Purpose We evaluate the efficacy of a short family intervention in reducing sexual risk behavior, drug use, and delinquent behaviors among homeless youth. Methods A randomized controlled trial of 151 families with a homeless adolescent aged 12 to 17 years. Adolescents were recruited from diverse sites in southern California from March 2006 through June 2009 and assessed at recruitment (baseline), 3, 6, and 12 months later. Families were randomly assigned to an intervention condition with five weekly home-based intervention sessions or a control condition (standard care). Main outcome measures reflect self-reported sexual, substance use and delinquent behaviors over the last 90 days. Results Sexual risk (e.g., mean number of partners) (p < .001), alcohol use (p = .003), hard drug use (p < .001), and delinquent behaviors (p = .001) decreased significantly more over 12 months in the intervention condition compared to the control condition. Marijuana use, however, significantly increased in the intervention condition compared to the control condition (p < .001). Conclusion An intervention to re-engage families of homeless youth has significant benefits in reducing risk over 12 months.

Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis in the United States. This paper describes the evaluation of a pilot of the Tu Amigo Pepe, a multimedia HIV testing campaign aimed at Latino MSM in Seattle, WA particularly targeting immigrants who may not identify as gay, ages 18-30 years old. The 16-week campaign included Spanish-language radio public service announcements (PSAs), a Web site, social media outreach, a reminder system using mobile technology, print materials and a toll-free hotline. In developing the PSAs, the Integrated Behavioral Model was used as a framework to reframe negative attitudes, beliefs and norms towards HIV testing with positive ones as well as to promote self-efficacy towards HIV testing. The campaign had a significant and immediate impact on attitudes, beliefs, norms and self-efficacy towards HIV testing as well as on actual behavior, with HIV testing rates increasing over time.

Abstract165 newly homeless adolescents from Melbourne, Australia and 261 from Los Angeles, United States were surveyed and followed for two years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within two years of becoming homeless. Keywordshomeless; homeless youth; runaways; Australia A large number of cross-sectional, epidemiological studies have documented the high rates of risky health behaviors and negative outcomes for homeless youth (i.e., runaway/throwaway youth) [1]. Representative cross-sectional data suggest that 1.7 million youth [2], approximately 7.6% of U.S. youth, experience at least one night of homelessness annually [3]. Globally, there is a perception that leaving home leads to chronic homelessness, but there are no longitudinal data to support or dispute this assumption. This study examines the rate and timing of returning home over 24 months among samples of newly homeless youth in Los Angeles, California and Melbourne, Australia. MethodsEach newly homeless youth was identified by an interviewer conducting a 13-item screening that established whether the youth: 1) was aged 12 to 20 years; 2) had spent at least two consecutive nights away from home (after being ejected or leaving without a guardian's permission); and 3) had lived away from home for less than six months. Time away rather than number of homeless episodes defined a newly homeless adolescent as determined from conversations with service providers. The sampling procedure varied slightly across countries, reflecting differences in the type, number, and geographical distribution of agencies serving homeless youth and policies in each setting [4]. In California, the probabilities of newly homeless youth presenting in each shelter (n = 17) and street site (n = 13) were assessed and an interviewing rotation plan was designed to yield a representative sample. In Australia, recruitment was based on staff referral from 95 service and homeless service agencies in Melbourne. In Los Angeles, 261 newly homeless youth were recruited (58% female; 23%For correspondence and reprint requests, contact Dr. Norweeta Milburn, UCLA, Center for Community Health, 10920 Wilshire Blvd., Suite #350, Los Angeles, CA, 90024-6521. Telephone: (310) 794-3773; Fax: (310) 794-8297; E-mail: nmilburn@mednet.ucla.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. African American, 43% Latino, and 20% White) and 165 newly homeless youth in Melbourne were recruited (75% female) ranging from 12 to 20 years old (M = 17.3; SD = 1...

The “Latina epidemiologic paradox” refers to the observation that despite socioeconomic disadvantages, Latina mothers in the United States (US) have a similar or lower risk for delivering an infant with low birth weight (LBW) compared to non-Latina White mothers. An analogous paradox may exist between foreign-born (FB) and US-born (USB) Latinas. Our goal was to assess differences in LBW in USB Latinas, FB Latinas, and non-Latina Whites in Los Angeles County in 2003 using birth records and survey data. Using logistic regression, we estimated associations between LBW and birthplace/ethnicity in a birth cohort and nested survey responder group and between LBW and acculturation in responders to a follow-up survey. USB Latinas and FB Latinas had a higher prevalence of LBW infants compared to Whites (odds ratio [OR] = 1.34, 95% confidence interval [CI] = (1.17, 1.53) and OR = 1.32, 95% CI = (1.18, 1.49), respectively); when we adjusted for additional maternal risk factors these point estimates were attenuated, and interval estimates were consistent with a modest positive or inverse association. Among Latinas only, LBW was more common for high-acculturated FB and USB Latinas compared to low-acculturated FB Latinas, and there was limited evidence that environmental or behavior risk factors had less impact in low-acculturated Latinas. In summary, adjusting only for demographics, Latinas in our study were more likely to have LBW infants compared to Whites, in contrast to the Latina paradox hypothesis. Furthermore, adjusting for environmental or behavioral factors attenuated the positive association, but there was little evidence that Latinas had a lower prevalence of LBW regardless of the variables included in the models. Finally, among Latinas, there was limited evidence that associations between known risk factors and LBW were modified by acculturation.

Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis. An exploratory study using qualitative interviews that assess the beliefs and attitudes of 54 Latino immigrant MSM in Seattle, Washington, is presented. The goal of this research is to determine whether attitudinal differences exist between participants who had and had not been tested and to use any insight into the development of a media campaign to promote testing. Over one-third of the men have never been tested for HIV. Nontesters are more likely to be men who have sex with men and women, have less knowledge about HIV risks, perceive their sexual behaviors as less risky, and deflect HIV-related stigma. Testers are more likely to be self-identified as being gays. Both groups believe that fear of a positive result is the main barrier to testing. Both groups believe that family members have negative attitudes towards HIV testing and that having Latino staff at HIV testing sites hinders confidentiality. Financial concerns with regard to the cost of testing were also expressed by both groups. Based on these insights, recommended strategies for the development of HIV prevention and testing campaigns are made.

Purpose To assess content validity and patient and provider prioritization of Patient Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, Fatigue, and Alcohol Use items in the context of clinical care for people living with HIV (PLWH), and to develop and assess new items as needed. Methods We conducted concept elicitation interviews (n=161), item pool matching, prioritization focus groups (n=227 participants), and cognitive interviews (n=48) with English-speaking (~75%) and Spanish-speaking (~25%) PLWH from clinical sites in Seattle, San Diego, Birmingham, and Boston. For each domain we also conducted item review and prioritization with two HIV provider panels of 3 to 8 members each. Results Among items most highly prioritized by PLWH and providers were those that included information regarding personal impacts of the concept being assessed, in addition to severity level. Items that addressed impact were considered most actionable for clinical care. We developed additional items addressing this. For depression we developed items related to suicide and other forms of self-harm, and for all domains we developed items addressing impacts PLWH and/or providers indicated were particularly relevant to clinical care. Across the 4 domains, 16 new items were retained for further psychometric testing. Conclusion PLWH and providers had priorities for what they believed providers should know to provide optimal care for PLWH. Incorporation of these priorities into clinical assessments used in clinical care of PLWH may facilitate patient-centered care.

Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay.

Intervention programs that contextualize discrimination and enhance racial/ethnic identification and pride among homeless young people are needed.