Journal of Adolescent Health

Covenant House is a nonprofit organization that provides housing and support services to youth facing homelessness. Homeless services are provided in congregate settings, which can facilitate the spread of infection. Recommendations to prevent COVID-19 may be difficult for a person experiencing homelessness to follow. For many, it is not possible to avoid crowded locations, such as shelters. However, once sheltered, some measures become more feasible, such as frequent handwashing with soap and water and wearing a face mask. Maintaining a distance of six feet from others may be more or less feasible depending on the limitations of spacing at the shelter but can be addressed with processes that make it possible. Covenant House staff members have been tirelessly working to maintain standard measures to protect our youth and to be able to sustain the shelters' mission during this unprecedented time. We serve at the health center within the Covenant House of Pennsylvania. Our first programmatic changes related to COVID-19 transmission were made in early March. While presented sequentially, many of our efforts happened simultaneously. Each new effort was introduced as it was developed with often overlapping time frames. We tried to minimize crowds by expanding mealtime and shower hours, thereby allowing fewer residents into those spaces at any time. We expanded access to hand sanitizers and required all youth to sanitize before entering public spaces. When we asked youth to abide by universal masking, many were initially resistant. Committed to avoiding punitive measures for youth not wearing their masks, we focused on methods of positive reinforcement. Our efforts were based on a diffusion of innovation model which has been successfully used with adolescents and young adults to achieve behavioral change [1Lawrence J.S. Fortenberry J.D. Behavioral interventions for STDs: Theoretical models and intervention methods.in: Aral S.O. Douglas Jr., J.M. Behavioral interventions for prevention and control of sexually transmitte...

Lessons Learned: Achieving Critical Mass in Masking Among Youth in Congregate Living