Brief Substance and HIV Interventions for Homeless Young Adults

针对无家可归的年轻人的简短物质和艾滋病毒干预措施

• 批准号: 8209929
• 负责人: Ronald Greer Thompson
• 金额: $ 18.21万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-15 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8209929
• 关键词: AIDS/HIV problem; Adolescent; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Award; Biometry; Clinical; Clinical Data; Clinical Research; Comorbidity; Data; Data Analyses; Dependence; Development; Disease; Dropout; Drug abuse; Drug usage; Effectiveness; Epidemiology; Evidence based intervention; Factor Analysis; Funding; Goals; HIV; HIV Infections; Homelessness; Housing; Individual; Intervention; Intervention Studies; Investigation; Knowledge; Lead; Marijuana Abuse; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Moods; Motivation; Outcome; Participant; Personality; Pharmaceutical Preparations; Population; Population Research; Provider; Public Health; Randomized Clinical Trials; Research; Research Design; Research Training; Risk; Risk Behaviors; Role; Sampling; Sex Behavior; Shelter facility; Socioeconomic Status; Substance abuse problem; Surveys; Testing; Time; Training; Underserved Population; Vulnerable Populations; Work; alcohol intervention; base; brief intervention; career; design; drinking; efficacy testing; evidence base; experience; follow-up; foster care; high risk; knowledge base; longitudinal analysis; low socioeconomic status; pilot trial; prospective; public health research; randomized trial; sex risk; skills; therapy development; treatment effect; young adult

DESCRIPTION (provided by applicant): Substance abuse, psychiatric disorders, HIV/AIDS, and homelessness are pressing public health concerns. Homeless young adults are at especially high risk for substance abuse, psychiatric disorders, and HIV infection. Understanding the relationships of these problems in this vulnerable population, and using this knowledge to inform the development of interventions to reduce substance abuse and HIV risk behaviors is crucial. My overarching aim for this Mentored Patient-Oriented Research Career Development Award (K23) award is to gain expertise developing and testing disseminable brief interventions to reduce substance and HIV risk behaviors in homeless young adults, an underserved and under-researched population. To succeed, I will require protected time. My training objectives are to develop a greater knowledge base in research on substance abuse, psychiatric disorders, and HIV risk behaviors. Specifically, I propose training on (a) study design, including randomized clinical trials, and sample selection; (b) biostatistics, specifically longitudinal data analysis; (c) assessment of psychiatric comorbidity, substance abuse outcomes, and their relationship; and (d) evidence-based interventions for substance abuse and substance reduction. The proposed research plan, combining clinical and public health research, will provide an opportunity to apply my training and lead to the development of brief interventions to reduce substance abuse and HIV risk behaviors in homeless young adults. Study 1 has two main components. The first, Study 1A, involves analyses of data from a pilot randomized trial to test the One Plus One (OPO), a 2-session, individual motivation-based intervention I designed to reduce drinking and HIV risk among homeless adolescents who exited foster care. The analyses will allow me to evaluate whether OPO affects substances other than alcohol, and whether participant baseline psychiatric status influences OPO dropout, substance, and HIV outcomes. Using these findings, I will design and conduct Study 1B, in which I will modify OPO to target illicit substances in addition to alcohol, adapt the design as necessary, and conduct a second small randomized trial to test feasibility and preliminary effectiveness of the revised OPO. This second small trial will provide the basis for an application for an R01- funded larger trial to test the efficacy of the revised OPO. To place my clinical research within a larger public health framework and to inform the development of OPO, I will also conduct Study 2. This will involve investigation of the relationships between substance and psychiatric disorders, HIV risk, and homelessness in a large national sample with a 3-year follow-up. Using these data, I will analyze factors affecting the risk of drinking alcohol before sexual activity (Study 2A) and the roles of socioeconomic status, substance abuse, and psychiatric disorders on the prospective likelihood of becoming homeless (Study 2B). This research plan will allow me to realize the potential of my clinical experience and research ideas to help reduce substance abuse and HIV risk behaviors among the population of homeless young adults who are badly in need of assistance. PUBLIC HEALTH RELEVANCE: Better understanding the relationships between the intersecting public health concerns of substance abuse, psychiatric disorders, HIV/AIDS, and homelessness, and using this knowledge to inform the development of brief interventions to reduce substance abuse and HIV risk behaviors among homeless young adults, is crucial. The proposed training and research plan will provide me an opportunity to acquire and apply knowledge and skills from expert mentoring, course work, and other activities to a research plan focused on the development and testing of brief interventions to reduce substance abuse and HIV risk behaviors in homeless young adults. Such interventions should have substantial public health impact due to their brevity and the ease of dissemination among this vulnerable and underserved population.

描述（由申请人提供）：药物滥用，精神病，艾滋病毒/艾滋病和无家可归者正在迫切关注公共卫生。无家可归的年轻人尤其有滥用药物，精神疾病和艾滋病毒感染的风险。了解这些问题在这个脆弱人群中的关系，并利用这些知识来告知干预措施以减少药物滥用和艾滋病毒风险行为是至关重要的。我对这项受过指导的面向患者的研究职业发展奖（K23）奖的总体目标是获得专业知识，以降低无家可归的年轻人，服务不足和研究不足的人群的不可思议的短暂干预措施，以减少毒品和艾滋病毒风险行为。为了成功，我将需要受保护的时间。我的培训目标是在滥用药物，精神疾病和艾滋病毒风险行为方面建立更大的知识基础。具体而言，我建议对（a）研究设计进行培训，包括随机临床试验和样本选择； （b）生物统计学，特别是纵向数据分析； （c）评估精神病合并症，药物滥用结果及其关系； （d）基于证据的药物滥用和减少物质的干预措施。拟议的研究计划结合了临床和公共卫生研究，将提供一个机会，以应用我的培训并导致短暂的干预措施，以减少无家可归的年轻人的药物滥用和艾滋病毒风险行为。研究1具有两个主要组成部分。第一个研究1a涉及对试验随机试验的数据分析，以测试一个加1（OPO），这是一项基于2节，基于动机的干预措施，我旨在减少退出寄养的无家可归者青少年的饮酒和HIV风险。这些分析将使我能够评估OPO是否会影响酒精以外的其他物质，以及参与者基线精神病状态是否影响OPO辍学，物质和HIV结果。使用这些发现，我将设计和进行研究1B，其中我将修改OPO以靶向非法物质，除了酒精之外，根据需要调整设计，并进行第二次小型随机试验，以测试修订后的OPO的可行性和初步效果。第二次小型试验将为R01资助的较大试验的申请提供基础，以测试修订后的OPO的功效。为了将我的临床研究置于更大的公共卫生框架内，并为OPO的发展提供信息，我还将进行研究2。这将涉及对物质与精神疾病，艾滋病毒风险，艾滋病毒风险和无家可归者之间的关系进行研究，并进行了为期3年的随访。使用这些数据，我将分析影响性活动之前饮酒风险的因素（研究2a）以及社会经济状况，药物滥用和精神疾病的作用在无家可归的可能性上（研究2B​​）。该研究计划将使我能够意识到自己的临床经验和研究思想的潜力，以帮助减少急需援助的无家可归年轻人人口中的滥用药物和艾滋病毒风险行为。 公共卫生相关性：更好地了解与滥用药物滥用，精神疾病，艾滋病毒/艾滋病和无家可归的公共卫生问题之间的关系，并利用这些知识来告知短暂的干预措施，以减少无家可归的年轻人中的毒品滥用和艾滋病毒风险行为，这是至关重要的。拟议的培训和研究计划将为我提供一个机会，从专家指导，课程工作和其他活动中获取和运用知识和技能到研究计划，重点是开发和测试短暂的干预措施，以减少无家可归的年轻人的滥用药物滥用和HIV风险行为。这种干预措施应由于其简洁而对公共卫生的影响产生重大影响，并在这个脆弱和服务不足的人群中易于传播。