Secondary Outcomes of a Brief Group Alcohol and Risky Sex Intervention for Emerging Adults Experiencing Homelessness

Abstract

AWARE is a four-session group-based motivational enhancement intervention designed to reduce substance use and sexual risk behavior among emerging adults experiencing homelessness. Expanding on promising intervention effects on substance use and risky sex outcomes, this study explored intervention effects on changes in secondary outcomes from baseline to 12 month post-intervention: depression, physical health (general health ratings, physical symptoms), social functioning (satisfaction, quality of friendships), and housing stability. Among the 240 participants with baseline and 12 month follow-up data, we found small effect sizes generally favoring the intervention over usual care for all outcomes. Findings show promise that addressing substance use and risky sexual behavior through interventions in drop-in centers could benefit emerging adults experiencing homelessness in additional areas of their lives. More work is needed to understand how interventions could be tailored to more directly address these outcomes and sustain changes in the long-term.

Keywords

substance use risky sex homeless housing depression

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References

Bender

Brown

S. M.

Thompson

S. J.

Ferguson

K. M.

Langenderfer

(2015). Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth. Child Maltreatment, 20(2), 115–124. https://doi.org/10.1177/1077559514562859

Booth

R. E.

Zhang

Kwiatkowski

C. F.

(1999). The challenge of changing drug and sex risk behaviors of runaway and homeless adolescents. Child Abuse & Neglect, 23(12), 1295–1306. https://doi.org/10.1016/s0145-2134(99)00090-3

Caccamo

Kachur

Williams

S. P.

(2017). Narrative review: Sexually transmitted diseases and homeless youth—what do we know about sexually transmitted disease prevalence and risk? Sexually Transmitted Diseases, 44(8), 466–476. https://doi.org/10.1097/OLQ.0000000000000633

Cutuli

J. J.

Treglia

Herbers

J. E.

(2020). Adolescent homelessness and associated features: Prevalence and risk across eight states. Child Psychiatry and Human Development, 51(1), 48–58. https://doi.org/10.1007/s10578-019-00909-1

Dewalt

D. A.

Thissen

Stucky

B. D.

Langer

M. M.

Morgan Dewitt

Irwin

D. E.

Lai

J. S.

Yeatts

K. B.

Gross

H. E.

Taylor

Varni

J. W.

(2013). PROMIS pediatric peer Relationships scale: Development of a peer relationships item bank as part of social health measurement. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 32(10), 1093–1103. https://doi.org/10.1037/a0032670

Fairbairn

Wood

Dong

Kerr

DeBeck

(2017). Unsafe sexual behaviour associated with hazardous alcohol use among street-involved youth. AIDS Care, 29(4), 481–488. https://doi.org/10.1080/09540121.2016.1220480

Narendorf

S. C.

Santa Maria

Bezette-Flores

(2015). Barriers and facilitators to shelter utilization among homeless young adults. Evaluation and Program Planning, 201553, 25–33. https://doi.org/10.1016/j.evalprogplan.2015.07.001

Heerde

J. A.

Hemphill

S. A.

(2017). The role of risk and protective factors in the modification of risk for sexual victimization, sexual risk behaviors, and survival sex among homeless youth: A meta‐analysis. Journal of Investigative Psychology and Offender Profiling, 14(2), 150–174. https://doi.org/10.1002/jip.1473

Henry

de Sousa

Roddey

Gayen

Bednar

T. J.

(2021). The 2020 Annual homeless assessment report (AHAR) to Congress. PART 1: Point-in-time estimates of homelessness. United States Department of Housing and Urban Development.

10.

Hwang

S. W.

Kirst

M. J.

Chiu

Tolomiczenko

Kiss

Cowan

Levinson

(2009). Multidimensional social support and the health of homeless individuals. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 86(5), 791–803. https://doi.org/10.1007/s11524-009-9388-x

11.

Kroenke

Spitzer

R. L.

Williams

J. B. W.

(2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64(2), 258–266. https://doi.org/10.1097/00006842-200203000-00008

12.

Kroenke

Strine

T. W.

Spitzer

R. L.

Williams

J. B. W.

Berry

J. T.

Mokdad

A. H.

(2009). The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders, 114(1-3), 163–173. https://doi.org/10.1016/j.jad.2008.06.026

13.

Kulik

D. M.

Gaetz

Crowe

Ford-Jones

E. L.

(2011). Homeless youth's overwhelming health burden: A review of the literature. Paediatrics & Child Health, 16(6), e43-e47. https://doi.org/10.1093/pch/16.6.e43

14.

Miller

W. R.

Rollnick

(2012). Motivational interviewing helping people change (3rd edn.). Guilford Press.

15.

Pedersen

E. R.

Tucker

J. S.

Kovalchik

S. A.

(2016). Facilitators and barriers of drop-in center use among homeless youth. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 59(2), 144–153. https://doi.org/10.1016/j.jadohealth.2016.03.035

16.

Slesnick

Guo

Brakenhoff

Bantchevska

(2015). A comparison of three interventions for homeless youth evidencing substance use disorders: Results of a randomized clinical trial. Journal of Substance Abuse Treatment, 54, 1–13. https://doi.org/10.1016/j.jsat.2015.02.001

17.

Thompson

R. G.

Jr Elliott

J. C.

M.-C.

Aivadyan

Aharonovich

Hasin

D. S.

(2017). Short-term effects of a brief intervention to reduce alcohol use and sexual risk among homeless young adults: Results from a randomized controlled trial. Addiction Research & Theory, 25(1), 24–31. https://doi.org/10.1080/16066359.2016.1193165

18.

Tucker

J. S.

D’Amico

E. J.

Ewing

B. A.

Miles

J. N. V.

Pedersen

E. R.

(2017). A group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among homeless young adults. Journal of Substance Abuse Treatment, 76, 20–27.

19.

Tucker

J. S.

D'Amico

E. J.

Pedersen

E. R.

Rodriguez

Garvey

(2020). Study protocol for a group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among young adults experiencing homelessness. Addiction Science & Clinical Practice, 15(1), 26. https://doi.org/10.1186/s13722-020-00201-x

20.

Tucker

J. S.

D’Amico

E. J.

Rodriguez

Garvey

Pedersen

E. R.

Klein

D. J.

(2022). A Randomized Controlled Trial of a Group-Based Motivational Interviewing Brief Intervention for Emerging Adults Experiencing Homelessness: 12-Month Effects on Substance Use and Sexual Risk Behavior. Manuscript submitted for publication.

21.

Tyler

K. A.

Ray

C. M.

(2019). Risk and protective factors for substance use among youth experiencing homelessness. Children and Youth Services Review, 107, 104548.

22.

Unger

J. B.

Kipke

M. D.

Simon

T. R.

Johnson

C. J.

Montgomery

S. B.

Iverson

(1998). Stress, coping, and social support among homeless youth. Journal of Adolescent Research, 13(2), 134–157. https://doi.org/10.1177/0743554898132003

23.

Ware

Jr. Kosinski

Keller

S. D.

(1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233. https://doi.org/10.1097/00005650-199603000-00003

24.

Wenzel

Holloway

Golinelli

Ewing

Bowman

Tucker

(2012). Social networks of homeless youth in emerging adulthood. Journal of Youth and Adolescence, 41(5), 561–571. https://doi.org/10.1007/s10964-011-9709-8

25.

Wright

E. R.

Attell

B. K.

Ruel

(2017). Social support networks and the mental health of runaway and homeless youth. Social Sciences, 6(4), 117. https://doi.org/10.3390/socsci6040117