Evaluation of Treatments for Homeless Youths
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Youth who leave home for the streets are at significantly more risk for a multitude of problems, yet little research is available to guide treatment intervention efforts with this population. Studies document high rates of substance use, HIV risk, mental health problems, teenage pregnancy and criminality. Research to date examining homeless, street living youth has been primarily descriptive; less effort has been directed towards developing and evaluating treatment interventions for this group. The majority of homeless youth do not receive substance abuse treatment, with one study reporting that only 15% of street living youth report ever receiving mental health services. The effectiveness of the Community Reinforcement Approach (CRA) with street living youth was studied in our recently completed Stage 1 trial. The proposed study is a Stage II clinical trial examining outcome of CRA individual therapy as compared to two interventions commonly employed, yet little researched, with this group. All clients will be randomized to one of three theoretically distinct interventions: (1) CRA therapy, (2) Motivational Enhancement Therapy (MET), or (3) Case Management (CM). The relative effectiveness of these interventions will be evaluated at 3, 6, and 12 months post-baseline. The Social Ecology Theory of Development (Bronfenbrenner, 1979) guides our change hypotheses and intervention. Proposed change mechanisms (mediators) for each intervention will be evaluated. Differential treatment response as a function of ethnicity, gender, age, sexual orientation and abuse (moderators) will be investigated to better understand the interventions. The study will also examine how, if at all, treatment engagement, retention and expectations impact youth response to the three treatments. Information gained through this project may help address the gap in our understanding of how best to effectively intervene with a group at high risk for continuing health and psychological problems.
Condition | Intervention | Phase |
---|---|---|
Substance Abuse |
Behavioral: Community Reinforcement Approach (CRA) + HIV prevention Behavioral: Case Management + HIV Prevention Behavioral: Motivational Enhancement Therapy (MET) + HIV prevention |
Phase 2 |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
Official Title: | Evaluation of Treatments for Homeless Youth: CRA, MET and Case Management |
- Substance use [ Time Frame: Three months ] [ Designated as safety issue: No ]Percentage of substance use days in prior three months.
- Substance use [ Time Frame: Six months ] [ Designated as safety issue: No ]Percentage of substance use days in prior three months.
- Substance Use [ Time Frame: Twelve months ] [ Designated as safety issue: No ]Percentage of substance use days in prior six months.
- HIV risk [ Time Frame: Three months ] [ Designated as safety issue: No ]Number of HIV risk behaviors in prior three months.
- Depressive symptoms [ Time Frame: Three months ] [ Designated as safety issue: No ]Beck Depression Inventory total score
- HIV Risk [ Time Frame: Six months ] [ Designated as safety issue: No ]Number of HIV risk behaviors in prior three months.
- Depressive Symptoms [ Time Frame: Six months ] [ Designated as safety issue: No ]Beck Depression Inventory total score
- HIV Risk [ Time Frame: Twelve months ] [ Designated as safety issue: No ]Number of HIV risk behaviors in prior six months.
- Depressive symptoms [ Time Frame: Twelve months ] [ Designated as safety issue: No ]Beck Depression Inventory total score
Enrollment: | 270 |
Study Start Date: | September 2006 |
Estimated Study Completion Date: | June 2012 |
Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: CRA + HIV prevention |
Behavioral: Community Reinforcement Approach (CRA) + HIV prevention
12 sessions of the CRA and 2 sessions of HIV prevention.
|
Active Comparator: Case Management + HIV prevention |
Behavioral: Case Management + HIV Prevention
12 sessions of case management and 2 sessions of HIV prevention.
|
Active Comparator: MET + HIV prevention |
Behavioral: Motivational Enhancement Therapy (MET) + HIV prevention
2 sessions of MET and 2 sessions of HIV prevention.
|
![](https://webarchive.library.unt.edu/web/20130315211550im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
Ages Eligible for Study: | 14 Years to 20 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Youth are between the ages of 14-20.
- Youth have plans to remain in the Columbus areas for at least 12 months.
- Youth meets abuse or dependence DSM-IV criteria for Psychoactive Substance Use or Alcohol disorder, as assessed by the computerized diagnostic interview schedule for children (CDISC, Shaffer, 1992).
- Youth agrees to participate in the assessment and treatment intervention.
- Youth meets criteria for homelessness as defined by DHHS.
Exclusion Criteria:
1. Evidence of unremitted psychosis or other condition which would impair their ability to understand and participate in the intervention or consent for research participation (as determined by CDISC).
![](https://webarchive.library.unt.edu/web/20130315211550im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
United States, Ohio | |
The Ohio State University | |
Columbus, Ohio, United States, 43210 |
Principal Investigator: | Natasha Slesnick, Ph.D. | Ohio State University |
![](https://webarchive.library.unt.edu/web/20130315211550im_/http://clinicaltrials.gov/ct2/html/images/frame/triangle.gif)
No publications provided
Responsible Party: | Natasha Slesnick, Ph.D., Ohio State University |
ClinicalTrials.gov Identifier: | NCT01143792 History of Changes |
Other Study ID Numbers: | 2005B0078, R01DA013549 |
Study First Received: | June 11, 2010 |
Last Updated: | September 6, 2011 |
Health Authority: | United States: Institutional Review Board |
Keywords provided by Ohio State University:
Substance abuse Homelessness HIV risk behavior |
Additional relevant MeSH terms:
Substance-Related Disorders Mental Disorders |
ClinicalTrials.gov processed this record on March 14, 2013