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Nursing intervention beneficial to homeless youth

Saturday October 6, 2012
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Nursing interventions can significantly decrease substance abuse among homeless youth, according to a study.

At least 1.2 million adolescents are homeless in the United States, according to background information in the study, which is scheduled for publication in the American Journal on Addictions. These youths abuse substances with far greater frequency than do their non-homeless counterparts, and once under the influence, they are more likely to participate in delinquency and a host of assorted destructive behaviors.

One such behavior, often called "survival sex" because youths exchange sex for necessities such as food or a place to stay, is accompanied by a lower rate of condom use, which can lead to unwanted pregnancies and HIV infection, hepatitis and other sexually transmitted diseases.

"Homeless youth often justify their use of drugs because of the need to stay awake at night to avoid getting mugged, because they are 'self-medicating’ to quell the voices in their head or because of the need to cope with the stress of life," Adey Nyamathi, ANP, PhD, FAAN, the study’s lead investigator and associate dean for international research and scholarly activities at the University of California, Los Angeles, School of Nursing, said in a news release.

"But the sad truth is that once substance abuse is entrenched, drugs begin to dominate all aspects of homeless youths’ lives. We must put programs in place that break this vicious cycle."

The study involved 154 drug-using homeless youths in Santa Monica, Calif., many of whom had experienced a multitude of life crises, including a history of foster care, a low level of education and a support system of individuals who themselves use drugs and/or alcohol.

The study assessed the impact of two group interventions: an HIV/AIDS and hepatitis health program led by nurses and an "art messaging" program led by artists.

The nurse-led program featured three highly interactive group sessions that focused on educating youths about disease transmission and vaccinations and providing them with training in self-management and the development of healthy social networks. In these settings, participants shared their experiences and discussed how they could integrate health promotion strategies into their lives.

In the art messaging program, faculty from the California Institute for the Arts engaged the youths in an exploration of their thoughts and feelings through art, photography and video and encouraged conversations about good health, risky behaviors and ways to stay safe.

After six months, alcohol use decreased 24% in the nurse intervention program and 25% in the art messaging program, while marijuana use declined 17% in the nurse intervention program and 20% with art messaging. Youth in the nurse-led program reported additional reductions in drug use for cocaine (15%), methamphetamine (18%) and hallucinogens (20%).

"These results are very promising, as reducing alcohol and drug abuse in any population is very difficult," Nyamathi said.

Support for the research was provided by a grant from the National Institute of Drug Abuse. The study abstract is available at http://onlinelibrary.wiley.com/doi/10.1111/j.1521-0391.2012.00288.x/abstract.


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