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

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DESCRIPTION (provided by applicant): Homeless youth exhibit high rates of alcohol and other drug (AOD) use, as well as sexual behaviors that increase their risk of HIV, STIs and unwanted pregnancy. 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, 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 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 par 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 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 AOD- and sexual activity- related intentions and risk behaviors among youth who participate in the program.