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

描述（由申请人提供）：无家可归的青年酗酒和吸毒（AOD）的比例很高，性行为也会增加他们感染艾滋病毒、性传播感染和意外怀孕的风险。为无家可归的年轻人制定的降低风险的方案很少，这些方案既有效，又可以很容易地纳入为这一人群服务的环境中。一些现有的项目是综合的AOD和性风险降低项目，需要大量的时间和资源来实现。然而，在当前服务需求增加、预算和人员减少的环境下，需要大量资源的项目根本不可行的。在另一个极端，一些现有的项目是简短的动机干预或外联努力，提供有限的治疗暴露，通常不解决多种风险行为。即使在相对较短的时间内，这些类型的方案也没有显示出持续的治疗效果。因此，针对无家可归的青少年的预防项目需要达到一个平衡，既要足够密集，以解决大多数青少年表现出的多种相互关联的风险行为，又要可行地融入到日常服务这一人群的环境中。拟议的R34研究将解决无家可归青年预防服务方面的一个重要差距，通过对这一人群进行一项创新的5期基于小组的mi提供的风险降低干预的试点测试，该干预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，在不同的会议上讨论，重点关注青少年的个人（AOD和性行为）和环境（社会网络）风险概况，帮助他们了解他们目前的行为，以及他们的社会网络如何导致他们的风险行为。据我们所知，这是第一次对以群体为基础的mi为无家可归的年轻人提供风险降低干预的评估，也是第一次将个性化反馈纳入以群体为基础的干预设置中。该研究将：(1)调查参与该计划的无家可归青年（N = 108）在3个月的时间内，与未接受该计划的对照样本（N = 108）相比，是否显示出AOD使用意图、行为和后果、性活动意图和风险行为的减少；(2)通过探索自我效能、改变准备、结果预期、接触同伴物质使用和提供是否可以作为参与该计划的青少年中与AOD和性活动相关的意图和风险行为减少的解释机制，从而更好地理解干预效果。

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.