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| Name | Class |
|---|---|
| ETR Associates | OTHER |
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This study will design and rigorously evaluate the efficacy of Project Legacy, a five week positive youth development intervention to decrease sexual risk for unintended pregnancies and STIs among youth experiencing homelessness or at risk of homelessness aged 14-19. This randomized control trial will compare Project Legacy to a usual services control.
The study uses a multi-site randomized group trial (RGT) cohort design to evaluate the Project Legacy intervention curriculum for reducing sexual risk behaviors among homeless youth age 14-19. CHLA project staff will work with 6 homeless youth serving sites in Southern California (Los Angeles, San Diego) to recruit 600 youth. Randomization to the intervention or control condition will occur at the group level and will be stratified by site. Field staff will survey all eligible homeless youth who provide consent to participate in the study at baseline (before randomization and implementation) and at 3 and 9 months post intervention (5-5.5 and 11-11.5 months post-baseline). The program group will receive an additional intervention-based survey immediately upon completion of the program.
Youth in the control condition will receive the normal standard of care provided at the recruitment sites. Services available as standard of care at the recruitment sites include: medical care; mental health services; substance abuse services; educational, career, and vocational services. Intervention participants will not be excluded from receiving these services as well. Surveys will capture mental and physical health care service utilization and services to reduce substance use across both groups. The study team will monitor HIV and pregnancy prevention programming and other similar goal-planning/decision-making interventions offered to homeless youth in the study areas during the program implementation and follow-up period via interviews with site staff. The study team will include selected program exposure items on the follow up surveys to assess youth's self-reported exposure to similar goal-planning/decision-making and sexual health (pregnancy prevention and STI/HIV) education.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | The control/comparison group will be receiving only their usual services which are offered at the agencies they frequent, including mental health services, case management, job training, educational services, and, in specific venue contexts, may receive HIV risk reduction or other "sex education" interventions such as Street Smart. These same services are also open to the intervention group. Usage of these services varies by site (residential vs drop-in; city (San Diego vs Los Angeles) and type of service (case management, mental health, health care, etc.). | |
| Project Legacy | Experimental | The experimental/intervention arm will receive the Project Legacy intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Project Legacy | Behavioral | Project Legacy - Project Legacy is a 5-week, twice a week, 10 sessions small group intervention that encourages homeless and at-risk of homeless youth ages 14-19 to imagine a positive future and discuss how current risk behaviors can be a barrier to a successful adulthood. The program includes thinking about the future, the importance of positive social supports, short and long-term goal planning, and decision making. The program also includes life skills building, addressing past and current risk behaviors, linking to resources and navigating service systems, information on contraception and condoms, a healthy life plan and self-sufficiency. The 5 content core elements are the following:
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline lack of consistent current use (<80%) of contraception (including condoms) at 11 months | Current use of contraception (including condoms) is defined as using contraception at >80% of instances of vaginal intercourse in the past 3 months. | Assessed at baseline and 11 months post-baseline |
| Change from baseline in current vaginal and anal sex without condom at 11 months | This outcome measure is defined as the proportion of instances of vaginal and anal sex without a condom in the past 3 months. | Assessed at baseline and 11 months post-baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Sexual initiation / activity (vaginal) | Ever engaged in vaginal sex. | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Current birth control use (vaginal sex) | Current birth control use is defined as the number of instances of vaginal sex during which contraception was used (including condoms) in the past 3 months. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Leslie F Clark, PhD, MPH | University of Southern California | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Five Keys | Boyle Heights | California | 90033 | United States | ||
| Youth Program |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10195802 | Background | De Rosa CJ, Montgomery SB, Kipke MD, Iverson E, Ma JL, Unger JB. Service utilization among homeless and runaway youth in Los Angeles, California: rates and reasons. J Adolesc Health. 1999 Mar;24(3):190-200. doi: 10.1016/s1054-139x(98)00081-0. | |
| 22120422 | Background | Edidin JP, Ganim Z, Hunter SJ, Karnik NS. The mental and physical health of homeless youth: a literature review. Child Psychiatry Hum Dev. 2012 Jun;43(3):354-75. doi: 10.1007/s10578-011-0270-1. |
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|
| Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Current condom use (vaginal sex) | Current condom use for vaginal sex is defined as: the number of instances of vaginal sex during which condoms were used in the past 3 months | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Proportion of youth who have vaginal intercourse without the consistent use of contraception | This outcome is defined as using contraception for less than 80% of instances of vaginal sex in the past 3 months.
| Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Current contraception use (among females) | Current contraception use is defined as the use of one or more methods of effective contraception in the past 3 months | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Current marijuana or alcohol use | Current marijuana or alcohol use is defined as marijuana or alcohol use in the past 3 months | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Stable living environment at the time of the follow-up (current) | Stable living defined as living in a parents', relatives' or foster parents' home; a group home or residential facility or a tenant of an apartment. | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Employment experience (current) | Employed part or full-time since baseline; certificate, post-high school or college completed; | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Engagement in job-readiness services | Services defined as job preparedness skill-building, job internships, or educational services | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Social support (current) | Social support is measured using The Multidimensional Scale of Perceived Social Support. Total scores range from 7 to 84 and each subscale score ranges from 4 to 28, with a higher score indicating greater social support. which are averaged together to get the total score. | Assessed at baseline, 5 months post-baseline, and 11 months post-baseline |
| Long Beach |
| California |
| 90712 |
| United States |
| Century Villages at Cabrillo | Long Beach | California | 90810 | United States |
| Da Vinci Rise High | Los Angeles | California | 90011 | United States |
| LA CAUSA Youth Build | Los Angeles | California | 90022 | United States |
| Covenant House | Los Angeles | California | 90027 | United States |
| Los Angeles LGBT Center | Los Angeles | California | 90038 | United States |
| YMCA of San Diego County | Oceanside | California | 92054 | United States |
| San Diego Central Library | San Diego | California | 92101 | United States |
| San Diego Youth Services | San Diego | California | 92110 | United States |
| Monarch School | San Diego | California | 92113 | United States |
| Safe Place for Youth | Venice | California | 90291 | United States |
| 12940468 | Background | Rotheram-Borus MJ, Song J, Gwadz M, Lee M, Van Rossem R, Koopman C. Reductions in HIV risk among runaway youth. Prev Sci. 2003 Sep;4(3):173-87. doi: 10.1023/a:1024697706033. |
| 23231333 | Background | Tucker JS, Sussell J, Golinelli D, Zhou A, Kennedy DP, Wenzel SL. Understanding pregnancy-related attitudes and behaviors: a mixed-methods study of homeless youth. Perspect Sex Reprod Health. 2012 Dec;44(4):252-61. doi: 10.1363/4425212. Epub 2012 Nov 13. |
| 2280326 | Background | Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990 Winter;55(3-4):610-7. doi: 10.1080/00223891.1990.9674095. |
| 21895358 | Background | Chen P, Vazsonyi AT. Future orientation, impulsivity, and problem behaviors: a longitudinal moderation model. Dev Psychol. 2011 Nov;47(6):1633-45. doi: 10.1037/a0025327. Epub 2011 Sep 5. |
| 12128042 | Background | Oyserman D, Terry K, Bybee D. A possible selves intervention to enhance school involvement. J Adolesc. 2002 Jun;25(3):313-26. doi: 10.1006/jado.2002.0474. |
| Background | Thompson, S., Pollio, D., Constantine, J., Reid, D., Nebbitt, V. Short-term outcomes of youth receiving runaway and homeless shelter services. Research on Social Work Practice. 2002 Sept; 12: 589-603 |
| Background | Juntunen, C.L., & Wettersten, K. Work hope: Development and initial validation of a measure. Journal of Counseling Psychology. 2006; 53(1): 94-106. |
| Background | Robitschek, C. Personal growth initiative: The construct and its measure. Measurement & Evaluation in Counseling & Development: American Counseling Association. 1998; 30(4): 183-198. |
| Background | Strauman, T.J. (2006). Adolescent Regulatory Focus Questionnaire. Unpublished questionnaire, Duke University, Durham, NC. |
| 21194011 | Background | Rice E, Milburn NG, Monro W. Social networking technology, social network composition, and reductions in substance use among homeless adolescents. Prev Sci. 2011 Mar;12(1):80-8. doi: 10.1007/s11121-010-0191-4. |
| 10557519 | Background | Hansen WB, Paskett ED, Carter LJ. The Adolescent Sexual Activity Index (ASAI): a standardized strategy for measuring interpersonal heterosexual behaviors among youth. Health Educ Res. 1999 Aug;14(4):485-90. doi: 10.1093/her/14.4.485. |
| 21477680 | Background | Trussell J. Contraceptive failure in the United States. Contraception. 2011 May;83(5):397-404. doi: 10.1016/j.contraception.2011.01.021. Epub 2011 Mar 12. |
| Background | Oyserman D, Bybee D, Terry K, & Hart-Johnson T. Possible selves as roadmaps. Journal of Research in Personality 38: 130-149, 2004. |
| 9414606 | Background | Higgins ET. Beyond pleasure and pain. Am Psychol. 1997 Dec;52(12):1280-300. doi: 10.1037//0003-066x.52.12.1280. |
| ID | Term |
|---|---|
| D012725 | Sexual Behavior |
| D003268 | Contraception Behavior |
| D012749 | Sexually Transmitted Diseases |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D043762 | Reproductive Behavior |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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