Participants
This cross-sectional study recruited all 120 runaway youth girls (age ranged from 12 to 21) who were arrested by Police and referred to Residency Centers of State Welfare Organization (RCSWO) of the 31 provinces of Iran during February 2016 to July 2016. Girls who left home intentionally and without parents’ permission, spent at least one night out of home and did not want to go back home included in the study. The RCSWO provide shelter, food and necessary health services. In addition, the social workers of the RCSWO try to provide social support to the girls and contact with their family. Runaway girls usually stay in this center for 10 days. Twenty-five of the runaway participants did not answer more than 15% of the questionnaire items. Therefore, the data of 95 subjects were analyzed. Further demographic characteristics of runaway girls are presented in Table 1. The excluded participants did not differ with other runaway girls on fathers’ education (x2 (2, N = 230) = 3.11, p = 0.37), Fathers’ employment (x2 (2, N = 230) = 4.73, p = 0.18), mothers’ education (x2 (2, N = 230) = 4.54, p = 0.20), family socioeconomic status (x2 (2, N = 230) = 1.29, p = 0.52).
The control group girls were female students (grade 7th to 12th) at intermediate and high schools of Tehran and Kerman that recruited via convenience sampling (n = 135) at the same timeframe. The exclusion criteria were the history of running away from house. Further demographic characteristics of control group girls are also presented in Table 1.
Instruments
Sociodemographic characteristics: This included age, religion, father and mother’s educational status, Father’s employment status, and family economic status.
Prevention Planning Survey (PPS) (21, 22) consists of items and short scales that measures a number of personality and social risk factors. The items of the PPS were short and use simple wording so that the individuals with weak reading skills could answer them. In the current study, we used strength of family (e.g. “Dose your family care about you? “Does your family care what you do?”, “How much do you care about your family?”), religious identification (e.g. “How important is religion in your life?”, “Are you religious?”), Physical, emotional, and sexual abuse (e.g. “have you ever beaten up by someone?”), and lifetime substance use (e.g. “How often have you ever used opium? If yes, how many times?”) subscales. The strength of family and religious identification scales used a 4 point Likert scale (1 = a lot to 4 = not at all) that higher scores indicate lower level of family strength and lower level of religious beliefs. The Physical, emotional, and sexual abuse subscale use yes/no answers. Validity and reliability of these subscales were established in Iranian population (Taremian, Bolhari, Peyravi, & Asgari, 2014). In the current study, internal consistency of these scales were satisfactory and ranged from 0.73 to 0.84.
Beck Depression Inventory, second edition (BDI-II) assesses the severity of depression symptoms (23) using a 4 point likert scale ( ranging from 0 to 3). Each item consisted of 4 sentences and participant was asked to choose a sentence that describe him/her best. The scale demonstrated good psychometric properties (24). The internal consistency, split half, and test–retest reliability of the scale in an Iranian sample were 0.91, 0.89 and 0.94, respectively (25). In the current study, internal consistency of the BDI-II was 0.93.
Rosenberg Self-esteem Scale (RSES) (26) is a 10-item self-report instrument that measures self-esteem (e.g. “I feel that I am a person of worth, at least on an equal plane with others”) using a 4 point Likert scale (from 0 = strongly disagree to 3 = strongly agree). The higher scores indicate higher self-esteem. Satisfactory internal consistency and validity of RSES has been demonstrated in Western (27, 28) as well as Persian speaking populations. In the current study, the RSES showed satisfactory internal consistency (0.81).
Coping Inventory for Stressful Situations (CISS) (29) is a 46 items inventory that assesses task oriented (e.g. “Focus on the problem and see how I can solve it”), emotion oriented (e.g. “Blame myself for having gotten into this situation”), and avoidance oriented (e.g. “Treat myself to a favorite food or snack”) coping strategies using a 5 point Likert scale (from 1 = not at all to 5 = very much). Validity and reliability of CISS are well established in Italian (30), Japanese (31) and Iranian population (32). In present study the internal consistency of the scale was 0.81.
Procedure
For runaway sample, 31 psychologists from social welfare organizations in 31 provinces were recruited as assessors. In other words, each assessor collected data from one province. Third author ran a 4-hour workshop and trained the 31 assessors about purpose and procedure of the study and content of the questionnaire items. Then, assessors invited runaway youth girls who admitted to RSCWO to participate in the study. Those who agreed to participate in the study and signed informed written consent were asked to complete the questionnaire package anonymously. During completing the questionnaires, the assessor was available to the participant to answer her questions.
In order to collect data from the control group, two assessors referred to the classrooms in Tehran and Kerman. They explained the purpose and procedure of the study to the students. Girls who agreed to participate in the study, were instructed about the questionnaires and asked to complete the same battery of questionnaires, anonymously. During completing the questionnaires, the assessor was available to the participant to answer her questions.
All participants which aged ≥ 16 years old signed an informed written consent. For runaway girls which aged less than 16 years old, social worker of the RCSWO contacted with their parents/guardians. When parents/guardians of the runaway girls referred to the RCSWO, they were provided an informed written consent. For control group girls which aged less than 16 years old, parents/guardians signed an informed written consent. Research procedure was approved by Ethics Review Board of Zanjan University of Medical Sciences and State Welfare Organization (Code of Ethics: 1394.103). All methods were carried out following the institutional guidelines and conforming to the ethical standards of the declaration of Helsinki. All participants were informed about the study and written informed consent was obtained before completing the survey.
Statistical Analysis
Data analysis were performed using Statistical Package for the Social Sciences (SPSS software version 24). The demographic characteristics of participants were estimated using descriptive statistics. Missing data were replaced by the means of the item in the corresponding group. We used independent t-test and Chi square in order to compare runaway girls with control group girls on sociodemographic characteristics and independent variables. We also used logistic model regression to examine the associations between running away from home and each independent variable. The dependent variable was running away from home. The independent variables were level of family strength, family income, history of illicit drugs use in life time, level of religious beliefs, coping style, self-esteem, depression, and history of physical, emotional, and sexual abuse. After checking for collinearity, variables that were significant in comparison analyses (p < 0.05) were included in the logistic analysis. We used adjusted odds ratios (aORs) and 95% CIs estimated using logistic regression.