Relationality, Overload, and Trust: How Housing-Insecure Youth Navigated Health Information During the COVID-19...

Youth experiencing homelessness and housing instability (YEH) face disproportionate health risks and structural barriers to health equity, which were intensified during the COVID-19 pandemic. We conducted a community-based participatory research study with 21 adolescents (ages 13-17) and transitional-aged youth (ages 18-26) experiencing homelessness or housing instability in San Diego, California, USA. Between February and July 2023, we conducted six "arts-based engagement sessions" (5 in English, 1 in Spanish) that blended expressive arts and focus group approaches to examine how YEH accessed, evaluated, and applied health information, and how trust and material and structural resource constraints shaped engagement with COVID-19 information and prevention guidance. We analyzed data via applied thematic analysis. Participants described how COVID-19 restrictions and economic disruption amplified pre-existing housing precarity, worsening material conditions and mental health. Participants selectively trusted COVID-19 information based on who provided it, how credible it felt, and whether it aligned with their lived experiences. Community-based providers and, for some, churches and cultural or ancestral knowledge were key information sources. Trust in government and public health messaging was conditional and shaped by perceptions of credibility, coherence, and political motivation. Participants described information overload and rapidly changing guidance as overwhelming and often incompatible with their material realities, leading to disengagement, reliance on intuition, or deprioritization of prevention behaviors. Effective communication during future health emergencies must center trusted relational messengers, align guidance with lived realities, and address the structural conditions that shape whether health information can be meaningfully acted upon.