Diverting homeless youth/chronic homelessness/risk/HIV

描述（由申请人提供）：青少年无家可归是一个严重的问题，长期无家可归的青少年也是感染艾滋病毒的风险最大的群体。当青年新近无家可归时，就有很大的机会进行干预，以减少长期无家可归，从而减少感染艾滋病毒的风险。这一机会之窗的理由是基于一个现有项目的结果，该项目发现：家庭冲突是离家出走的主要诱因；68%的新无家可归的年轻人在3个月内返回家园，但这种团聚是不稳定的，随着时间的推移，离家出走的时间越来越长；与父母的接触是团聚的重要预测因素；与药物滥用者、无家可归者和辍学者建立社交网络预示着他们将继续无家可归。父母与青少年合作（PACT）是一项针对新无家可归青年的5期家庭干预，旨在改善居住稳定性和居住生活质量，减少离家出走事件的数量，并减少与艾滋病毒相关的性行为和药物使用风险行为。PACT将通过重新定义家庭冲突，提高解决问题的能力，获得角色清晰，促进积极的家庭互动，重新定义离家出走的情节，改善家庭功能。该项目将分两个阶段进行。第一阶段将试行并最终确定所有文书、干预程序，并改善所有收容所的标准护理，以定期评估家庭团聚。第二阶段将采用分组交叉随机化设计进行随机对照试验，检验PACT对12-17岁新近无家可归的青少年及其父母的疗效。在四家提供短期庇护所的社区机构中，新无家可归的青年（n- 320）将被随机分配到两种条件之一：1)标准护理（n =160）；2) PACT干预（n = 160）。在青年在庇护所和过渡到更稳定的生活环境（例如回到家中）期间，将与处于干预条件下的家庭进行PACT会议。将在招聘、3、6、12、18和24个月时监测青年的结果；父母将在招募、3个月（即位）、12个月和24个月时接受评估，以检查PACT对以下方面的有效性：性行为和物质使用风险行为；居住稳定性、离家出走事件与居住生活质量；家庭功能;对青少年心理健康、多重问题行为和学习成绩的影响。

DESCRIPTION (provided by applicant): Homelessness among adolescents is a significant problem, with youth that become chronically homeless also being those at greatest risk for acquiring HIV. When youth are newly homeless, there is a significant opportunity to intervene to reduce chronic homelessness and, thus, risk for HIV. The rationale for this window of opportunity is based on results from an existing project that has found: family conflicts to be the predominant precipitant for leaving home; 68% of newly homeless youth return home within 3 months, but this reunification is unstable, with longer runaway episodes over time; contact with parents being a significant predictor of reunification; developing social networks with peers that are substance abusers, homeless, and out of school predicts remaining homeless. A 5-session family intervention for newly homeless youth, Parents and Adolescents Collaborating Together (PACT), is proposed to improve residential stability and the quality of residential life, reduce the number of runaway episodes, as well as reduce HIV-related sexual and substance use risk acts. PACT will reframe the runaway episode and improve family functioning by redefining the family conflict, increasing problem-solving skills, gaining role clarity, and promoting positive family interactions. The project will proceed in two phases. Phase 1 will serve to pilot and finalize all instruments, intervention procedures, and to improve the standard care in all shelters to a routinely evaluating family reunification. In Phase 2, a randomized control trial will be conducted based on a group cross-over randomization design to test the efficacy of PACT for newly homeless youth aged 12-17 years and their parents. In four community-based agencies that provide short-term shelter, newly homeless youth (n--320) will be randomized to one of two conditions: 1) standard care (n =160); or 2) the PACT intervention (n = 160). PACT sessions will take place with the families in the intervention condition while youth are in the shelter and as they transition to a more stable living environment (e.g. back to the home). Youth's outcomes will be monitored at recruitment, 3, 6, 12, 18, and 24 months; parents will be assessed at recruitment, 3 (immediate post), 12 and 24 months to examine the efficacy of PACT on: sexual and substance use risk acts; residential stability, runaway episodes, and quality of residential life; family functioning; and generalization to youth's mental health, multiple problem behaviors, and school performance.