Diverting Homeless Youth/chronic Homelessness/risk/HIV
Norweeta Germaine Milburn, Associate Research Psychologist
University Of California Los Angeles
Grant 5R01MH070322-05 from National Institute Of Mental Health, IRG: BSPH
Abstract: Homelessness among adolescents is a significant problem, with youth that become chronically homeless also being those at greatest risk for acquiring HIV. When youth are newly homeless, there is a significant opportunity to intervene to reduce chronic homelessness and, thus, risk for HIV. The rationale for this window of opportunity is based on results from an existing project that has found family conflicts to be the predominant precipitant for leaving home; 68% of newly homeless youth return home within 3 months, but this reunification is unstable, with longer runaway episodes over time; contact with parents being a significant predictor of reunification; developing social networks with peers that are substance abusers, homeless, and out of school predicts remaining homeless. A 5-session family intervention for newly homeless youth, Parents and Adolescents Collaborating Together (PACT), is proposed to improve residential stability and the quality of residential life, reduce the number of runaway episodes, as well as reduce HIV-related sexual and substance use risk acts. PACT will reframe the runaway episode and improve family functioning by redefining the family conflict, increasing problem-solving skills, gaining role clarity, and promoting positive family interactions. The project will proceed in two phases. Phase 1 will serve to pilot and finalize all instruments, intervention procedures, and to improve the standard care in all shelters to a routinely evaluating family reunification. In Phase 2, a randomized control trial will be conducted based on a group cross-over randomization design to test the efficacy of PACT for newly homeless youth aged 12-17 years and their parents. In four community-based agencies that provide short-term shelter, newly homeless youth (n--320) will be randomized to one of two conditions 1) standard care (n =160); or 2) the PACT intervention (n = 160). PACT sessions will take place with the families in the intervention condition while youth are in the shelter and as they transition to a more stable living environment (e.g. back to the home). Youth´s outcomes will be monitored at recruitment, 3, 6, 12, 18, and 24 months; parents will be assessed at recruitment, 3 (immediate post), 12 and 24 months to examine the efficacy of PACT on sexual and substance use risk acts; residential stability, runaway episodes, and quality of residential life; family functioning; and generalization to youth´s mental health, multiple problem behaviors, and school performance
Keywords: HIV infection, adolescence (12-20), behavior therapy, disease /disorder proneness /risk, family therapy, high risk behavior /lifestyle, homeless, human therapy evaluation, parent offspring interaction academic achievement, conflict, gender difference, mental health, problem solving, quality of life, racial /ethnic difference, runaway child, sex behavior, socioeconomics, substance abuse related disorder behavioral /social science research tag, clinical research, human subject, interview, patient oriented research
Project start date: 2004-09-10
Project end date: 2009-07-31
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Diverting Homeless Youth/chronic Homelessness/risk/HIV
Norweeta Germaine Milburn, Associate Research Psychologist
University Of California Los Angeles Office Of Research Administration Los Angeles, Ca 90095
Grant 5R01MH070322-04 from National Institute Of Mental Health, IRG: BSPH
Abstract: Homelessness among adolescents is a significant problem, with youth that become chronically homeless also being those at greatest risk for acquiring HIV. When youth are newly homeless, there is a significant opportunity to intervene to reduce chronic homelessness and, thus, risk for HIV. The rationale for this window of opportunity is based on results from an existing project that has found family conflicts to be the predominant precipitant for leaving home; 68% of newly homeless youth return home within 3 months, but this reunification is unstable, with longer runaway episodes over time; contact with parents being a significant predictor of reunification; developing social networks with peers that are substance abusers, homeless, and out of school predicts remaining homeless. A 5-session family intervention for newly homeless youth, Parents and Adolescents Collaborating Together (PACT), is proposed to improve residential stability and the quality of residential life, reduce the number of runaway episodes, as well as reduce HIV-related sexual and substance use risk acts. PACT will reframe the runaway episode and improve family functioning by redefining the family conflict, increasing problem-solving skills, gaining role clarity, and promoting positive family interactions. The project will proceed in two phases. Phase 1 will serve to pilot and finalize all instruments, intervention procedures, and to improve the standard care in all shelters to a routinely evaluating family reunification. In Phase 2, a randomized control trial will be conducted based on a group cross-over randomization design to test the efficacy of PACT for newly homeless youth aged 12-17 years and their parents. In four community-based agencies that provide short-term shelter, newly homeless youth (n--320) will be randomized to one of two conditions 1) standard care (n =160); or 2) the PACT intervention (n = 160). PACT sessions will take place with the families in the intervention condition while youth are in the shelter and as they transition to a more stable living environment (e.g. back to the home). Youth s outcomes will be monitored at recruitment, 3, 6, 12, 18, and 24 months; parents will be assessed at recruitment, 3 (immediate post), 12 and 24 months to examine the efficacy of PACT on sexual and substance use risk acts; residential stability, runaway episodes, and quality of residential life; family functioning; and generalization to youth s mental health, multiple problem behaviors, and school performance.
Keywords: HIV infection, adolescence (12-20), behavior therapy, disease /disorder proneness /risk, family therapy, high risk behavior /lifestyle, homeless, human therapy evaluation, parent offspring interaction, academic achievement, conflict, gender difference, mental health, problem solving, quality of life, racial /ethnic difference, runaway child, sex behavior, socioeconomics, substance abuse related disorder, behavioral /social science research tag, clinical research, human subject, interview, patient oriented research
Project start date: 2004-09-10
Project end date: 2009-07-31
5R01MH070322-04 (2007): $782720
Grants awarded to Norweeta Germaine Milburn
Recruiting, Engaging & Retaining Families For Interventions To Prevent HIV Transm
Norweeta Germaine Milburn, Associate Research Psychologist
University Of California Los Angeles
Grant 1R21DA024955-01 from National Institute On Drug Abuse, IRG: BSCH
Abstract: The goal of this application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of a brief family intervention for African American youth at risk for HIV infection - delinquent adolescents - can be significantly strengthened. The proposed study will utilize "Families that Care Guiding Good Choices" (GGC) (aka "Preparing for the Drug Free Years"); a brief efficacious family intervention that increases family connectedness and decreases drug use. We will attempt to optimize participation by developing an enhanced protocol that addresses contextual barriers pertaining to recruitment, engagement and retention. The enhanced protocol will include a motivational DVD for parents, a motivational recruitment session and a pre-session for families to tell their stories and describe their current family goals. The efficaciousness of the GGC will be further increased by customizing it for use with African American delinquent adolescents and their families. The research will entail two phases. Phase 1 will encompass the tailoring of GGC and development of the enhanced protocol. Phase 2 will pilot test the enhanced protocol and GGC with 60 African American delinquent adolescents currently on probation who are enrolled in 6 Los Angeles County Office of Education´s Community Day Schools and their parents (parents includes an adult guardian). Families (African American students on probation and their parents) will be randomly assigned to a protocol condition (enhanced protocol/GGC or standard protocol/GGC) and monitored at 3 months. The research aims are to 1.) develop an enhanced protocol for recruiting, engaging and retaining African American delinquent adolescents in probation schools and their parents in GGC; 2.) examine the appropriateness of GGC for a new population (African American delinquent adolescents in probation schools and their parents) as perceived by administrators, teachers, students and parents through qualitative focus groups and key informant interviews; and 3.) pilot test the enhanced protocol and GGC using a randomized two groups design to evaluate the efficacy of the enhanced protocol in achieving optimal recruitment, engagement and retention, and preliminarily examine the efficacy of GGC to improve family functioning, mental health, and problem behaviors (HIV risk behaviors, school performance and recidivism). PUBLIC HEALTH RELEVANCE African Americans are at high risk for long-term negative, HIV-related outcomes (Anderson & Smith, 2005; Centers for Disease Control and Prevention, 2005; Shavers-Hornaday et al., 1997) as are delinquent adolescents on probation (Morris et al., 1995), and delinquent adolescents who cycle in and out of the juvenile justice system (Benda et al., 2001). Recent efforts that have achieved success suggest that individually focused prevention efforts need to be embedded within broader social contexts, such as the family system, to sustain behavior change (Lightfoot et al., 2006; Rotheram-Borus, 2005; Pequegnat et al., 2001; Boyd-Franklin et al., 2001).The goal of this R21 application is to show that by enhancing the recruitment, engagement, and retention of families, the rate of participation in, and the effectiveness of an evidence based brief family intervention for African American youth at risk for HIV infection can be significantly strengthened
Project start date: 2008-05-15
Project end date: 2010-04-30
Diverting Homeless Youth/chronic Homelessness/risk/HIV
Norweeta Germaine Milburn, Associate Research Psychologist
University Of California Los Angeles
Grant 5R01MH070322-05 from National Institute Of Mental Health, IRG: BSPH
Abstract: Homelessness among adolescents is a significant problem, with youth that become chronically homeless also being those at greatest risk for acquiring HIV. When youth are newly homeless, there is a significant opportunity to intervene to reduce chronic homelessness and, thus, risk for HIV. The rationale for this window of opportunity is based on results from an existing project that has found family conflicts to be the predominant precipitant for leaving home; 68% of newly homeless youth return home within 3 months, but this reunification is unstable, with longer runaway episodes over time; contact with parents being a significant predictor of reunification; developing social networks with peers that are substance abusers, homeless, and out of school predicts remaining homeless. A 5-session family intervention for newly homeless youth, Parents and Adolescents Collaborating Together (PACT), is proposed to improve residential stability and the quality of residential life, reduce the number of runaway episodes, as well as reduce HIV-related sexual and substance use risk acts. PACT will reframe the runaway episode and improve family functioning by redefining the family conflict, increasing problem-solving skills, gaining role clarity, and promoting positive family interactions. The project will proceed in two phases. Phase 1 will serve to pilot and finalize all instruments, intervention procedures, and to improve the standard care in all shelters to a routinely evaluating family reunification. In Phase 2, a randomized control trial will be conducted based on a group cross-over randomization design to test the efficacy of PACT for newly homeless youth aged 12-17 years and their parents. In four community-based agencies that provide short-term shelter, newly homeless youth (n--320) will be randomized to one of two conditions 1) standard care (n =160); or 2) the PACT intervention (n = 160). PACT sessions will take place with the families in the intervention condition while youth are in the shelter and as they transition to a more stable living environment (e.g. back to the home). Youth´s outcomes will be monitored at recruitment, 3, 6, 12, 18, and 24 months; parents will be assessed at recruitment, 3 (immediate post), 12 and 24 months to examine the efficacy of PACT on sexual and substance use risk acts; residential stability, runaway episodes, and quality of residential life; family functioning; and generalization to youth´s mental health, multiple problem behaviors, and school performance
Keywords: HIV infection, adolescence (12-20), behavior therapy, disease /disorder proneness /risk, family therapy, high risk behavior /lifestyle, homeless, human therapy evaluation, parent offspring interaction academic achievement, conflict, gender difference, mental health, problem solving, quality of life, racial /ethnic difference, runaway child, sex behavior, socioeconomics, substance abuse related disorder behavioral /social science research tag, clinical research, human subject, interview, patient oriented research
Project start date: 2004-09-10
Project end date: 2009-07-31