Skip to main content

Advertisement

SpringerLink
Log in

Predictors of Retention in an Alcohol and Risky Sex Prevention Program for Homeless Young Adults

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Homeless young adults are at risk for alcohol and other drug (AOD) use and risky sexual behavior. Interventions are needed to help these young people reduce their risky behavior, but this population is often difficult to engage and retain in services. We offered a four-session AOD and risky sex reduction program to 100 participants and examined if retention in the program was predicted by a number of factors: demographics, homelessness severity, other service use, AOD behaviors, mental health symptoms, sexual risk behaviors, and readiness to change AOD and condom use. Nearly half (48%) of participants completed all sessions. In bivariate analyses, participants were significantly less likely to be retained in the program if they had slept outdoors in the past month, engaged in more alcohol and marijuana use, experienced more alcohol-related consequences, and received the program in an urban drop-in center (as opposed to a drop-in center near the beach). When controlling for all significant bivariate relationships, only sleeping outdoors and receipt of the program in the urban setting predicted fewer sessions completed. The most endorsed reasons for program non-completion were being too busy to attend and inconvenient day/time of the program. Findings can help outreach staff and researchers better prepare methods to engage higher risk homeless youth and retain them in services. Finding unique ways to help youth overcome barriers related to location of services appears especially necessary, perhaps by bringing services to youth where they temporarily reside or offering meaningful incentives for program attendance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Al-Tayyib, A. A., Rice, E., Rhoades, H., & Riggs, P. (2014). Association between prescription drug misuse and injection among runaway and homeless youth. Drug and Alcohol Dependence, 134, 406–409.

    Article  PubMed  Google Scholar 

  • Baruch, G., Vrouva, I., & Fearon, P. (2009). A follow-up study of characteristics of young people that dropout and continue psychotherapy: Service implications for a clinic in the community. Child and Adolescent Mental Health, 14, 69–75.

    Article  Google Scholar 

  • Becker, K., Berry, S. H., Orr, N., & Perlman, J. (2014). Finding the hard to reach and keeping them engaged in research. In R. Tourangeau, B. Edwards, T. P. Johnson, K. M. Wolter, & N. Bates (Eds.), Hard-to-survey populations (pp. 619–641). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Begun, S. (2015). The paradox of homeless youth pregnancy: A review of challenges and opportunities. Social Work in Health Care, 54, 444–460.

    Article  PubMed  Google Scholar 

  • Bender, K., Brown, S. M., Thompson, S. J., Ferguson, K. M., & Langenderfer, L. (2015). Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth. Child Maltreatment, 20, 115–124.

    Article  PubMed  Google Scholar 

  • Boudreaux, E. D., Sullivan, A., Abar, B., Bernstein, S. L., Ginde, A. A., & Camargo Jr., C. A. (2012). Motivation rulers for smoking cessation: A prospective observational examination of construct and predictive validity. Addiction Science & Clinical Practice, 7, 8.

    Article  Google Scholar 

  • Carmona, J., Slesnick, N., Guo, X., & Letcher, A. (2014). Reducing high risk behaviors among street living youth: Outcomes of an integrated prevention intervention. Children and Youth Services Review, 43, 118–123.

    Article  PubMed  PubMed Central  Google Scholar 

  • De Rosa, C. J., Montgomery, S. B., Hyde, J., Iverson, E., & Kipke, M. D. (2001). HIV risk behavior and HIV testing: A comparison of rates and associated factors among homeless and runaway adolescents in two cities. AIDS Education and Prevention, 13, 131–148.

    Article  PubMed  Google Scholar 

  • Dennis, M. L., Chan, Y. F., & Funk, R. R. (2006). Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing and substance use disorders and crime/violence problems among adolescents and adults. American Journal on Addictions, 15, 80–91.

    Article  PubMed  Google Scholar 

  • Friedman, M. S., Marshal, M. P., Stall, R., Kidder, D. P., Henny, K. D., Courtenay-Quirk, C., & Holtgrave, D. R. (2009). Associations between substance use, sexual risk taking and HIV treatment adherence among homeless people living with HIV. AIDS Care, 21, 692–700.

    Article  PubMed  Google Scholar 

  • Garvey, R., Pedersen, E. R., D'Amico, E. J., Ewing, B. E., & Tucker, J. S. (2018). Recruitment and retention of homeless youth in a substance use and HIV risk reduction program. Field Methods. https://doi.org/10.1177/1525822X17728346.

  • Golinelli, D., Tucker, J. S., Ryan, G. W., & Wenzel, S. L. (2014). Strategies for obtaining probability samples of homeless youth. Field Methods, 27, 131–143.

    Article  Google Scholar 

  • Gomez, R., Thompson, S. J., & Barczyk, A. N. (2010). Factors associated with substance use among homeless young adults. Substance Abuse, 31, 24–34.

    Article  PubMed  PubMed Central  Google Scholar 

  • Green, H. D., de la Haye, K., Tucker, J. S., & Golinelli, D. (2013). Shared risk: Who engages in substance use with American homeless youth? Addiction, 108, 1618–1624.

    Article  PubMed  Google Scholar 

  • Greene, J. M., & Ringwalt, C. L. (1998). Pregnancy among three national samples of runaway and homeless youth. Journal of Adolescent Health, 23, 370–377.

    Article  CAS  PubMed  Google Scholar 

  • Henry, M., Watt, R., Rosenthal, L., & Shivji, A. (2016). The 2016 annual homeless assessment report (AHAR) to congress. Part 1: Point-in-time estimates of homelessness. Retrieved from Washington, DC: https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf.

  • Huba, G. J., Melchoir, L. A., Greenberg, B., Trevithick, L., Feudo, R., et al. (2000). Predicting substance abuse among youth with, or at high risk for, HIV. Psychology of Addictive Behaviors, 14, 197–205.

    Article  CAS  PubMed  Google Scholar 

  • Kahler, C. W., Strong, D. R., & Read, J. P. (2005). Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The brief young adult alcohol consequences questionnaire. Alcoholism: Clinical and Experimental Research, 29, 1180–1189.

    Article  Google Scholar 

  • Kahler, C. W., Hustad, J., Barnett, N. P., Strong, D. R., & Borsari, B. (2008). Validation of the 30-day version of the Brief Young Adult Alcohol Consequences Questionnaire for use in longitudinal studies. Journal of Studies on Alcohol and Drugs, 69, 611–615.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kennedy, D. P., Tucker, J. S., Green, H. D., Golinelli, D., & Ewing, B. (2012). Unprotected sex of homeless youth: Results from a multilevel dyadic analysis of individual, social network, and relationship factors. AIDS and Behavior, 16, 2015–2032.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kipke, M. D., Montgomery, S. B., Simon, T. R., & Iverson, E. F. (1997). Substance abuse’ disorders among runaway and homeless youth. Substance Use & Misuse, 32, 969–986.

    Article  CAS  Google Scholar 

  • Koopman, C., Rosario, M., & Rotheramborus, M. J. (1994). Alcohol and drug-use and sexual behaviors placing runaways at risk for HIV-infection. Addictive Behaviors, 19, 95–103.

    Article  CAS  PubMed  Google Scholar 

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003). The patient health Questionnaire-2—validity of a two-item depression screener. Medical Care, 41, 1284–1292.

    Article  PubMed  Google Scholar 

  • Lankenau, S. E., Sanders, B., Bloom, J. J., Hathazi, D., Alarcon, E., Tortu, S., & Clatts, M. C. (2008). Migration patterns and substance use among young homeless travelers. In Y. F. Thomas, D. Richardson, & I. Cheung (Eds.), Geography and drug addiction (pp. 65–83). Dordrecht: Springer Netherlands.

    Chapter  Google Scholar 

  • Lee, M. T., Garnick, D. W., O'Brien, P. L., Panas, L., Ritter, G. A., et al. (2012). Adolescent treatment initiation and engagement in an evidence-based practice initiative. Journal of Substance Abuse Treatment, 42, 346–355.

    Article  PubMed  Google Scholar 

  • Martino, S. C., Tucker, J. S., Ryan, G., Wenzel, S. L., Golinelli, D., & Munjas, B. (2011). Increased substance use and risky sexual behavior among migratory homeless youth: Exploring the role of social network composition. Journal of Youth and Adolescence, 40, 1634–1648.

    Article  PubMed  PubMed Central  Google Scholar 

  • McKay, J. R. (2005). Is there a case for extended interventions for alcohol and drug use disorders? Addiction, 100, 1594–1610.

    Article  PubMed  Google Scholar 

  • Medlow, S., Klineberg, E., & Steinbeck, K. (2014). The health diagnoses of homeless adolescents: A systematic review of the literature. Journal of Adolescence, 37, 531–542.

    Article  PubMed  Google Scholar 

  • Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York: Guilford Press.

    Google Scholar 

  • Nyamathi, A., Hudson, A., Greengold, B., & Leake, B. (2012). Characteristics of homeless youth who use cocaine and methamphetamine. American Journal on Addictions, 21, 243–249.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pedersen, E. R., Tucker, J. S., & Kovalchik, S. A. (2016). Facilitators and barriers of drop-in center use among homeless youth. Journal of Adolescent Health, 59, 144–153.

  • Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38–48.

    Article  CAS  PubMed  Google Scholar 

  • Rice, E., Milburn, N. G., Rotheram-Borus, M. J., Mallett, S., & Rosenthal, D. (2005). The effects of peer group network properties on drug use among homeless youth. American Behavioral Scientist, 48, 1102–1123.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rotheram-Borus, M. J., Song, J., Gwadz, M., Lee, M., Van Rossem, R., & Koopman, C. (2003). Reductions in HIV risk among runaway youth. Prevention Science, 4, 173–187.

    Article  PubMed  Google Scholar 

  • Slesnick, N., Prestopnik, J. L., Meyers, R. J., & Glassman, M. (2007). Treatment outcome for street-living, homeless youth. Addictive Behaviors, 32, 1237–1251.

    Article  PubMed  Google Scholar 

  • Slesnick, N., Kang, M. J., & Aukward, E. (2008). Treatment attendance among homeless youth: The impact of childhood abuse and prior suicide attempts. Substance Abuse, 29, 43–52.

    PubMed  PubMed Central  Google Scholar 

  • Slesnick, N., Erdem, G., Collins, J., Bantchevska, D., & Katafiasz, H. (2011). Predictors of treatment attendance among adolescent substance abusing runaways: A comparison of family and individual therapy modalities. Journal of Family Therapy, 33, 66–84.

    Article  Google Scholar 

  • Slesnick, N., Feng, X., Guo, X., Brakenhoff, B., Carmona, J., et al. (2016). A test of outreach and drop-in linkage versus shelter linkage for connecting homeless youth to services. Prevention Science, 17, 450–460.

    Article  PubMed  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166, 1092–1097.

    Article  PubMed  Google Scholar 

  • Tucker, J. S., Ryan, G. W., Golinelli, D., Ewing, B., Wenzel, S. L., Kennedy, D. P., & Zhou, A. (2012a). Substance use and other risk factors for unprotected sex: Results from an event-based study of homeless youth. AIDS and Behavior, 16, 1699–1707.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tucker, J. S., Hu, J. H., Golinelli, D., Kennedy, D. P., Green, H. D., & Wenzel, S. L. (2012b). Social network and individual correlates of sexual risk behavior among homeless young men who have sex with men. Journal of Adolescent Health, 51, 386–392.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tucker, J. S., D’Amico, E. J., Ewing, B. A., Miles, J. N. V., & Pedersen, E. R. (2017). A group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among homeless young adults. Journal of Substance Abuse Treatment, 76, 20–27.

    Article  PubMed  Google Scholar 

  • Wenzel, S. L., Tucker, J. S., Golinelli, D., Green Jr., H. D., & Zhou, A. (2010). Personal network correlates of alcohol, cigarette, and marijuana use among homeless youth. Drug and Alcohol Dependence, 112, 140–149.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors want to thank Ruthie Brownfield, Ali Johnson, and Fred Mills of the RAND Survey Research Group for their assistance with data collection and intervention delivery, the two drop-in centers for their support of this research, and the youth who participated in the study.

Funding

This study was funded by grant R34 DA034813 from the National Institute on Drug Abuse (PI: Tucker).

Author information

Authors and Affiliations

  1. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA

    Eric R. Pedersen, Brett A. Ewing, Elizabeth J. D’Amico, Jeremy N. V. Miles, Ann C. Haas & Joan S. Tucker

Authors
  1. Eric R. Pedersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brett A. Ewing
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth J. D’Amico
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeremy N. V. Miles
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ann C. Haas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joan S. Tucker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric R. Pedersen.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interests.

Ethical Approval Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pedersen, E.R., Ewing, B.A., D’Amico, E.J. et al. Predictors of Retention in an Alcohol and Risky Sex Prevention Program for Homeless Young Adults. Prev Sci 19, 459–467 (2018). https://doi.org/10.1007/s11121-018-0866-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-018-0866-9

Keywords

Search

Navigation