The goal of the proposed research is to enhance health status among homeless women by conducting a 2- year longitudinal quasi-experimental study designed to assess the effectiveness of a Peer Mentored Program and a Case Managed Program on subjective and objective measures of risky behaviors, health protecting behaviors, and health outcome of 648 African-American, Latino, and White women and 648 significant others (SOs) at risk for AIDS. Structural equation modeling of a revised theoretical framework to assess its ability to predict risky behaviors, health protecting behaviors, and health outcome will also be conducted using the longitudinal data. The setting, sober living shelters (SLSs), will be selected by randomizing study-eligible SLSs with similar service delivery characteristics into African-American, Latina (English and Spanish Speaking) and white ethnic groups. Eighteen SLSs within each of these ethnic groups will then be randomized into the Peer-Mentored, Case- Managed, or control group. Women and their SOs in the Peer-Mentored and Case-Managed groups will complete baseline questionnaires and will receive the intervention weekly over 6 weeks, and follow-up at 6, 12, and 24 months. The weekly intervention program incorporates information on behaviors that increase risk for AIDS, personal health protecting and maintenance techniques, empowerment in negotiating health protecting behaviors, and assistance with referrals to health and community services. Women and their SOs in the Peer-Mentored Program will receive this content by a peer mentor, assisted by an outreach worker. Women and their SOs in the Case-Managed Program will receive the intervention by a nurse and outreach worker. Women and SOs in the control group will be administered questionnaires similar to subjects in the treatment groups. It is hypothesized that: 1) women in the Peer-Mentored Program will have lower risky behaviors, more health protective behaviors, and improved health outcomes in the posttest measures than the Case-Managed or control group; and, 2) the SOs of women in the Peer-Mentored group will, likewise, have lower risky behaviors, more health protective behaviors, and improved health outcomes than SOs in the Case-Managed or control group.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH052029-05
Application #
2675192
Study Section
Psychobiological, Biological, and Neurosciences Subcommittee (MHAI)
Program Officer
Stoff, David M
Project Start
1994-09-30
Project End
2000-07-31
Budget Start
1998-05-05
Budget End
2000-07-31
Support Year
5
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of California Los Angeles
Department
Type
Schools of Nursing
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Stein, Judith A; Nyamathi, Adeline; Ullman, Jodie B et al. (2007) Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach. AIDS Behav 11:87-98
Ullman, Jodie B (2006) Structural equation modeling: reviewing the basics and moving forward. J Pers Assess 87:35-50
Nyamathi, Adeline M; Dixon, Elizabeth L; Robbins, Wendie et al. (2002) Risk factors for hepatitis C virus infection among homeless adults. J Gen Intern Med 17:134-43
Stein, Judith A; Leslie, Michelle Burden; Nyamathi, Adeline (2002) Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood. Child Abuse Negl 26:1011-27
Nyamathi, A; Wenzel, S L; Lesser, J et al. (2001) Comparison of psychosocial and behavioral profiles of victimized and nonvictimized homeless women and their intimate partners. Res Nurs Health 24:324-35
Nyamathi, A; Flaskerud, J H; Leake, B et al. (2001) Evaluating the impact of peer, nurse case-managed, and standard HIV risk-reduction programs on psychosocial and health-promoting behavioral outcomes among homeless women. Res Nurs Health 24:410-22
Flaskerud, J H; Nyamathi, A M (2000) Attaining gender and ethnic diversity in health intervention research: cultural responsiveness versus resource provision. ANS Adv Nurs Sci 22:15-Jan
Nyamathi, A M; Stein, J A; Swanson, J M (2000) Personal, cognitive, behavioral, and demographic predictors of HIV testing and STDs in homeless women. J Behav Med 23:123-47
Nyamathi, A; Wenzel, S; Keenan, C et al. (1999) Associations between homeless women's intimate relationships and their health and well-being. Res Nurs Health 22:486-95