Substance Use and Sexual Risk Reduction Intervention for Homeless Youth
Condition: Substance Use; Sexual Risk Behavior
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The goal of this study is to evaluate a group-based motivational interviewing (MI)-delivered
      risk reduction program for homeless young adults. It is hypothesized that youth who
      participate in the program will show greater reductions in substance use intentions, behavior
      and consequences, as well as sexual activity intentions and risk behavior, over a 3-month
      period compared to a usual care control sample of youth who do not participate in the
      program.
    

Detailed description: 
      This study addresses an important gap in prevention services for homeless youth by conducting
      a pilot test of an innovative 4-session integrated substance use and sexual risk reduction
      program for this population that is feasible to deliver in settings where these youth seek
      services. The study has 2 specific aims:

      Aim 1: Investigate whether homeless youth who participate in the program show reductions in
      substance use and intentions, behavior and consequences, as well as sexual activity
      intentions and risk behavior, over a 3-month period compared to a usual care control sample
      of youth who do not receive the program.

      Aim 2: Gain a better understanding of intervention effects by exploring whether improvements
      in self-efficacy, readiness to change, outcome expectancies, and exposure to peer substance
      use and offers serve as explanatory mechanisms for reductions in substance use- and sexual
      activity- related intentions and risk behaviors among youth who participate in the program.

      The program will be evaluated using a form of group-randomized design, although with
      crossover of conditions and groups to avoid the problems of power reduction associated with
      conventional group randomization. The unit of analysis will be the individual, but
      individuals will be assigned to groups based on the agency where they are seeking services.
      Youth at two drop-in centers serving homeless youth will either be in the intervention
      condition or a "usual care" control condition. The field period will be divided into four
      phases. The two agencies will alternate across phases in serving as the "intervention site"
      or "control site," with each agency having a total of two intervention phases and two control
      phases.

      Intervention Condition: This condition involves a four-session voluntary intervention that is
      delivered within a drop-in center setting and is based on the investigator's previous
      intervention work with adolescents and young adults. Each session lasts approximately 1 hour.
      The intervention focuses on both sexual risk behavior and substance use. Although some
      sessions focus more heavily on sexual risk and others on substance use, each session includes
      content that emphasizes the interrelated nature of these two risk behaviors. In all sessions,
      participants will receive a personalized feedback sheet that specifically addresses a topic
      being discussed during that particular session. An motivational interviewing approach will be
      used to present material during the group sessions.

      "Usual Care" Condition: The "usual care" condition reflects the resources typically available
      in settings that serve homeless youth: an HIV informational brochure that discusses the
      connection between substance use and HIV risk, and a Community Resource Guide that lists free
      or low-cost substance use and HIV-related services.
    

Intervention name(s): Group MI risk reduction program
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: homeless; young adults; substance use; HIV risk; sexual risk behavior; group motivational interviewing