Enhancing Psychological Capital to Foster Health Outcomes in Homeless Young Women

描述（由申请人提供）：无家可归的年轻女性，18-23岁，是无家可归群体中最脆弱的群体。她们经历了许多可怕的健康后果，如性传播感染、乙型和丙型肝炎以及意外怀孕，特别是与药物使用和伴随的性行为有关；然而，他们也有内在的优势，如希望、自我效能和弹性，这些都是他们的心理资本。迄今为止，在这一人群寻求卫生和社会服务的环境中，很少有理论驱动的干预措施得到开发和试验。这项可行性随机对照试验的具体目的是：1)检验短期街头干预的可行性，以增强无家可归的年轻女性（18-23岁）的心理资本（希望、弹性、自我效能和乐观主义），并促进认知、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）；2)确定这一短暂干预的初步效果和成本。我们将招募总共0名年轻女性，并随机分配40名到干预组，40名到注意控制组。每个小组将参加四次小组讨论和技能培养活动。干预组将侧重于在设定目标和确定策略的背景下发展他们的心理资本（希望、恢复力、自我效能和乐观主义），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。四个疗程结束后，两组参与者都将收到一个月的预付费手机。干预组的参与者每周都会收到小组辅导员通过手机发来的鼓励信息，而对照组的参与者每周都会收到提醒他们研究最终数据收集日期的信息。定量数据将在基线、干预组或对照组四次疗程后立即和4周后收集。在最后的数据收集期后，将对干预组的参与者进行退出访谈。定量数据将使用描述性和推断性统计检验进行分析，包括重复测量方差分析（ANOVA）和均值差异的t检验。采访数据将被录音，逐字记录，并使用内容分析程序进行分析。干预保真度将通过对随机选择的干预小组会议录音的回顾来确定。研究结果将用于修订干预手册和研究方案，以便采用随机对照试验设计进行更大规模的多地点干预试验。

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.