Hair Collection for Cortisol Among Youth Experiencing Homelessness.
Jodi L Ford, Natasha Slesnick, Kelly Kelleher and 10 others
PMID 37625179WHAT IT FOUND
Collecting hair samples for cortisol testing was feasible in youth experiencing homelessness, with 88.4% participating.
The main barrier was insufficient hair length, not refusal. Nurses working with this population can expect high engagement with this non-invasive stress biomarker collection.
Key findings
01Hair collection for cortisol measurement was feasible, with a high overall participation rate of 88.4% among youth experiencing homelessness.
02The most common reason for non-participation was insufficient hair length (7 of 10 cases), followed by hair extensions, rather than refusal due to distrust or concerns about testing.
03Descriptive analysis suggested lower participation rates among Black, multiracial, and male youths compared to White and female youths, though statistical significance was not tested due to small sample sizes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used convenience sampling from a single drop-in center in one Midwest city, limiting generalizability to other homeless youth populations. The sample size of non-participants (n=10) was too small to statistically analyze differences in participation rates by race, sex, or sexual orientation. The data comes from three different pilot studies with different primary aims, which may have influenced recruitment and engagement strategies. The study did not measure actual cortisol levels or their clinical significance, only the feasibility of collection.
Declared interests
The authors reported no conflicts of interest. The research was supported by the National Institutes of Health (N.I.H.).
The easy way to misread this
Do not conclude that hair cortisol collection is equally feasible across all demographic groups. While overall participation was high, descriptive data showed lower participation among Black and male youth, likely driven by hair length restrictions rather than refusal. This suggests that standard posterior vertex collection methods may inadvertently exclude specific populations unless alternative collection sites or methods are validated.