Intervention to Promote Healthy Behaviors in Homeless Youth

促进无家可归青少年健康行为的干预措施

• 批准号: 9251835
• 负责人: DONNA LYNN REW
• 金额: $ 52.49万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9251835
• 关键词: AIDS/HIV problem; Address; Affective; Age; Alcohol consumption; Alcohol or Other Drugs use; Alcoholism; Analysis of Covariance; Area; Behavior; Behavioral; Capital; Cellular Phone; Characteristics; Cognitive; Communication; Data; Development; Distal; Drops; Drug usage; Effectiveness; Effectiveness of Interventions; Electronic Mail; Equation; Feasibility Studies; Fright; Future; Geographic Locations; Geography; Goals; HIV; HIV risk; Health; Health Care Costs; Health behavior; Healthcare; Homeless Youth; Homelessness; Human; Image; Intervention; Intervention Studies; Lead; Life; Measures; Mediating; Mediation; Modeling; Outcome; Participant; Population; Preventive Intervention; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Research Project Grants; Resources; Risk Behaviors; Risk Factors; Safe Sex; Sampling; Self Efficacy; Self-Examination; Services; Sex Behavior; Sex Orientation; Sexual abuse; Sexually Transmitted Diseases; Site; Social Work; Societies; Substance abuse problem; Technology; Testing; Time; United States Public Health Service; Youth; addiction; austin; base; behavioral health; behavioral outcome; brief intervention; condoms; cost; design; ethnic difference; ethnic minority population; follow-up; gratitude; group intervention; healthy lifestyle; high risk sexual behavior; housing instability; image reconstruction; improved; member; motivational enhancement therapy; novel; optimism; peer; post intervention; prevent; psychologic; public health relevance; racial and ethnic; resilience; response; satisfaction; service utilization; sex; sex risk; sexual minority; skills; social; statistics; theories; therapy design

 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.

 说明(申请人提供)：18-23岁的无家可归青年极易受到不良健康后果的影响，特别是与药物使用和性行为有关的不良健康后果；不良健康后果包括药物滥用和艾滋病毒/艾滋病，往往是两者兼而有之。尽管这些年轻人的生活特点是不可预测的，对他们和整个社会来说，未来看起来都很黯淡，但他们也有内在的力量，如乐观、希望、自我效能、韧性和感恩，这些都代表了他们的一些心理资本。心理资本已被证明是行为的强大推动力。到目前为止，很少有理论驱动的基于优势的干预措施在这一人群中开发和测试，这些干预措施是在他们顺道寻求卫生和人类服务的环境中制定和测试的。本申请的具体目的是(1)确定自我反思性预防干预的有效性，以促进18-23岁无家可归青年负责任的药物使用和安全的性行为(预防艾滋病毒/艾滋病)；(2)确定心理资本因素是否在背景风险因素(性取向、无家可归持续时间、性虐待史、药物使用史、既往性风险行为和服务利用)与改善的近期结果(自我效能和意图)和远期结果(负责任的药物使用、安全的性行为、生活满意度)之间的关系中起中介作用；(3)确定预先测试对(干预后立即)和(干预后间隔3个月和6个月)干预的近端和远端结果的影响；以及探索性目标(4)探索在两个不同地点(德克萨斯州奥斯汀和俄亥俄州哥伦布)的参与者之间干预的近端和远端结果的一般和具体差异。我们将从美国中部两个地理区域的两个收容中心招募总共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。采用具有重复测量的所罗门四组设计，我们将进行一项简短的可能自我干预(PSI)的随机对照试验，该试验由6个简短的个性化会话组成，集中于生成一个人可能害怕的或最好的可能自我的图像。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。在干预前、干预后立即、干预后间隔3个月和6个月收集定量数据，以检验关于干预对健康行为和生活满意度的有效性的假设，以及使用结构方程模型和ANCOVA统计分析预测试对这些结果的影响。这一发现预计将对进一步发展个性化服务产生公共卫生影响，以促进弱势青少年的健康行为、健康生活方式和生活满意度。