A Group-Based Motivational Interviewing Brief Intervention to Reduce Substance Use and Sexual Risk Behavior Among Homeless Young Adults

Published in: Journal of Substance Abuse Treatment, Volume 76, May 2017, Pages 20-27. doi: 10.1016/j.jsat.2017.02.008

Posted on RAND.org on March 16, 2017

by Joan Tucker, Elizabeth J. D'Amico, Brett Ewing, Jeremy N. V. Miles, Eric R. Pedersen

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Research Question

  1. Is AWARE effective in reducing substance use and sexual risk behavior among homeless young adults?

Homeless young adults ages 18-25 exhibit high rates of alcohol and other drug (AOD) use, and sexual risk behaviors such as unprotected sex. Yet few programs exist for this population that are both effective and can be easily incorporated into settings serving this population. This pilot cluster cross-over randomized controlled trial evaluates AWARE, a voluntary four session group-based motivational interviewing (MI) intervention to reduce AOD use and sexual risk behavior. We evaluated AWARE with 200 homeless young adults using drop-in center services in Los Angeles County (mean age = 21.8 years; 73% male; 79% heterosexual; 31% non-Hispanic White, 25% African American, 24% Hispanic, 21% multiracial/other). Surveys were completed at baseline and three months after program completion. Retention in the AWARE program was excellent (79% attended multiple sessions) and participants reported high levels of satisfaction with the program. AWARE participants self-reported positive change in their past 3 month and past 30 day alcohol use (ps ≤ 0.05), motivation to change drug use (ps < 0.05), and condom use self-efficacy (p = 0.05) compared to the control group. Among those with multiple sex partners, AWARE participants showed a decrease in unprotected sexual events (p < 0.05), whereas the control group did not. Results from this pilot evaluation are promising, suggesting that a brief group-MI risk reduction intervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use. Further work is needed to more fully evaluate the efficacy of AWARE on AOD behavior and sexual risk behavior outcomes.

Key Findings

  • This pilot study is the first to test AWARE, a brief motivational interviewing (MI) intervention that targets both sexual risk behavior and alcohol and other drug use among young homeless adults.
  • AWARE intervention participants reported positive change in their alcohol use in the past three months and past 30 days.
  • Intervention participants also reported motivation to change their drug use and condom use self-efficacy, compared to the control group.
  • Participants with multiple sex partners who were in the AWARE intervention showed a decrease in unprotected sexual events, whereas the control group did not.

Recommendation

  • Results from this pilot evaluation are promising, suggesting that a brief group-MI risk reduction intervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use.

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