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: 8656673
• 负责人: JOAN S TUCKER
• 金额: $ 24.76万
• 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/8656673
• 关键词: AIDS prevention; 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; Unwanted pregnancy; 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; public health relevance; sex; sex risk; sexually active; treatment as usual; treatment effect

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.

描述（由申请人提供）：无家可归的青年表现出高比率的酒精和其他药物（AOD）的使用，以及性行为，增加他们的艾滋病毒，性病和意外怀孕的风险。为无家可归的青年制定的减少风险方案很少既有效又容易纳入为这一群体服务的环境。一些现有的计划是综合性的AOD和性风险降低计划，需要大量的时间和资源来提供。然而，在目前服务需求不断增加、预算和人员不断减少的服务环境下，需要大量资源的方案根本不可行。在另一个极端，一些现有的计划是简短的动机干预或外展工作，提供有限的治疗暴露，通常不解决多种风险行为。这些类型的方案甚至在相对较短的时间内都没有表现出持续的治疗效果。因此，针对无家可归青年的预防方案需要在以下两者之间取得平衡：足够密集，以解决大多数青年表现出的多种相互关联的风险行为，但又可以融入经常为这一人群服务的环境。拟议的R34研究将解决无家可归青年预防服务中的一个重要差距，方法是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，这些反馈在不同的会议上进行讨论，并侧重于青少年的个人（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目前的行为以及他们的社交网络如何有助于他们的风险行为。据我们所知，这是第一次对无家可归青年进行基于群体的MI提供的风险降低干预进行评估，也是第一次将个性化反馈纳入该人群的基于群体的干预环境。拟议的研究将：（1）调查参与该计划的无家可归青年（N = 108）与未接受该计划的青年对照样本（N = 108）相比，在3个月内是否表现出减少使用AOD的意图，行为和后果，以及性活动意图和风险行为;（2）通过探讨自我效能、改变准备、结果预期、和暴露于同伴物质使用和提供作为解释机制，减少在AOD和性活动有关的意图和危险行为的青年谁参加该计划。