Brief AOD Use and Sexual Risk Reduction Group MI Intervention for Homeless Youth

简短的 AOD 使用和性风险降低小组 MI 对无家可归青少年的干预

• 批准号: 8519031
• 负责人: JOAN S TUCKER
• 金额: $ 25.15万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8519031
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Alcohol abuse; Alcohol or Other Drugs use; Area; Attention; Behavior; Budgets; Climate; Control Groups; Data; Disease; Drug abuse; Drug usage; Employee Strikes; Equilibrium; Evaluation; Exhibits; Expectancy; Exposure to; Feedback; Future; General Population; HIV; Health; Homeless Youth; Individual; Intervention; Los Angeles; Manuals; Mediator of activation protein; Outcome; Population; Population Intervention; Population Programs; Pregnancy; Prevention program; Program Development; Provider; Randomized Controlled Trials; Readiness; Recording of previous events; Reporting; Research; Resources; Rice; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Sampling; Self Efficacy; Services; Sex Behavior; Sexual Partners; Social Environment; Social Network; Testing; Time; Unsafe Sex; Variant; Work; Writing; Youth; alcohol and other drug; base; brief motivational intervention; condoms; follow-up; group intervention; injection drug use; innovation; intervention effect; journal article; meetings; motivational enhancement therapy; outreach; peer; prevention service; programs; sex; sex risk; sexually active; treatment as usual; treatment effect

Homeless youth exhibit high rates of alcohol and other drug (AOD) use and sexual risk behaviors that increase their likelihood of getting HIV/AIDS. Few risk reduction programs have been developed for homeless youth that are both effective and can be easily incorporated into settings serving this population. Some existing programs are integrated AOD and sexual risk reduction programs that require substantial time and resources to deliver. However, programs requiring substantial resources are simply not feasible in the current service delivery climate of increasing demand for services combined with decreasing budgets and staffing. At the other extreme, some existing programs are brief motivational interventions or outreach efforts that provide limited treatment exposure and do not typically address multiple risk behaviors. These types of programs have not demonstrated sustained treatment effects over even a relatively short period of time. Thus, HIV prevention programs for homeless youth need to strike a balance between being intensive enough to address the multiple and interrelated risk behaviors that most youth exhibit, yet feasible to integrate into settings that routinely serve this population. The proposed R34 study will address an important gap in HIV prevention services for homeless youth by conducting a pilot test of an innovative 5-session group-based MI-delivered risk reduction intervention for this population that is feasible to deliver in settings where these youth seek services. An integral part of the program is the provision of written personalized feedback that is discussed across different sessions and focuses on the youth¿s individual (AOD and sexual behavior) and contextual (social network) risk profiles to help them understand their current behavior and how their social networks may contribute to their risk behavior. To our knowledge, this is the first evaluation of a group-based MI-delivered risk reduction intervention for homeless youth, as well as the first to incorporate personalized feedback into a group-based intervention setting for this population. The proposed study will: (1) Investigate whether homeless youth who participate in the program (N = 108) show reductions in HIV-related risk factors (e.g., AOD use intentions, behavior and consequences, as well as sexual activity intentions and risk behavior), over a 3-month period compared to a control sample of youth who do not receive the program (N = 108); and (2) Gain a better understanding of intervention effects by exploring whether improvements in self-efficacy, readiness to change, outcome expectancies, and exposure to peer substance use and offers serve as explanatory mechanisms for reductions in these HIV-related risk factors among youth who participate in the program.

无家可归的青少年酒精和其他药物 (AOD) 的使用率以及性风险行为的比例较高，这些行为增加了他们感染艾滋病毒/艾滋病的可能性。针对无家可归青年制定的既有效又可以轻松纳入为该人群服务的环境中的降低风险计划很少。一些现有计划是综合性 AOD 和性风险降低计划，需要大量时间和资源来实施。然而，在当前服务需求不断增加、预算和人员配备不断减少的服务提供环境下，需要大量资源的计划根本不可行。在另一个极端，一些现有计划是简短的激励干预或外展工作，提供有限的治疗机会，通常不能解决多种风险行为。即使在相对较短的时间内，这些类型的计划也没有表现出持续的治疗效果。因此，针对无家可归青年的艾滋病毒预防计划需要在足够强度以解决大多数青年所表现出的多种且相互关联的风险行为之间取得平衡，同时又可以融入到经常为该人群提供服务的环境中。拟议的 R34 研究将通过对一项创新性的 5 次小组型 MI 为无家可归青年提供的风险降低干预措施进行试点测试，解决无家可归青年艾滋病毒预防服务方面的一个重要差距，该干预措施在这些青年寻求服务的环境中是可行的。该计划的一个组成部分是提供书面的个性化反馈，这些反馈在不同的会议中进行讨论，重点关注青少年的个人（AOD 和性行为）和背景（社交网络）风险概况，以帮助他们了解他们当前的行为以及他们的社交网络如何影响他们的风险行为。据我们所知，这是对基于群体的 MI 为无家可归青少年提供的风险降低干预措施的首次评估，也是首次将个性化反馈纳入针对该人群的基于群体的干预设置中。拟议的研究将： (1) 调查与未接受该计划的青年对照样本 (N = 108) 相比，在 3 个月的时间内，参与该计划的无家可归青年 (N = 108) 是否表现出 HIV 相关风险因素（例如 AOD 使用意图、行为和后果，以及性活动意图和危险行为）的减少； (2) 通过探索自我效能、改变准备程度、预期结果以及接触同伴物质使用和优惠的情况的改善是否可以作为参与该计划的青年中减少这些艾滋病毒相关风险因素的解释机制，更好地了解干预效果。