Brief Group MI Intervention for AOD and Sexual Risk Behavior in Homeless Youth

项目摘要 无家可归的新兴成年人（18-25奥尔兹）的酒精和其他药物使用率（AOD）高得惊人， 与一系列性风险行为有关，如无保护的性行为，交易性行为，以及与多个人发生性关系。 临时搭档很少有针对这一人群的风险降低计划得到制定和严格评估， 特别是那些同时处理这两种相互关联的行为的人， 这是一种新的方法，在无家可归的年轻人寻求服务的环境中是可行的。我们团队最近 开发和试点测试AWARE，一个简短的动机访谈（MI）知情的群体风险降低干预 为无家可归的18-25奥尔兹的年轻人提供教育、技能培养和个性化反馈。意识 包括四个45分钟的会议，重点是使用AOD和性风险行为。试点结果表明， AWARE的可接受性和可行性，以及对AOD和性风险行为结果的积极影响 在3个月的时间里。拟议的R 01通过对以下方面进行更大规模的评估来继续这一研究路线： 意识到。我们与四个为南加州无家可归青年服务的机构合作， 随机选择N=400名18-25奥尔兹无家可归的青少年，接受AWARE计划或标准的救助中心护理 并在3个月、6个月和12个月随访时评估物质使用和性风险行为。此外，我们将 通过评估是否意识到，通过激励无家可归的新兴成年人， 更健康的选择，对与健康有关的生活质量和社会稳定具有积极的次级影响。最后我们将 研究小组层面的变化谈话（一种假设的小组MI的作用机制）对个人的影响。 AOD和性风险行为结果。这项创新研究的结果有可能填补一个重要的 为无家可归的新兴成年人提供预防服务的差距，证明一种可行的短期干预措施， 在这一人群通常寻求服务的环境中提供服务，可以大大减少相互关联的 使用AOD和性风险行为的问题。

PROJECT SUMMARY Homeless emerging adults (18-25 year olds) have alarmingly high rates of alcohol and other drug use (AOD), which is associated with a range of sexual risk behaviors such as unprotected sex, trading sex, and sex with multiple casual partners. Few risk reduction programs for this population have been developed and rigorously evaluated, particularly those that address both of these interrelated behaviors, use a collaborative and non-judgmental approach, and are feasible to deliver in settings where homeless young people seek services. Our team recently developed and pilot tested AWARE, a brief Motivational Interviewing (MI)-informed group risk reduction intervention for homeless 18-25 year olds that incorporates education, skills building, and personalized feedback. AWARE consists of four 45-minute sessions that focus on both AOD use and sexual risk behavior. Pilot results demonstrate the acceptability and feasibility of AWARE, as well as positive effects on AOD and sexual risk behavior outcomes over a 3 month period. The proposed R01 continues this line of research by conducting a larger-scale evaluation of AWARE. In collaboration with four agencies serving homeless youth in Southern California, we propose to randomize N=400 homeless 18-25 year olds to receive either the AWARE program or standard drop-in center care and evaluate substance use and sexual risk behavior at 3, 6, and 12 month follow-up. In addition, we will significantly extend our pilot work by evaluating whether AWARE, by motivating homeless emerging adults to make healthier choices, has positive secondary effects on health-related quality of life and social stability. Finally, we will examine the effects of group-level change talk (one hypothesized mechanism of action for group MI) on individual AOD and sexual risk behavior outcomes. Results from this innovative study have the potential to fill a significant gap in prevention services for homeless emerging adults by demonstrating that a brief intervention, feasible to deliver within settings where this population typically seeks services, can significantly reduce the interrelated problems of AOD use and sexual risk behavior.