Date that you joined UNL: August 2001

Hometown: Winnipeg, Canada

Describe your research and how it contributes to alleviating or understanding health disparities?
I have spent the past 20 years working with youth experiencing homelessness (YEH). I have focused on their early family histories, such as child maltreatment, foster care placement, and substance misusing parents and family members. Many youth leave home due to conflict and abuse and once on the streets, they are at heightened risk for participation in risky sexual behaviors, delinquency, substance misuse, and becoming a victim of physical or sexual assault. While the decision to leave home is sometimes that of the youth, others are “pushed out” (i.e., told to leave) due to conflict, pregnancy, or their sexual orientation. In other cases, some youth may be removed by state agencies. Many adolescents and youth have trajectories marked by multiple living arrangements such as home, foster care, detention facility, staying with friends and drug rehabilitation. All these living situations culminate in a lack of permanent housing for these young people.

Once youth leave home, many will take advantage of a variety of existing services. For example, our research has shown that approximately 65% of YEH had utilized street outreach services and 56% had stayed at a shelter in the past 12 months. Despite this, our work also showed that there is a sizeable group of youth who do not access any services. That is, 44% of YEH had not used a shelter, 57% had not used counseling, and 35% of YEH had not used street outreach services. This means there are a sizeable number of youths who are not receiving the services they may need and this group is most at risk for poor physical and mental health outcomes.

Most recently my work has used ecological momentary assessment (EMA) via short message service surveying to gather daily data from YEH over 30 days. This research has demonstrated that if youth were physically or sexually victimized earlier in the day, they were almost five times as likely to drink alcohol later that day. Also, we found that youth who stayed with a friend/partner reported more frequent marijuana use. Moreover, youth who reported feeling depressed earlier in the day were more likely to drink alcohol later that day. Depressed youth were also more likely to use marijuana. On a positive note, responses to open ended questions revealed that YEH enjoyed participating in the EMA study because they felt someone cared about them while they were receiving the text messages.

Because YEH are a highly nomadic group and many do not access shelters, we proposed to develop a just-in-time personal support intervention (JIT-PSI), which could be delivered to youth on cell phones regardless of their service utilization. This would ensure that we could reach all YEH, even those who do not generally access services but tend to be at heightened risk for poor outcomes. The goal of this work is to identify key factors that lead YEH to negatively cope (i.e., substance use) versus positively cope (i.e., service utilization) with risk factors and develop a JIT-PSI that would mitigate negative coping in favor of positive coping. Following this, we will examine the acceptability and feasibility of our intervention with YEH. If youth report positive experiences with our intervention, we will test with a larger sample with the overall goal of reducing substance misuse among YEH.

What inspired you to study health disparities and/or your field of research?
I have always been passionate about helping people. When I first started working with YEH as a graduate student, I immediately became interested in the topic areas of child abuse and revictimization. YEH are a group who sometimes have parents with mental health or substance misuse issues and the youth lack guidance and support from their family. When we collected the EMA data (referenced above) and we asked youth what they liked about participating in our study, their answers really solidified the work I have been doing to better serve this population. The youth thanked me for raising awareness about homelessness and for giving them the opportunity to tell others what their daily experiences are like. Youth also appreciated having a supportive person listen to them and who cared about them and what they had to say. These types of responses from the youth were the inspiration for the just-in-time personal support intervention that our research team is well poised to develop.

What advice would you give to incoming students (graduate or undergraduate) who are interested in studying health disparities?
I would tell students that there are no shortages of topics and no shortage of amazing faculty at UNL both within MHDI, the RDAR Center, and other entities on campus that would be happy to provide mentoring for any student interested in studying health disparities.

What advice would you give to incoming faculty who are interested in health disparity research?
Similarly, I would tell new faculty that there are no shortages of topics to study on health disparities. There are also amazing faculty at UNL who would be very interested in collaborating on research related to health disparities. I would also encourage new faculty to join the MHDI to learn more about faculty research in this area.

What would your colleagues/students be surprised to learn about you?
I am Canadian, and my family has roots from around the globe including Germany, Ukraine, England, Czechoslovakia (now the Czech Republic), and South Korea. I love returning to my hometown, which I do every chance I get, and eating all the amazing foods from these countries.

Learn more about Kimberly A. Tyler