Brief Group MI Intervention for AOD and Sexual Risk Behavior in Homeless Youth

项目总结 无家可归的新兴成年人(18-25岁)酒精和其他毒品使用率(AOD)高得惊人，这 与一系列的性危险行为有关，如无保护措施的性行为、交易性行为和多次性行为 临时搭档。很少有针对这一人群的风险降低计划被开发和严格评估， 尤其是那些处理这两种相互关联的行为的行为，使用协作和非评判 在无家可归的年轻人寻求服务的环境中提供服务是可行的。我们的团队最近 开发和试点测试Aware，一种简短的动机访谈(MI)知情的团体风险降低干预措施 针对18-25岁的无家可归者，包括教育、技能培养和个性化反馈。意识到 由四个45分钟的课程组成，重点关注AOD的使用和性风险行为。试点结果表明 认知的可接受性和可行性，以及对AOD和性危险行为结果的积极影响 超过3个月的时间。拟议的R01通过进行更大规模的评估来继续这一研究路线 意识到了。我们与四个为南加州无家可归青年提供服务的机构合作，建议 随机将N=400名18-25岁无家可归的青少年接受Aware计划或标准的临时中心护理 并在3个月、6个月和12个月的随访中评估药物使用和性危险行为。此外，我们还将 通过评估是否意识到，通过激励无家可归的新兴成年人 更健康的选择，对与健康相关的生活质量和社会稳定有积极的次要影响。最后，我们会 考察群体层面的改变谈话(一种假设的群体MI的行动机制)对个体的影响 AOD和性危险行为结果。这项创新研究的结果有可能填补一个重要的 通过证明对无家可归的新成人进行短暂的干预，可行的 在这些人群通常寻求服务的环境中提供服务，可以显著减少相互关联 AOD使用和性危险行为的问题。

PROJECT SUMMARY Homeless emerging adults (18-25 year olds) have alarmingly high rates of alcohol and other drug use (AOD), which is associated with a range of sexual risk behaviors such as unprotected sex, trading sex, and sex with multiple casual partners. Few risk reduction programs for this population have been developed and rigorously evaluated, particularly those that address both of these interrelated behaviors, use a collaborative and non-judgmental approach, and are feasible to deliver in settings where homeless young people seek services. Our team recently developed and pilot tested AWARE, a brief Motivational Interviewing (MI)-informed group risk reduction intervention for homeless 18-25 year olds that incorporates education, skills building, and personalized feedback. AWARE consists of four 45-minute sessions that focus on both AOD use and sexual risk behavior. Pilot results demonstrate the acceptability and feasibility of AWARE, as well as positive effects on AOD and sexual risk behavior outcomes over a 3 month period. The proposed R01 continues this line of research by conducting a larger-scale evaluation of AWARE. In collaboration with four agencies serving homeless youth in Southern California, we propose to randomize N=400 homeless 18-25 year olds to receive either the AWARE program or standard drop-in center care and evaluate substance use and sexual risk behavior at 3, 6, and 12 month follow-up. In addition, we will significantly extend our pilot work by evaluating whether AWARE, by motivating homeless emerging adults to make healthier choices, has positive secondary effects on health-related quality of life and social stability. Finally, we will examine the effects of group-level change talk (one hypothesized mechanism of action for group MI) on individual AOD and sexual risk behavior outcomes. Results from this innovative study have the potential to fill a significant gap in prevention services for homeless emerging adults by demonstrating that a brief intervention, feasible to deliver within settings where this population typically seeks services, can significantly reduce the interrelated problems of AOD use and sexual risk behavior.