Just like us

Editor's note: Gillian Styring is a senior at Riverdale High School in Portland, Ore. For more information visit https://teen2teenweb.wordpress.com.

Today’s high school students are exposed to research from a young age. Polls permeate social media and our science classes apply research to the learning process on a daily basis. In fact, at our high school we use Google Forms to collect information and share it almost every week in class. So when I decided to conduct research on a real issue with real people, it didn’t seem daunting. After all, how hard could it be? 

Turns out, it wasn’t as easy as it looked.

Growing up on a farm in Newberg, Ore., I’ve seen birth, life, injury and death. My interest in health has really been lifelong (I’ve wanted to be a surgeon since I was six years old) and has motivated me to participate in sports (soccer and pole vaulting) and lead community health projects (organ donor drives and CPR certification for high school students).

Living near Portland, it’s an everyday occurrence to see homeless people pretty much anywhere around the city and I’ve seen kids who look to be my age among them. This drove me to ask, “How does homelessness affect health, specifically teen health?”

Bam. I had a question. I would research the health of homeless teens and compare it to the health of mainstream teens.

I planned to measure height, weight, blood pressure, resting pulse and body fat. I soon discovered that measuring body fat takes too much time in the field, so I removed that. I also found a blood pressure cuff that simply went on a person’s wrist to minimize physical interaction so someone could self-administer if they didn’t want me to touch them.

Also, I would ask questions about eating habits, drug and alcohol use, crime and their feelings of stress.

Before anything else, I had to know if my respondents were, in fact, living on the streets. One of the first questions asked how many nights someone slept indoors and one of the last asked them how confident they were that they would sleep indoors. Answers to those questions, in addition to others about how often and where they received their meals, qualified their responses for inclusion in the study.

I had no specific hypothesis – I simply wanted to see how homelessness affected teen health. To accomplish this, I needed many questions in my survey. I worked to streamline the questionnaire, so that someone could complete the 46 questions in five-to-10 minutes.

I first tried contacting research agencies, knowing that they do this sort of thing in shopping malls and grocery stores all the time. But finding homeless teens, a hard-to-reach population, is not easy in a suburban shopping mall. So they turned me down.

Then I reached out to various social service organizations that serve the homeless. Initially, the organizations were interested but when they saw my questionnaire, most of them turned me down. It wasn’t that they weren’t interested in the results but they serve the homeless with a promise of “no questions asked” and thus they felt the nature of my questions was too invasive and violated that promise. While I understood their concerns, I had questions and they had the potential to help people. Questions that aren’t asked have no impact.

Beyond my comfort zone

My whole life I have been told to avoid strangers but I realized that to get answers to my questions I would need to reach beyond my comfort zone and connect directly with people I thought were different from me. So I contacted the organizers of Potluck in the Park, a “feed” for Portland’s homeless held every Sunday. About 500 hungry Portlanders are served a hot meal there every week, so I thought it might be a place to connect with homeless teens.

The organizer wasn’t very confident I would find teens to survey, but then he said, “It’s a public park. I don’t see how anybody could stop you.” He told me where the few kids at Potluck typically hung out as they waited their turn. I felt a glimmer of hope.

Since I decided to take to the field, I needed to keep my equipment simple and organized. The last thing I wanted to do was be fumbling around looking for a pencil and lose a potential respondent. In a backpack, I carried a scale, a tape measure, a blood pressure cuff, six snack bags and six clipboards loaded with surveys and pencils, ready to go.

The snack bags were the incentive to take the survey. They included a Capri Sun juice drink, a bag of Doritos and a package of Junior Mints, a fun little snack to brighten their day. It was the Potluck in the Park organizer who recommended using food instead of money, since handing out cash in a crowd of homeless people (including adults, many of whom have mental or substance abuse issues) could cause, as he put it, a kerfuffle.

The day of the potluck, I was ready. The crowd was huge. Each person received a number and groups of numbers would be called to keep the feed organized and moving smoothly. I went to the area the organizer recommended and sure enough, there was a group of teenagers hanging out, waiting their turn to eat.

Not surprisingly, they eyed me pretty suspiciously.

“Hi! Would you like to take my survey?” Not the best ice-breaker in the world but it did start a conversation. And once one teen agreed to participate, others followed. That first day, I ended up with six qualified surveys. It wasn’t much but it was a start.

I was surprised to find that the teens were actually pretty nice, friendly and helpful. They would provide me with suggestions on places to go to meet other teens, where they hang out or the tent communities where they lived. So, I would go there (with one of my parents or my older brother along, standing about 20 feet away, carrying extra snack bags and keeping me safe). Unfortunately, most of the time, the kids would see me coming with my clipboard and backpack and disappear before I could talk with them. I had to be smart and choosy about where I was looking, and how I approached them.

The feeds, as they are called, became the best time and place to find potential respondents. The teens were happy, with their friends and just waiting for their number to be called so that they could eat.

But it wasn’t easy. When it rained, the feed moved into a dark, underground parking garage. Sometimes I went to makeshift tent encampments that made me (and my parents) a little nervous. I came home with part of a hypodermic needle stuck in my shoe. Some of the people at the camps were intimidating. And once they were fed, the teens were gone like smoke.

I adjusted my pitch, from “How are you? Would you like to take my survey?” to finally a little small talk, followed by, “Hey, have you had a chance to take the Teen2Teen survey yet?” This resulted in the best response. Asking them if they had had the chance to take the survey implied that others had, that they would want to and it got them engaged in finding out what they survey was. Being generous with the snack bags helped, too.

For months I conducted the research. I became known as “the girl with the scale” at the events and was often asked by homeless adults if they could weigh themselves. Of course, I obliged.

Never find the numbers

There were times I thought I would never find the numbers I needed to complete the study, but I kept going out. When I think back on it, it’s pretty remarkable that I didn’t give up. What kept me going was the first group of surveys; the answers were really interesting and I wanted to see if what I saw in the initial data was true.

Ultimately, it took four months to secure 37 qualified interviews. By comparison, the local research agency who recruited the mainstream teens was able to find 47 qualified participants in a week and I completed those interviews in just four hours.

I learned how to use a data analysis and statistical software program called Stata to do the correlations and regressions. Since I was taking a statistics class that semester, that really helped, too.

There were certain findings I could have predicted: Homeless teens sleep indoors less, get less sleep in general and consume fewer meals on average than a mainstream teenager. However, I was surprised to find that the most prevalent threat to the health of homeless teens wasn’t alcohol, drugs or crime but smoking cigarettes. Homeless teens are more likely to use marijuana and alcohol and they are victims of crime more often than their mainstream counterparts. However, 78 percent of them reported smoking more than one pack of cigarettes every day compared to only 15 percent of mainstream teens who smoke half a pack or less daily. This takes an obvious toll on their health now and sets them up for more health issues in the future.

Homeless teens exhibited hypertension, or high blood pressure, at three times the rate of mainstream teens. According to the Mayo Clinic, there are 10 potential risk factors for high blood pressure and homeless teens exhibit four of them at a high rate in this survey: tobacco use, diet, alcohol use and stress. But far and away, the biggest impact is that they smoke so much.

I expected that not knowing where you were going to sleep at night or how you were going to get your next meal would make a person feel extremely stressed, anxious, lonely and especially less in control of your life but it didn’t. And nearly half the homeless teens said that they feel happy, which surprised me.

Surprisingly as well, homeless youth reported similar levels of feeling stress, anxiety, loneliness, and in control of their life as their mainstream counterparts.

Just the beginning

As with any research, completing the survey is just the beginning. Using the data I’ve collected, I can go back to some of the social service organizations I’ve contacted to help work with them to see if we can decrease the prevalence of smoking among homeless teenagers.

In November 2017, I presented at the TedxYouth@Portland conference, not only to shine a light on the effects of homelessness on teen health but also to change the way my fellow teens view homeless youth. I want my peers to learn what I have discovered: Homeless teens aren’t so different from us.

Before I started the survey, I had ideas of what homeless teens were like. We all understand the stereotypes many have of homeless people – that they’re mentally ill, addicted to alcohol or drugs, or that they’re mean and miserable people. But that’s not what I found with the teens I interviewed.

In many ways, they are just like me or the other kids in my class. They were nice, friendly and helpful. I actually felt bad for being surprised and it made me think differently. Ultimately, along with helping improve the health of homeless teenagers, I’d like to change how others perceive homeless teens and help them see that they’re just teens like me who have fallen on hard times.

I also have a much deeper respect for what researchers go through every day, trying to contact a hard-to-reach or uncooperative population; drafting an approach that will be successful; offering compensation that is meaningful but not problematic; and designing questions that will accurately qualify a participant without creating a negative barrier between the person and the researcher.

When you approach someone you think is very different from yourself, you have to treat them with empathy and respect. You have to think about how they might react, how you would react if approached this way and, ultimately, think about those you are researching as people first, not just respondents.

If you want a great response and insightful results, sometimes you can’t just run a survey through Google Forms. Digging in and going into the field directly is hard but rewarding work. Just don’t forget to bring Junior Mints.