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，精神疾病，艾滋病毒/艾滋病和无家可归是紧迫的公共卫生问题。无家可归的年轻人特别容易滥用药物、精神疾病和感染艾滋病毒。了解这些问题在这一弱势群体中的关系，并利用这些知识来制定干预措施，以减少药物滥用和艾滋病毒风险行为是至关重要的。我的首要目标是这个指导以病人为导向的研究职业发展奖（K23）奖是获得专业知识，开发和测试可传播的简短干预措施，以减少无家可归的年轻人的物质和艾滋病毒风险行为，这是一个服务不足和研究不足的人群。为了成功，我需要保护时间。我的培训目标是在药物滥用，精神疾病和艾滋病毒风险行为的研究方面建立更大的知识基础。具体而言，我建议培训（a）研究设计，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）精神病合并症，药物滥用结果及其关系的评估;（d）药物滥用和药物减少的循证干预措施。拟议的研究计划，结合临床和公共卫生研究，将提供一个机会，应用我的培训，并导致简短的干预措施，以减少无家可归的年轻人的药物滥用和艾滋病毒的危险行为的发展。研究1有两个主要组成部分。第一项研究是研究1A，涉及对一项试点随机试验的数据分析，以测试一加一（OPO），这是一项为期2天的基于个人动机的干预措施，旨在减少退出寄养的无家可归青少年的饮酒和艾滋病毒风险。这些分析将使我能够评估OPO是否影响酒精以外的物质，以及参与者基线精神状态是否影响OPO辍学，物质和HIV结果。利用这些发现，我将设计和进行研究1B，其中我将修改OPO以针对酒精以外的非法物质，根据需要调整设计，并进行第二项小型随机试验以测试修订后的OPO的可行性和初步有效性。第二个小型试验将为R 01资助的大型试验提供基础，以测试修订后的OPO的有效性。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。这将涉及在大规模全国样本中调查物质与精神疾病、艾滋病毒风险和无家可归之间的关系，并进行3年随访。利用这些数据，我将分析影响性活动前饮酒风险的因素（研究2A）以及社会经济地位，药物滥用和精神疾病对无家可归的可能性的作用（研究2B）。这项研究计划将使我认识到我的临床经验和研究思路的潜力，以帮助减少物质滥用和艾滋病毒的危险行为之间的无家可归的年轻人谁是迫切需要援助的人口。 公共卫生相关性：更好地了解药物滥用，精神疾病，艾滋病毒/艾滋病和无家可归的交叉公共卫生问题之间的关系，并利用这些知识来告知制定简短的干预措施，以减少无家可归的年轻人中的药物滥用和艾滋病毒风险行为，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应用知识和技能，以制定和测试简短的干预措施，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。由于这些干预措施时间短，易于在这一弱势和得不到充分服务的人口中传播，因此应能产生重大的公共卫生影响。