Stressors, Protective Factors, and Substance Use among Homeless Youth and Young A

描述(申请人提供)：每天，多达280万名离家出走和无家可归的年轻人生活在美国街头。在他们面临的许多重大问题中，药物滥用可能是对他们的长期健康和生存最有害的。与有房的同龄人相比，无家可归的年轻人使用毒品的比例高出惊人的两到三倍。超过75%的无家可归青年/青年报告终生饮酒和/或吸食大麻。多达三分之一的人表示使用非法药物。这些物质使用趋势是一个主要的健康问题，因为短期和长期后果包括精神健康障碍、癌症和艾滋病毒。无家可归青年的药物使用与虐待儿童和父母滥用药物有关，但人们对保护机制如何运作以抵消这一极其脆弱人口使用药物/滥用药物的风险条件知之甚少。该协会研究方案的长期目标是通过宣传预防药物滥用和防止未来的健康风险来改善无家可归的青年/年轻人的生活。为了支持这一目标，本研究的具体目的是：1)确定初级应激源和物质使用之间的直接联系；2)阐明保护性因素(包括心理和社会资源)和次级应激源(包括离家后的心理和社会压力)在多大程度上调节初级应激源和物质使用之间的关系；3)确定保护性心理和社会资源是否调节了初级应激源和物质使用之间的关系；4)确定次级应激源和保护性社会资源是否随着物质使用和使用的变化而变化；5)确定短信调查的实用性和可行性，以实时收集物质使用、二次应激源和保护性社会资源的多个日常数据。虽然人们了解物质使用的一些风险因素，但缺乏考察主要和次要应激源的实证研究，以及保护机制如何在儿童劣势(主要应激源)和物质使用之间起到调节或缓冲作用。此外，考察与物质使用相关的资源和压力源的研究也很少见。虽然确定物质使用的风险因素至关重要，但同样重要的是了解为什么一些青年从不开始或能够戒除物质使用，并确定独特的可改变的社会和心理资源，作为防止物质使用的保护因素。数据收集方法将包括通过两个服务机构对120名无家可归的青年/青年进行面对面的结构化访谈，然后在30天内向受访者发送多个每日短信问题，并以后续结构化电话访谈结束。发现无家可归的年轻人成功地利用保护性因素戒除物质使用，并了解随着时间的推移物质使用的变化模式，将为未来的干预战略提供信息，以改善健康结果。

DESCRIPTION (provided by applicant): Every day, as many as 2.8 million runaway and homeless youth live on the streets of America. Of the many significant problems they face, substance abuse may be the most detrimental to their long-term health and survival. Relative to housed peers, a staggering two to three times more homeless youth use substances. Over 75% of homeless youth/young adults report lifelong alcohol and/or marijuana use. As many as one-third indicate illicit drug use. These substance use trends are a major health issue, given that the short- and long- term consequences include mental health disorders, cancer, and HIV. Substance use among homeless youth has been linked to child abuse and parental substance abuse, but little is known about how protective mechanisms operate to offset conditions of risk for substance use/abuse for this extremely vulnerable population. The long-term goal of the PI's research program is to improve the lives of homeless youth/young adults by informing the prevention of substance abuse and protection against future health risks. In support of this goal, the specific aims of this study are to: 1) identify the direct association between primary stressor and substance use; 2) elucidate the extent to which protective factors (including psychological and social resources) and secondary stressors (including psychological and social stress since leaving home) mediate the relations between primary stressors and substance use; 3) determine whether protective psychological and social resources moderate the relations between primary stressors and substance use; 4) determine whether secondary stressors and protective social resources co-vary with substance use and change in use over 30 days; and 5) determine the utility and feasibility of short message service (SMS) surveying to gather multiple daily data on substance use, secondary stressors and protective social resources in real time. While some of the risk factors for substance use are understood, there is a dearth of empirical studies examining both primary and secondary stressors and how protective mechanisms mediate or buffer between childhood disadvantage (a primary stressor) and substance use. Additionally, studies that examine resources and stressors that co- vary with substance use are rare. While identifying risk factors for substance use is critical, equally important is understanding why some youth never initiate or are able to abstain from substance use, and identifying unique modifiable social and psychological resources that serve as protective factors against substance use. Data collection methods will include a face-to-face structured interview with 120 homeless youth/young adults through two service agencies, followed by multiple daily text questions sent to respondents over a 30-day period, and conclude with a follow-up structured phone interview. Uncovering protective factors successfully used by homeless young people to abstain from substance use and understanding patterns of change in substance use over time will inform future intervention strategies to improve health outcomes.