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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Reorienting risk to resilience: street-involved youth perspectives on preventing the transition to injection drug use

BMC Public Health > Ausgabe 1/2015
Kira Tozer, Despina Tzemis, Ashraf Amlani, Larissa Coser, Darlene Taylor, Natasha Van Borek, Elizabeth Saewyc, Jane A. Buxton
Wichtige Hinweise

Competing interests

The authors have no competing interests to declare.

Authors’ contributions

KT and DTz analysed the findings and drafted the manuscript. AA provided critical input into the manuscript. LC and NVB facilitated data acquisition and performed primary data coding. DTa and ES provided input re study design and analysis. JB conceived and was principal investigator and provided critical input into the manuscript. All authors have read and approved the final manuscript.



The Youth Injection Prevention (YIP) project aimed to identify factors associated with the prevention of transitioning to injection drug use (IDU) among street-involved youth (youth who had spent at least 3 consecutive nights without a fixed address or without their parents/caregivers in the previous six months) aged 16–24 years in Metro Vancouver, British Columbia.


Ten focus groups were conducted by youth collaborators (peer-researchers) with street-involved youth (n = 47) from November 2009-April 2010. Audio recordings and focus group observational notes were transcribed verbatim and emergent themes identified by open coding and categorizing.


Through ongoing data analysis we identified that youth produced risk and deficiency rather than resiliency-based answers. This enabled the questioning guide to be reframed into a strengths-based guide in a timely manner. Factors youth identified that prevented them from IDU initiation were grouped into three domains loosely derived from the risk environment framework: Individual (fear and self-worth), Social Environment (stigma and group norms – including street-entrenched adults who actively discouraged youth from IDU, support/inclusion, family/friend drug use and responsibilities), and Physical/Economic Environment (safe/engaging spaces). Engaging youth collaborators in the research ensured relevance and validity of the study.


Participants emphasized having personal goals and ties to social networks, supportive family and role models, and the need for safe and stable housing as key to resiliency. Gaining the perspectives of street-involved youth on factors that prevent IDU provides a complementary perspective to risk-based studies and encourages strength-based approaches for coaching and care of at-risk youth and upon which prevention programs should be built.
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