Stressors, Protective Factors, and Substance Use among Homeless Youth and Young A

描述（由申请人提供）：每天，多达280万离家出走和无家可归的青年生活在美国街头。在他们面临的许多重大问题中，药物滥用可能对他们的长期健康和生存最为有害。与有住房的同龄人相比，无家可归的年轻人使用药物的人数高出两到三倍。超过75%的无家可归青年/年轻人报告终身使用酒精和/或大麻。多达三分之一的人表示使用非法药物。这些药物使用趋势是一个重大的健康问题，因为短期和长期后果包括精神健康障碍、癌症和艾滋病毒。无家可归青年的药物使用与虐待儿童和父母药物滥用有关，但人们对保护机制如何运作以抵消这一极其脆弱群体的药物使用/滥用风险状况知之甚少。PI的研究计划的长期目标是通过宣传预防药物滥用和防止未来健康风险来改善无家可归青年/年轻成年人的生活。为了支持这一目标，本研究的具体目标是：1）确定主要压力源和物质使用之间的直接联系; 2）阐明保护因素在多大程度上影响了物质使用，（包括心理和社会资源）和次级压力源（包括离家后的心理和社会压力）在主要压力源和物质使用之间起中介作用;（3）确定保护性心理和社会资源是否调节初级压力源和物质使用之间的关系;（4）确定次级压力源和保护性社会资源是否与物质使用和30天内使用变化共变;以及5）确定短消息服务（SMS）调查的实用性和可行性，以收集真实的时间的物质使用、次级压力源和保护性社会资源的多种日常数据。虽然人们了解使用药物的一些风险因素，但缺乏实证研究，研究主要和次要压力源以及保护机制如何在儿童不利因素（主要压力源）和药物使用之间进行调解或缓冲。此外，研究资源和压力源与物质使用的共同变化是罕见的。虽然确定吸毒的风险因素至关重要，但同样重要的是理解为什么有些青年从未开始或能够戒除吸毒，并确定独特的可改变的社会和心理资源，作为防止吸毒的保护因素。数据收集方法将包括通过两个服务机构与120名无家可归的青年/年轻人进行面对面的结构化访谈，然后在30天内向受访者发送多个每日文本问题，并以后续结构化电话访谈结束。揭示无家可归的年轻人成功地使用的保护因素，以避免物质使用和了解随着时间的推移物质使用的变化模式，将告知未来的干预战略，以改善健康结果。

DESCRIPTION (provided by applicant): Every day, as many as 2.8 million runaway and homeless youth live on the streets of America. Of the many significant problems they face, substance abuse may be the most detrimental to their long-term health and survival. Relative to housed peers, a staggering two to three times more homeless youth use substances. Over 75% of homeless youth/young adults report lifelong alcohol and/or marijuana use. As many as one-third indicate illicit drug use. These substance use trends are a major health issue, given that the short- and long- term consequences include mental health disorders, cancer, and HIV. Substance use among homeless youth has been linked to child abuse and parental substance abuse, but little is known about how protective mechanisms operate to offset conditions of risk for substance use/abuse for this extremely vulnerable population. The long-term goal of the PI's research program is to improve the lives of homeless youth/young adults by informing the prevention of substance abuse and protection against future health risks. In support of this goal, the specific aims of this study are to: 1) identify the direct association between primary stressor and substance use; 2) elucidate the extent to which protective factors (including psychological and social resources) and secondary stressors (including psychological and social stress since leaving home) mediate the relations between primary stressors and substance use; 3) determine whether protective psychological and social resources moderate the relations between primary stressors and substance use; 4) determine whether secondary stressors and protective social resources co-vary with substance use and change in use over 30 days; and 5) determine the utility and feasibility of short message service (SMS) surveying to gather multiple daily data on substance use, secondary stressors and protective social resources in real time. While some of the risk factors for substance use are understood, there is a dearth of empirical studies examining both primary and secondary stressors and how protective mechanisms mediate or buffer between childhood disadvantage (a primary stressor) and substance use. Additionally, studies that examine resources and stressors that co- vary with substance use are rare. While identifying risk factors for substance use is critical, equally important is understanding why some youth never initiate or are able to abstain from substance use, and identifying unique modifiable social and psychological resources that serve as protective factors against substance use. Data collection methods will include a face-to-face structured interview with 120 homeless youth/young adults through two service agencies, followed by multiple daily text questions sent to respondents over a 30-day period, and conclude with a follow-up structured phone interview. Uncovering protective factors successfully used by homeless young people to abstain from substance use and understanding patterns of change in substance use over time will inform future intervention strategies to improve health outcomes.