Randomized trial of group interventions to reduce HIV/STD risk and change theoretical mediators among detained adolescents.

Abstract

Criminally involved adolescents engage in high levels of risky sexual behavior and alcohol use, and alcohol use may contribute to lack of condom use. Detained adolescents (n = 484) were randomized to (1) a theory-based sexual risk reduction intervention (GPI), (2) the GPI condition with a group-based alcohol risk reduction motivational enhancement therapy component (GPI + GMET), or (3) an information-only control (INFO). All interventions were presented in same-sex groups in single sessions lasting from 2 to 4 hr. Changes to putative theoretical mediators (attitudes, perceived norms, self-efficacy, and intentions) were measured immediately following intervention administration. The primary outcomes were risky sexual behavior and sexual behavior while drinking measured 3 months later (65.1% retention). The GPI + GMET intervention demonstrated superiority over both other conditions in influencing theoretical mediators and over the INFO control in reducing risky sexual behavior. Self-efficacy and intentions were significant mediators between condition and later risky sexual behavior. This study contributes to an understanding of harm reduction among high-risk adolescents and has implications for understanding circumstances in which the inclusion of GMET components may be effective.

Proposed Model of the Neurobiological Mechanisms Underlying Psychosocial Alcohol Interventions: The Example of Motivational Interviewing

“…Consistent with clinical approaches (Miller and Rollnick, 2002) and empirical research (Amrhein et al, 2003), once the client has expressed substantial change talk, the therapist explores plans for changing, relying on the client's expertise for what may be possible in his or her world. Through relying on clients, autonomy and self-effi cacy are supported, empowering the clients to feel like they can execute a change should they choose to do so (e.g., LaChance et al, 2009;Moyers et al, 2005;Schmiege et al, 2009). …”

Motivational enhancement career intervention for youth with disabilities

“…Moreover, while there are MI studies conducted with survivors of traumatic brain injury and stroke (Suarez, 2011;Mendel & Hipkins, 2002), there are no studies with high school students with high incidence disabilities. Lastly, there are few studies using MI in a group format with adolescents (D'Amico, Ewing, Engle, Hunter, Oscilla, & Bryan, 2011;Schmiege, Broaddus, Levin, & Bryan, 2009). …”

A Systematic Review of Randomized Controlled Trials of Interventions to Improve the Health of Persons During Imprisonment and in the Year After Release

“…109 A combined sexual risk reduction intervention and alcohol risk reduction motivational enhancement therapy led to more condom use compared with information only, but there was no difference between these 2 groups and a sexual risk reduction only group with respect to intercourse while drinking or problems related to alcohol use. [71][72][73] In a trial conducted in adolescents, randomization to an HIV education intervention with a booster session was associated with more condom use compared with no intervention in girls only, and there was no difference in drug use among those randomized to the HIV education intervention with a booster, the same intervention without a booster, or no intervention. 91 There was no difference in adolescents with past year alcohol or marijuana use who were randomized to relaxation training or motivational enhancement sessions of substance abuse treatment training, although in those with fewer depression symptoms, motivational enhancement sessions led to a greater reduction in some risk behaviors than did relaxation training.…”

“…Substance abuse Adolescents Sexual risk reduction intervention plus alcohol risk reduction motivational enhancement therapy vs information only [71][72][73] Infectious diseases…”

“…118 Interventions to reduce sexual risk behaviors after release-Five studies with adolescents targeted sexual risk behaviors after release, 71-73, 91,109,117,126 4 of which had some positive impact. [71][72][73]91,109,117 A study in persons who abused substances found that relaxation and substance abuse education training were more effective than an individual motivational interviewing session plus group cognitive-behavioral therapy. 109 A combined sexual risk reduction intervention and alcohol risk reduction motivational enhancement therapy led to more condom use compared with information only, but there was no difference between these 2 groups and a sexual risk reduction only group with respect to intercourse while drinking or problems related to alcohol use.…”