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.

Public Health Relevance

Homeless young women, ages 18-23 years, are extremely vulnerable to poor health outcomes related particularly to substance use and sexual behaviors;thus, we need to develop and test interventions that help them live lives that are productive and satisfying. Without such interventions, they represent a great threat to the public health for costly health problems such as substance abuse, HIV/AIDS, multiple sexually transmitted infections (STIs), hepatitis B and C, and post-traumatic stress disorder (PTSD). Findings from this study will contribute to the further development and testing of theory-driven interventions that are effective and that can be delivered at little cost in multiple public health service settigs.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-NRCS-G (08))
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Roary, Mary
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University of Texas Austin
Schools of Nursing
United States
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