Integrated Youth Service Preferences of Caregivers of Justice-Involved Youth: A Discrete Choice Conjoint Experiment

Deanna F. Klymkiw; David M. Day; J. L. Henderson; Lisa D. Hawke

doi:10.5334/ijic.7044

Figures & Tables

Table 1

Sociodemographic and clinical characteristics of caregivers of justice-involved (C-YJ) and caregivers of non-justice-involved (C-non-YJ) participants, with significance tests and effect sizes.

GROUP	C-YJ	C-non-YJ	χ² (df)	p	Φ
GROUP	(n = 46)	(n = 204)
Gender	n (%)	n (%)	2.19 (2)	.335	.095¹
Woman	42 (97.7)	183 (91.0)
Man	1 (2.3)	17 (8.5)
Transgender/non-binary	0 (0.0)	1 (0.5)
Race/Ethnicity			4.12 (4)	.392	.128¹
White	41 (89.1)	168 (82.8)
Other	1 (2.2)	20 (9.9)
Asian	3 (6.5)	10 (4.9)
Black	0 (0.0)	3 (1.5)
Indigenous	1 (2.2)	2 (1.0)
Socioeconomic Status			2.01 (3)	.566	.090¹
Live comfortably	27 (58.7)	125 (61.3)
Meets needs with a little left	13 (28.3)	45 (22.1)
Just meets basic expenses	6 (13.0)	28 (13.7)
Does not meet basic expenses	0 (0.0)	6 (2.9)
Marital Status			1.16 (2)	.560	.068
Married or common law	29 (65.9)	150 (73.5)
Single, separated, or divorced	13 (29.5)	45 (22.1)
Other	2 (4.5)	9 (4.4)
Region of Residence			4.05 (2)	.132	.128
Rural to Small Population	11 (23.9)	25 (12.4)
Medium Population	8 (17.4)	36 (17.9)
Large Urban Population	27 (58.7)	140 (69.7)
Physical Health			.998 (1)	.318	.063
Good to excellent	42 (93.1)	175 (85.8)
Fair to poor	4 (8.7)	29 (14.2)
Mental Health			.630 (1)	.466	.050
Good to excellent	36 (78.3)	148 (72.5)
Fair to poor	10 (21.7)	56 (27.5)
Education Level			.270 (2)	.874	.034
High school or less	2 (4.8)	10 (5.2)
Some college/university	7 (16.7)	26 (13.6)
Graduated college/university	33 (78.6)	155 (81.2)
Employed			4.01 (1)	.045	.127
Yes	36 (80.0)	131 (64.5)
No	9 (20.0)	72 (35.5)

[i] ¹ Cramer’s V (V∈) was used as a measure of effect size due to small cell sizes.

Table 2

Sociodemographic and clinical characteristics of justice-involved (YJ) non-justice-involved (non-YJ) youth as reported by caregivers, with significance tests and effect sizes.

GROUP	YJ	NON-YJ	χ² (df)	p	Φ
GROUP	(n = 46)	(n = 204)
Gender	n (%)	n (%)	16.77 (2)	<.001	.260¹
Woman	13 (28.3)*	107 (52.7)*	9.0 (1)	.003
Man	32 (69.6)*	75 (36.9)*	16.0 (1)	<.001
Transgender/non-binary	1 (2.2)	21 (10.3)	3.24 (1)	.072
Race/Ethnicity			4.81 (4)	.308	.139¹
White	36 (78.3)	159 (78.3)
Other	5 (10.9)	32 (15.8)
Asian	3 (6.5)	7 (3.4)
Black	0 (0.0)	3 (1.5)
Indigenous	2 (4.3)	2 (1.0)
Relationship to Youth			1.90 (3)	.595	.087¹
Parent	41 (89.1)	190 (93.1)
Grandparent	0 (0.0)	2 (1.0)
Sibling or other relative	2 (4.3)	5 (2.5)
Other	3 (6.5)	7 (3.4)
Physical Health			2.24 (1)	.135	.095
Good to excellent	24 (52.2)	130 (64.0)
Poor to fair	22 (47.8)	73 (36.0)
Mental Health			.851 (1)	.356	.058
Good to excellent	4 (8.7)	28 (13.7)
Poor to fair	42 (91.3)	176 (86.3)
Student Status			11.03 (1)	.001	.210
Part- or full-time enrollment	15 (32.6)	121 (59.6)
Not enrolled	31 (67.4)	82 (40.4)
Education Level			3.95 (2)	.139	.126
High school or less	37 (80.4)	134 (65.7)
Some college/university	5 (10.9)	45 (22.1)
Graduated college/university	4 (8.7)	25 (12.3)
Employment Status			2.34 (3)	.506	.097¹
Full-time	5 (10.9)	22 (10.8)
Part-time	8 (17.4)	54 (26.6)
Unemployed	29 (63.0)	105 (51.7)
Other	4 (8.7)	23 (10.8)
Housing			6.66 (4)	.070	.186¹
Lives independently	3 (6.5)	14 (6.9)
With a partner	5 (10.9)	11 (5.4)
With family	29 (63.0)	151 (74.0)
With friends	0 (0.0)	10 (4.9)
Other/transitional-housing	9 (19.6)	18 (8.8)

[i] * Statistically significant at the Bonferroni corrected p-value of .017.

¹ Cramer’s V (V∈) was used as a measure of effect size due to small cell sizes.

Table 3

The relative importance of each IYS attribute for caregivers of justice-involved and non-justice-involved youth, and between-group MANOVA Pillai’s Trace statistic.

	JUSTICE-INVOLVED		NON- JUSTICE-INVOLVED
ATTRIBUTE	n = 46		n = 204		F (df)	p	η_p²
ATTRIBUTE	M	SD	M	SD	F (df)	p	η_p²
1. Core Health Services	8.01%	1.65	6.90%	2.16	10.74 (1)^a	.001*	.042
2. Other Services	9.64%	1.75	8.27%	1.92	19.56 (1)	<.001*	.073
3. Caregiver Involvement	11.68%	2.70	11.15%	2.50	1.64 (1)	.201	.007
4. Peer Support	5.70%	1.72	6.20%	2.33	1.89 (1)^a	.170	.008
5. Cultural Sensitivity	4.97%	2.16	5.76%	2.19	4.87 (1)	.028	.019
6. E-Health Services	9.17%	1.92	10.25%	1.98	11.29 (1)	<.001*	.044
7. Age Range	6.68%	1.87	7.45%	2.55	3.75 (1)^a	.054	.015
8. Time of Appointments	8.47%	2.04	7.91%	2.49	2.00 (1)	.158	.008
9. Wait Time	9.86%	2.37	11.89%	2.50	25.20 (1)	<.001*	.092
10. Location	8.16%	1.78	7.91%	1.96	0.64 (1)	.425	.003
11. Engagement	3.77%	1.70	3.98%	1.68	0.53 (1)	.466	.002
12. Information Sharing	13.90%	2.61	12.35%	2.96	10.82 (1)	.001*	.042
Total	100%		100%

[i] IYS = Integrated Youth Service.

^a Levene’s test of equality of error variance statistically significant.

* Statistically significant at the Bonferroni corrected p-value of .0042.

Table 4

Utility values of IYS levels for caregivers of justice-involved and non-justice-involved youth, and between-group MANOVA Pillai’s Trace statistic on attributes with follow-up Bonferroni corrected ANOVA results on levels.

	JUSTICE-INVOLVED		NON-JUSTICE-INVOLVED
ATTRIBUTE LEVELS	n = 46		n = 204		V	F(df)	p	η_P²
ATTRIBUTE LEVELS	M	SD	M	SD
1. Core Health Services					.261	28.92 (3,246)	<.001	.261
Only mental health counseling.	–59.82	12.05	–43.56	16.00		42.11 (1)	<.001*	.145
Mental health and substance misuse counseling.	15.00	12.01	–2.22	13.50		63.49 (1)	<.001*	.204
Mental health and substance misuse counseling, and medication management.	14.87	10.59	11.33	12.30		3.27 (1)	.072	.013
Mental health and substance misuse counseling, medication management, and physical/sexual health.	29.95	16.50	34.45	20.88		1.87 (1)	.173	.007
2. Other Services					.091	8.19 (3,246)	<.001	.091
Education and employment services.	–5.65	19.27	–9.28	18.93		1.37 (1)	.243	.005
Housing, shelter and income support services.	16.57	17.41	18.11	20.68		.220 (1)	.640	.001
Legal support services.	–62.72	14.32	–52.42	17.28		14.17 (1)	<.001*	.054
Choice of education, employment, housing, income support, and legal support services.	51.80	11.96	43.58	12.16		17.27 (1)	<.001*	.065
3. Caregiver Involvement					.160	15.60 (3,246)	<.001	.160
No caregiver involvement.	–83.90	19.29	–84.22	20.67		.009 (1)	.925	.000
Caregivers receive own counseling.	–5.37	17.65	15.16	21.29		37.01 (1)	<.001*	.130
Caregivers involved in family counseling with youth, with youth consent.	51.23	21.14	34.51	21.29		23.21 (1)	<.001*	.086
Caregivers involved in decisions regarding youth counseling, with youth consent.	38.05	17.46	34.55	20.71		1.13 (1)	.288	.005
4. Peer Support					.138	13.07 (3,246)	<.001	.138
Recreational activities led by trained peer support worker.	–22.72	13.63	–28.93	16.36	5.73 (1)	.017	.023
Can talk to a trained peer support worker, upon request.	–9.66	12.03	2.57	15.50		25.19 (1)	<.001*	.092
Mental health groups run solely by a trained peer support worker.	–7.31	17.44	–11.49	21.69		1.49 (1)	.224	.006
Youth can be matched to an ongoing trained peer support worker to learn life skills and help them with services they need.	39.69	15.05	37.85	18.82		.384 (1)^a	.536	.002
5. Cultural Sensitivity					.392	52.96 (3,246)	<.001	.392
Cultural background is not considered when picking a service or service provider.	–2.85	20.01	–27.36	21.04		51.81 (1)	<.001*	.173
Can ask for a service provider with a certain cultural background, when available.	–10.70	11.83	9.33	11.13		118.78 (1)	<.001*	.324
Services are culturally sensitive and trauma-informed.	30.39	22.08	26.14	26.85		.998 (1)	.319	.004
Culturally-based services are available for cultures common in the local area.	–16.84	14.58	–8.11	16.41		11.04 (1)	<.001*	.043
6. E-Health Services					.079	7.02 (3,246)	<.001	.079
No e-health or electronic services.	–41.09	18.33	–51.33	23.07		7.92 (1)	.005*	.031
Can schedule or reschedule appointments via email, text or online.	24.28	11.95	34.52	15.93		16.82 (1)^a	<.001*	.064
E-health services are offered 24/7 alongside in-person services during office hours.	56.69	15.13	56.37	21.32		.009 (1)	.924	.000
All services are delivered only through a website, e-mail, text, or phone app.	–39.88	19.94	–39.56	22.40		.008 (1)	.929	.000
7. Age Range					.100	9.07 (3,246)	<.001	.100
Services for ages 12–24, in a youth-only setting.	–2.58	21.68	12.55	23.16		16.38 (1)	<.001*	.062
Services for ages 12–29, in a youth-only setting.	28.22	14.18	24.50	21.74		1.23 (1)^a	.269	.005
Services for ages 12–24, in a setting that also has services for children 0–12.	–39.26	18.27	–43.54	22.92		1.40 (1)	.238	.006
Services for ages 12–29, in a setting that also has services for adults 29+.	13.62	27.42	6.49	33.49		1.81 (1)	.180	.007
8. Time of Appointments					.133	12.55 (3,246)	<.001	.133
Monday to Friday, 9AM-5PM.	–51.71	16.37	–44.82	21.84		4.06 (1)	.045	.016
Monday to Friday, 9AM-9PM.	–11.77	14.69	–12.69	19.10		.096 (1)^a	.757	.000
Monday to Friday, 9AM-9PM, and Saturday, 9AM-5PM.	44.18	14.86	28.36	17.46		32.44 (1)	<.001*	.116
24/7.	19.29	25.40	29.15	32.07		3.81 (1)^a	.052	.015
9. Wait Time					.155	15.08 (3,246)	<.001	.155
See a counselor for the first time immediately, during office hours.	63.09	17.39	72.18	20.37		7.86 (1)	.005*	.031
See a counselor for the first time after about 72 hours.	23.16	12.60	37.63	14.56		38.83 (1)	<.001*	.135
See a counselor for the first time after about 1 month.	–36.98	16.24	–46.70	17.85		11.49 (1)	.001*	.044
See a counselor for the first time after more than 1 month.	–49.27	20.23	–63.10	22.09		15.17 (1)	<.001*	.058
10. Location					.143	13.63 (3,246)	<.001	.143
Building or office in the community that specializes in mental health services.	53.16	14.61	39.42	18.54		22.14 (1)	<.001*	.082
Youth cafe and recreation centre.	1.66	21.00	21.52	25.40		24.35 (1)	<.001*	.089
Hospital or doctor’s office.	–11.50	15.62	–15.26	23.68		1.06 (1)^a	.305	.004
School setting.	–43.32	13.75	–45.68	15.89		.865 (1)	.353	.003
11. Engagement					.252	27.60 (3,246)	<.001	.252
Youth and caregivers give feedback, e.g., anonymous surveys.	–2.72	15.04	–10.92	16.90		9.18 (1)	.003*	.036
Youth and caregivers are on staff at the organization.	–18.67	14.67	–0.49	14.38		59.61 (1)	<.001*	.194
Youth and caregivers are on an advisory group that gives feedback on services and evaluation.	13.79	15.33	19.00	16.27		3.92 (1)	.049	.016
Youth and caregivers play a leadership role in making decisions for the organization.	7.60	15.56	–7.59	16.77		31.61 (1)	<.001*	.113
12. Information Sharing					.105	9.62 (3,246)	<.001	.105
No sharing of personal information with caregivers.	–103.90	22.66	–89.96	26.54		10.89 (1)	.001*	.042
All personal information is available to caregivers, with youth consent.	31.10	26.75	27.19	31.00		.628 (1)	.429	.003
Service provider decides what information to share with caregivers, with youth consent.	12.48	20.43	15.04	24.43		.437 (1)	.509	.002
Youth and service provider work together to decide what personal information to share with caregivers and how that can be helpful.	60.32	13.52	47.73	17.89		20.14 (1)	<.001*	.075

[i] ^a Levene’s test of equality of error variance statistically significant.

* Statistically significant at the Bonferroni corrected p-value of .0125.

Table 5

Randomized first choice simulation results of each caregiver group’s ideal IYS scenario, with standard errors and 95% confidence intervals.

	CAREGIVERS OF JUSTICE-INVOLVED YOUTH n = 46			CAREGIVERS OF NON-JUSTICE-INVOLVED YOUTH n = 204
	SHARES OF PREFERENCE	SE	95% CI	SHARES OF PREFERENCE	SE	95% CI
Scenario 1	25.1%	4.5%	16.2%–33.9%	51.6%	2.7%	46.4%–56.9%
Scenario 2	74.9%	4.5%	66.1%–83.8%	48.4%	2.7%	43.1%–53.6%

[i] SE = Standard Error.

CI = 95% Confidence Interval.

Scenario 1 refers to when the most preferred level of caregivers of non-justice-involved is implemented across all 12 attributes.

Scenario 2 refers to when the most preferred level of caregivers of justice-involved is implemented across all 12 attributes.