Intervention to Promote Healthy Behaviors in Homeless Youth

 描述（由申请人提供）：无家可归的青年，年龄在18-23岁之间，特别容易受到与药物使用和性行为有关的不良健康结果的影响;不良健康结果包括药物滥用和艾滋病毒/艾滋病，通常是组合。虽然这些年轻人的生活通常是不可预测的，未来对他们和更大的社会来说是暗淡的，但他们也有内在的力量，如乐观，希望，自我效能，韧性和感激之情，这是他们的一些心理资本。心理资本已被证明是一个强大的行为动机。到目前为止，很少有理论驱动的力量为基础的干预措施已经制定和测试，在这个人口的设置，他们下降，以寻求健康和人类服务。本申请的具体目的是（1）确定自我反思预防性干预的有效性，以促进负责任的物质使用和安全的性行为（预防艾滋病毒/艾滋病）在无家可归的青年，年龄18 -23岁;（2）确定心理资本因素是否介导背景风险因素之间的关系（性取向，无家可归的时间，性虐待史，物质使用史，过去的性风险行为和服务利用）和改善的近端结果（自我效能和意图）和远端结果（负责任的物质使用、安全性行为、生活满意度）;（3）确定预测试对干预近端结果的影响（介入后即刻）和远端结局（干预后间隔3至6个月）;一个探索性的目标（4）探索两个地理位置不同的参与者之间近端和远端干预结果的一般和具体差异，研究中心（德克萨斯州奥斯汀和俄亥俄州哥伦布）。我们将从美国中部两个地理区域的两个救助中心招募600名无家可归的年轻人：德克萨斯州奥斯汀和俄亥俄州哥伦布。采用所罗门四组设计，重复测量，我们将进行一项随机对照试验，简要的可能自我干预（PSI），包括6个简短的个性化会议，重点是产生一个人的可能自我的图像作为恐惧或最好的。干预参与者还将每周收到电子信息，鼓励他们朝着成为最好的自己的目标前进。将在干预前、干预后立即以及干预后3个月和6个月收集定量数据，以使用结构方程模型和ANCOVA统计来检验有关干预对健康行为和生活满意度的有效性以及预测试对这些结果的影响的假设。研究结果预计将对进一步发展个性化服务产生公共卫生影响，以促进弱势青年的健康行为，健康生活方式和生活满意度。

 DESCRIPTION (provided by applicant): Homeless youths, ages 18-23 years, are extremely vulnerable to poor health outcomes related particularly to substance use and sexual behaviors; adverse health outcomes include substance abuse and HIV/AIDs, often in combination. Although these youths' lives are characteristically unpredictable and the future looks bleak to them and to the larger society, they also have inherent strengths such as optimism, hope, self-efficacy, resilience, and gratitude that represent some of their psychological capital. Psychological capital has been shown to be a strong motivator of behavior. To date very few theory-driven strengths-based interventions have been developed and tested in this population in settings where they drop-in to seek health and human services. The specific aims of this application are to (1) determine the effectiveness of a self-reflective preventive intervention to promote responsible substance use and safe sex behaviors (prevent HIV/AIDS) in homeless youths, ages18-23 years; (2) determine whether psychological capital factors mediate the relationship between background risk factors (sexual orientation, duration of homelessness, sex abuse history, history of substance use, past sexual risk behaviors, and service utilization) and improved proximal outcomes (self-efficacy and intentions) and distal outcomes (responsible substance use, safer sex, life satisfaction); (3) determine the effect of pre-testing on interventin proximal outcomes (immediately following intervention) and distal outcomes (at an interval of 3 and 6 months following intervention); and an exploratory aim (4) to explore general and specific differences in proximal and distal outcomes of the intervention between participants in two geographically different sites (Austin, TX and Columbus, OH). We will recruit a total of 600 homeless youths from 2 drop-in centers in 2 geographic areas of the central US: Austin, TX and Columbus, OH. Using a Solomon four-group design with repeated measures, we will conduct a randomized controlled trial of a brief possible selves intervention (PSI) consisting of 6 brief individualized sessions that focus on generating images of one's possible self as feared or as best. Intervention participants will also receive weekly electronic messages to encourage them to move toward a goal of becoming their best possible self. Quantitative data will be collected before, immediately after the intervention, and at intervals of 3 and 6 months following intervention to test hypotheses about the effectiveness of the intervention on health behaviors and life satisfaction as well as the effects of pre-testing on these outcomes using structural equation modeling and ANCOVA statistics. The findings are expected to have a public health impact on further development of individualized services to promote healthy behaviors, healthy lifestyles and life satisfaction for vulnerable youths.