RAND
The goal of this clinical trial is to learn if AWARE-a brief, 4-session group program based on motivational interviewing-reduces alcohol and other drug use and sexual risk behavior among young adults experiencing homelessness (ages 18-25). The study will also learn how well AWARE can be delivered in real-world drop-in center settings and what it would take to keep the program running long-term. The main questions it aims to answer are: * Does AWARE reduce the frequency, quantity, and consequences of alcohol use more than services as usual? * Does AWARE reduce sexual risk behavior (condomless sex with primary and casual partners, number of sexual partners, and alcohol or other drug use during sexual activity)? * How consistently and well can AWARE be delivered at community drop-in centers? Researchers will compare AWARE to services as usual at three drop-in centers in Los Angeles and Pittsburgh to see if AWARE works to better. Participants will: * Attend up to 4 group sessions of AWARE or continue receiving usual services at their drop-in center * Complete surveys about their alcohol and drug use, sexual behavior, and health at study enrollment, and 3 and 6 month follow-ups.
Young adults experiencing homelessness (YAEH) are disproportionately affected by alcohol and other drug (AOD) use and sexual risk behavior, yet drop-in centers serving this population have limited access to brief, evidence-based programs that address both. AWARE is a 4-session group intervention grounded in motivational interviewing (MI) that targets AOD use and sexual risk behavior among 18-25 year olds experiencing homelessness. The program integrates education, skills building, and normative feedback in an interactive group format, incorporating components shown to be effective with homeles…
Inclusion Criteria: * aged 18-25 years * receiving services at the drop-in center * plans to stay in the geographic area for the next month * English speaking Exclusion Criteria: * Observed cognitive impairment during enrollment
AWARE is a brief (four-session) group counseling intervention that uses motivational interviewing and psychoeducation to address hazardous alcohol use and sexual risk behaviors. AWARE was developed with input from young adults experiencing homelessness and service providers and has shown to be feasible, acceptable, and efficacious when delivered in young adult homeless service settings. AWARE sessions are 45-minutes in length and delivered by one to two facilitators who receive training on the AWARE protocol and motivational interviewing. AWARE sessions provide normative feedback about alcohol use, and education about sexual risk behaviors and sexually transmitted infections. AWARE is designed to be collaborative and strengths-based, helping young adults identify and plan for high-risk situations and develop effective coping strategies to reduce the likelihood of alcohol-related negative consequences and sexual risk behaviors.