Enhancing Psychological Capital to Foster Health Outcomes in Homeless Young Women

描述（由申请人提供）：无家可归的年轻妇女，18-23岁，是最脆弱的无家可归群体。他们经历了许多可怕的健康后果，如性传播感染，乙肝B和丙肝，以及计划外怀孕，特别是与物质使用和伴随的性行为有关;然而，他们也有内在的力量，如希望，自我效能和韧性，这代表了他们的一些心理资本。到目前为止，很少有理论驱动的干预措施已经制定和测试，在这一人群中，他们寻求健康和社会服务的设置。这项可行性随机对照试验的具体目的是：1）检查以街头为基础的简短干预措施增强心理资本的可行性（希望，韧性，自我效能和乐观），并培养认知，情感（社会联系、未来期望、生活质量）和行为健康相关结果（目标实现，安全性行为，和负责任的物质使用行为）在无家可归的年轻女性（年龄18-23）;和2）确定初步的疗效和成本，这种简短的干预。我们将招募0名年轻女性，并随机分配40名为干预组，40名为注意力控制组。每个小组将参加四次小组讨论和技能建设活动。干预组将重点发展他们的心理资本（希望，韧性，自我效能和乐观）的背景下，设定目标和确定战略，以减少他们的危险物质使用和性行为。注意力控制组将收到有关街道安全和保持健康的一般信息。在四次会议之后，两组的参与者都将获得一个月的预付费手机。干预组的参与者将每周通过手机收到来自小组协调员的鼓励信息，而对照组的参与者将每周收到提醒他们研究最终数据收集日期的信息。将在基线时、干预组或对照组的四个阶段后立即以及4周后收集定量数据。在最终数据收集期结束后，将对干预组的人员进行离职访谈。将使用描述性和推断性统计检验分析定量数据，包括重复测量方差分析（ANOVA）和平均值差异的t检验。访谈数据将被录音，逐字转录，并使用内容分析程序进行分析。干预保真度将通过审查干预组会议的随机选择录音来确定。研究结果将用于修订干预手册和研究方案，以便使用随机对照试验设计进行更大规模的多中心干预试验。 公共卫生相关性：18-23岁的无家可归年轻妇女极易受到与药物使用和性行为有关的不良健康后果的影响;因此，我们需要制定和测试干预措施，帮助她们过上富有成效和令人满意的生活。如果不采取这种干预措施，它们就会对公共健康构成巨大威胁，造成代价高昂的健康问题，如药物滥用、艾滋病毒/艾滋病、多种性传播感染、B型和C型肝炎以及创伤后应激障碍。这项研究的结果将有助于进一步开发和测试理论驱动的干预措施，这些干预措施是有效的，并且可以在多个公共卫生服务环境中以很小的成本提供。

DESCRIPTION (provided by applicant): Homeless young women, 18-23 years of age, are the most vulnerable of homeless groups. They experience many dire health outcomes such as sexually transmitted infections, Hepatitis B and C, and unplanned pregnancies, related particularly to substance use and concomitant sexual behaviors; however, they also have inherent strengths such as hope, self-efficacy, and resilience that represent some of their psychological capital. To date very few theory-driven interventions have been developed and tested in this population in settings where they seek health and social services. The specific aims of this feasibility randomized controlled trial are to 1) Examine the feasibility of a brief, street-based intervention to enhance psychological capital (hope, resilience, self-efficacy, and optimism) and foster cognitive, affective (social connectedness, future expectations, quality of life), and behavioral health-related outcomes (goal attainment, safe sex behaviors, and responsible substance use behaviors) in homeless young women (ages 18-23); and 2) Determine the preliminary efficacy and cost of this brief intervention. We will recruit a total of 0 young women and randomly assign 40 to the intervention group and 40 to an attention control group. Each group will attend four sessions of group discussions and skill-building activities. The intervention group will focus on developing their psychological capital (hope, resilience, self-efficacy, and optimism) in the context of setting goals and identifying strategies to curtail their risky substance use and sexual behavior. An attention control group will receive general information about street safety and staying healthy. Following the four sessions, participants in both groups will receive a one-month pre-paid cell phone. Those in the intervention group will receive encouraging messages from their group facilitators weekly via the cell phones while those in the control group will receive weekly messages reminding them of the date of the final data collection for the study. Quantitative data will be collected at baseline, immediately following the four sessions of intervention or control groups, and 4 weeks later. Exit interviews will be done with those in the intervention group following the final data collection period. Quantitative data will be analyzed using descriptive and inferential statistical tests including repeated measures analysis of variance (ANOVA) and t-tests for differences between means. Interview data will be audio-recorded, transcribed verbatim, and analyzed using content analysis procedures. Intervention fidelity will be ascertained by reviews of a random selection of audio recordings of the intervention group sessions. Findings will be used to revise the intervention manual and research protocol for a larger multi-site test of the intervention using a randomized controlled trial design. PUBLIC HEALTH RELEVANCE: Homeless young women, ages 18-23 years, are extremely vulnerable to poor health outcomes related particularly to substance use and sexual behaviors; thus, we need to develop and test interventions that help them live lives that are productive and satisfying. Without such interventions, they represent a great threat to the public health for costly health problems such as substance abuse, HIV/AIDS, multiple sexually transmitted infections (STIs), hepatitis B and C, and post-traumatic stress disorder (PTSD). Findings from this study will contribute to the further development and testing of theory-driven interventions that are effective and that can be delivered at little cost in multiple public health service settigs.