite increased resources and attention to this issue, the January 2017 Point-in-Time count showed that there are over 11,000 individuals experiencing homelessness in the Seattle / King County area.[ii] The 2017 count demonstrated that nearly 30% of those individuals are under the age of 25, with 1,498 unaccompanied youth and young adults under age 25; of these youth and young adults, 76% were unsheltered the night of the count.[iii]

In addition, a much higher proportion of homeless youth and young adults reported not accessing any homeless support services (15% vs. 6% of other survey respondents). Among the youth and young adults reporting some support service use, the greatest number (63%) accessed free meals (versus just 37% for drop-in/day shelters and 35% for targeted healthcare services). Homeless youth surveyed had much higher systems involvement compared to the total homeless population, with 29% ever in foster care and 17% currently on probation or parole. They also reported high rates of family/domestic violence and violence as a primary reason for their homelessness.

Despite the prevalence of children and adolescents within the homeless population, published research in the U.S. has focused on homeless adults, ignoring the unique risk factors, community supports, and health, legal, education, and emotional needs of children and adolescents experiencing homelessness.[iv] Further, studies have shown that homeless youth who experience perceived stigma and community marginalization are more likely to experience negative outcomes.[v]

+ Significance

Trauma is a common denominator in the lives of homeless youth, who often leave home to escape family conflict, abuse, or neglect. The realities of street life—violence, use of addictive sub- stances, survival sex, poor nutrition, and limited access to health care—place these youth at especially high risk for negative health consequences. They have disproportionately high rates of suicide, substance use, and sexually transmitted diseases, including HIV.19 Sexual, racial, and ethnic minorities are over-represented among homeless youth, for whom stigma and victimization go hand-in-hand with homelessness.

The more global outcome of quality of health care of increased trust and connections with adults and the community is important to consider for monitoring performance of health care for homeless youth. Many youth widened the outcome to be connections and continuity within a network of social supports for homeless youth; this points to the need for further research into how to measure these community connections. This outcome of health care is probably more important to homeless youth than to their non-homeless peers who are more likely to have other avenues for community connectedness through school and family.Youth consistently stated that desired outcomes of health care for homeless youth were more global in nature, and included fostering a sense of purpose in life and connectedness to the wider community. They talked about positive health care experiences helping them to be able to trust adults and to make positive changes in other areas of their lives. A personal testimonal from a 2004 national report on youth homelessness:

  • “Happy healthy kids, basically, that’s how you can know that health care works. And you can tell they’re happy and healthy by the smile on their face, and they’ve gotten clean and off the streets and come back to volunteer on the van or something. You know, we get healthy enough that we can give back to people who helped us and help other kids get out of the situation as well." (18-year-old white male, focus group interview on streets) [vi]

In June 2017, the Washington State legislature highlighted the University District (U District) in Seattle as an area in need of specialized attention and they allocated funding to “support youth and young adults experiencing homelessness” in this area through launching and supporting a one-stop navigation center with services for homeless youth.[vii]

In order to ensure that the design of the Doorway Café project is effective at quickly linking homeless youth to a comprehensive array of needed services and supports, we must fully understand the needs of these young people as well as the community capacity to provide services and supports. By using participatory research methodologies and generating empathy-centered, visual reporting and intervention design, we, as researchers, can strengthen community resilience and capacity and increase empathy and understanding of the homeless youth population. This will be a community-based, action-research oriented project which will focus on both upstream/prevention efforts as well as downstream policies and services. With the provision of appropriate services and supports, many of the young people experiencing homelessness in the U District thrive and find more stability in their lives.

The University of Washington, as the largest public research-intensive university in the region, and as an integral part of the U District neighborhood, can contribute more to the health and well-being of the most vulnerable community members—homeless and marginalized young people. Building on the strengths and assets of the homeless youth, the community agencies, and the faculty and students of the University of Washington, we propose to create a community café to address marginalization and stigma and serve as a community/navigation hub for homeless adolescents and young adults in the U District.

+ Overall Goal

The overall goal of this project is to contribute to significantly reducing if not ending youth homelessness in the U District of Seattle. The primary aim of this project is:

  • to design, implement, and evaluate an effective and sustainable navigation center/community café for youth experiencing and at risk of experiencing homelessness in the U District of Seattle.

This project will build on similar models, including the navigation centers in Seattle and San Francisco for homeless adults, as well as homeless youth and community-based models in other cities nationally and internationally. One primary model is the Merge Café in Auckland New Zealand which serves as a community café and navigation center on “K-Road” (similar to the U District’s “Ave”) which is near major universities. The Merge Café serves as a one-stop navigation and resource center for people experiencing homelessness and related issues; it also serves as a vibrant and safe space where the entire community can connect. The Merge Café was opened in 2010 by the faith-based social service agency LifeWise. Beginning in 1885, they had operated a soup kitchen in Auckland for people experiencing homelessness and food insecurity. By 2008, they were serving over 40,000 meals a year. Based on a growing body of evidence, they decided that their soup kitchen was maintaining rather than solving the issue of homelessness, so they closed the soup kitchen and opened a café in its place. Their goal is to end homelessness, starting with addressing barriers that keep people marginalized and challenging public (including policy makers) perceptions of homelessness. As they state:

  • The first step towards bringing down any barriers is to offer a space where anyone and everyone is welcome, regardless of their background or their social and economic status. The goal is to merge. Merge Café aims to provide anyone the opportunity to enjoy meals together, in an environment that embraces choice, dignity and respect. It connects patrons with wraparound services that provide pathways out of homelessness.

Based on the participatory design phase, the Merge Café utilizes a community peer team (formerly homeless), the members of which provide support and advocacy for the homeless community members utilizing the café as the main hub. Patrons of the café who can afford it are encouraged to “pay it forward” by paying more for their meals (breakfast currently~ $2 and lunch ~$4 served daily); people living in poverty and/or homelessness are provided free meals via coupons. The café also has meeting room and event space available for community group meetings, as well as for ongoing university service-learning and community engagement projects.

In Seattle, we have several population-specific cafés including the Recovery Café in downtown Seattle (for people in recovery from mental health and substance use disorders) and the Aurora Commons in North Seattle (low-barrier, harm reduction drop-in center/kitchen space mainly for homeless and prostituted women and trans women living/working on Aurora Avenue). While such cafés can be beneficial to the populations served, they do not promote the wider community interchange, dialogue, and participatory problem-solving and support envisioned for the Doorway Café model. Population-specific cafés can unintentionally serve to isolate and stigmatize people further, as well as antagonize nearby businesses and other neighbors. (Similar critiques have been raised about navigation centers.) In contrast, true community cafés such as the Merge Café are developed with community members and are viewed as community assets by a wide range of stakeholders.

Of note here is the historical context of the “U District Center” on the corner of NE 56th and U Way that was in existence between 1969 and 1972. Walt Crowley, in his memoir Rites of Passage: A Memoir of the Sixties in Seattle (Seattle: University of Washington Press, 1995), describes the center when he became the center’s full-time director: “Programs were virtually nonexistent, and the physical environment was filthy. The center was essentially an indoor sidewalk.” (p. 183) This provides advice on what not to do with the Doorway Café hub/navigation center in the U District. In addition, since 1990, the University District Youth Center (UDYC) has served as an effective drop-in and multi-services center for homeless and street-involved youth ages 13-24 years. It has a good location adjacent to the University Congregation United Church of Christ, although the physical structure of the building it occupies is less than ideal. The proposed Doorway Café project would work in collaboration with the UDYC (currently operated by YouthCare), as well as ROOTS Young Adult Shelter, TeenFeed, Sanctuary Arts Center and other service agencies working with youth experiencing homelessness in the U District.

+ Plan/Design/Methods

We will begin by compiling all available previous needs assessment data on homeless youth in Seattle and especially in the U District. We will also compile and review published research related to this population of young people. This will be completed within the first month of the project grant period in consultation with the community agencies and the UW advisory committee. We will then conduct an updated participatory needs assessment to identify the resources and gaps in services for youth experiencing homelessness in the U District. This needs assessment will also include preliminary design ideas from the young people as to the ideal Doorway Café project.

Youth participants will be recruited through community partner agencies, primarily youth drop-in centers and shelters, as well as street-outreach programs and transitional housing programs. In order to ensure compensation for participant time, each research activity will be designed to last no more than one hour and each youth that participates in a research activity will be given a $25 gift card for each completed research activity.

The project will employ four primary research methods, in addition to participant satisfaction questionnaires and requests for feedback to policy proposals.

1) Community Mapping:

Participant youth will work in small groups (e.g. 2-5 people) be given poster board and art supplies and will be asked to draw physical a map of their community. The term “community” can be widely interpreted as the youth see fit, but interviewers will suggest that youth consider including places they generally spend time and places where they get their basic needs met. Law and nursing students can ask questions about places drawn on the maps to ensure clarity and understanding, and can help label locations, but the participating youth will be encouraged to include as much or as little detail as they see fit.

2) In-depth semi-structured interviews:

Law and Nursing students will conduct in-depth semi-structured interviews (using a semi-structured interview schedule) with youth, focusing on one basic need per interview. For youth that have already completed the community mapping activity, the in-depth interview can connect to a high priority (according to the youth) basic need identified in their community map. Because of the transient nature of the population, youth will not be required to participate in community mapping in order to participate in the interview process. The goal of the interview will be for the student to learn how the participant youth navigates their community in order to get the basic need met, and the challenges that the participant youth must overcome in order to meet the need. In order to encourage a client-centered interview, the participant youth will be encouraged to select the topic of the interview from a list of basic needs. In order to accurately capture the participant youth voice and accurate quotes, voice recorders will be used whenever the participant youth provides written and informed consent. UW Human Subjects review/approval of this project will be obtained before collecting data.

3) Photovoice documentation.

Youth participants will be given a disposable camera (if they do not have a cellphone/camera) and encouraged to document, through photography, their communities and the sources of their basic needs. This methodology allows participant youth to engage in creative expression while simultaneously collecting data for the study. Once cameras are returned to student researchers, participant youth will be encouraged to attend a follow-up interview to explain the photos and provide captions. Whenever photo releases are able to be obtained or are deemed unnecessary, photovoice pictures and captions will be set aside for possible inclusion in the Empathy Tool. Multiple copies of photos can be made so that participant youth can keep any copies of photos they are interested in keeping. Because of the expense, ethical considerations, and participant commitment involved in the photovoice methodology.

4) Participatory digital storytelling (DS) videos

DS refers to short video segments (typically 3-5 minutes in length) personal narratives that incorporate digital images, music, and voice-over narration by the person making the video. They are typically created within a workshop-based process that includes a Story Circle to share, critique, and refine stories-in-progress. Developed in the early 1990s by media/theater artists Dana Atchley and Joe Lambert and promoted through their Center for Digital Storytelling/Story Center, DS has been used for public health research, training, and policy campaigns (such as the Silence Speaks campaign); community building (such as the BBC Capture Wales program); literacy programs; and reflective practice with health science students. DS is increasingly used as an innovative community-based participatory method that is especially effective at informing program planners and policy makers about the lived experiences of marginalized people. Of note, Josephine Ensign (PI) has training and experience using DS with this population. She completed a participatory digital storytelling video workshop in August, 2015 with a group of six homeless youth through the Zine Project Seattle. With their permission she shares links to two of their videos here: “Harm Reduction is Good” and “Tug of War.” The young people picked their own health-related stories to tell in their videos and most all of them focused on mental health and substance use issues.

Once the data are collected, the co-investigators along with the students involved will analyze the data and generate policy and legal reform suggestions that can reduce barriers to basic needs for homeless adolescents. These initial policy suggestions will then be discussed with participant homeless youth in focus groups. These focus group discussions with homeless youth will allow youth to provide suggestions for improvement on these recommendations and prioritize the recommendations that are most important to them. The findings and suggestions will be shared with and refined during a day-long community social charrette/workshop that will include homeless youth, community partners, and any interested UW students and faculty members. The main outcome of the charrette will be the design of the Doorway project’s navigation center/community café.

After the policy, healthcare access, and legal reform suggestions have been finalized with youth input, the collected data will be compiled into an empathy tool and Policy Report, based on the model produced by The Family 100 Project in New Zealand.[viii] The empathy tool is aimed at increasing public understanding and empathy for homeless youth by sharing the experiences of homeless youth using images, data and text. Unlike an academic paper, the empathy tool will be easily read by a lay person. The report will include suggested policy and legal reforms that stem from the needs identified.

+ Evaluation Plan

Project success will be evaluated through multiple metrics. A successful data collection effort will include:

  • 20 or more youth-created community maps
  • 50 or more youth interviews about meeting one of the identified basic needs
  • 10 or more completed photo voice projects

A timeline of projected milestones is included below:

Quarter 1, Fall 2017:

  • Community partner agencies commit to allowing students to interview homeless and formerly homeless youth and conduct research activities at their facilities
  • Students trained on interviewing skills and goals of project
  • Initial community maps developed
  • Host at least one pop-up community café in the U District that will include community design input for the Doorway project

Quarter 2, Winter 2018:

  • 20 total community maps drawn by youth identified through community partner agencies
  • 25 follow-up interviews about basic needs conducted
  • Host at least one pop-up community café in the U District that will include community design input for the Doorway project

Quarter 3, Spring 2018:

  • 50 total interviews with separate or repeat youth conducted regarding various basic needs identified by youth
  • At least 10 photo voice projects completed by youth
  • At least 10 participatory digital storytelling videos completed by youth
  • Initial policy reform suggestions identified
  • Host at least one pop-up community café in the U District that will include community design input for the Doorway project
  • Convene a day-long community social charrette/workshop to report out/refine policy and program reform suggestions

Quarter 4, Summer 2018:

  • 10 youth consulted on initial policy and program reform suggestions in a focus group
  • Content of Empathy Report Drafted
  • Graphic Design of Empathy Report Completed
  • Empathy Report Published and Printed
  • Host at least one pop-up community café in the U District and/or have this be in conjunction with the designed place-based navigation center/community café

The investigators understand that, due to the transient nature of the study population, the same youth may or may not be available to participate in each of the different study methodologies. Therefore, each youth will be asked to complete a short feedback questionnaire at the end of each methodology in order to evaluate the project’s effectiveness at meeting goals 2 & 3: providing a positive, creative outlet for homeless youth and improving the interviewing and counseling skills of students. Participating law and nursing students will also complete quarterly evaluations on the project to reflect upon personal skills growth they have identified.

Finally, project success will be most clearly apparent through the production of the final products: the design, implementation, and evaluation of a navigation center/community café for homeless youth in the U District; and a report on youth homelessness in the University District, following the empathy tool model, that incorporates data, stories, and images and appeals to a public audience.

+ Notes and References

*Editor's Note: Original Project Plan written by Josephine Ensign and Lisa Kelly, July 2017. Abbreviated summary compiled by Noah Weatherton, January 10, 2018.

References

  • i) Seattle/King County Coalition on Homelessness, 2016 Annual Report, 1
  • ii) Seattle / King County Count Us In, Point in Time Count of Persons Experiencing Homelessness, 8 (2017). Because the methodology for the point-in-time count changed significantly between 2016 and 2017, it is difficult to compare this figure to the 2016 numbers.
  • iii) Id., 19.
  • iv) CITE (this focus on homeless adults is noted in Townley, et. al, Utlizing Participtory Mapping and GIS to Examine the Activity Spaces of Homeless Youth, Am J. Community Psychol, 404 (2016)).
  • v) Sean A. Kidd, Youth Homelessness and Social Stigma, J Youth Adolesc. (2007).
  • vi) Ammerman, S. D., Ensign, J., Kirzner, R., Meininger, E. T., Tornabene, M., Warf, C. W., ... & Post, P. (2004). Homeless young adults ages 18–24: Examining service delivery adaptations. Nashville, TN: National Health Care for the Homeless Council
  • vii) SB 5883, Washington State Operating Budget, 2017
  • viii) ThinkPlace, Demonstrating the Complexities of Being Poor; An Empathy Tool (June 2014)

Timeline

From the first seeds of inspiration, to the signing of the State budget bill into law, to our first Pop-Up Café, we want to document and share the progress of the Doorway Project every step of the way. Below is a "living" timeline to highlight our development and growth in the U District.

“Know from whence you came. If you know whence you came, there are absolutely no limitations to where you can go.”
— James Baldwin, "Go Tell It On The Mountain"