Researchers present unique program aimed at HIV prevention in runaway youth

Researchers at Wake Forest University Baptist Medical Center are the first in the U.S. to develop an HIV prevention and intervention program for adolescent runaways that focuses on their strengths.

Liz Arnold, Ph.D., assistant professor of psychiatry and behavioral medicine, presented the details of this 15-month pilot program at the National HIV Prevention Conference today in Atlanta.

The Runaway Youth Project is based on a Strengths-Based Case Management (SBCM) model. For example, if a teen doesn't excel in a certain subject in school, but is strong in another, the case manager would help the participant to identify the skills he has developed in his stronger area, and show him how he can apply those same skills to his more challenging areas. Arnold says that what makes the SBCM model unique is that programs that are currently implemented are deficit-focused models. These programs examine the teens' problems instead of their strengths and try to fix those problems.

The SBCM was originally developed for adults with severe mental illness or substance abuse problems. SBCM is used in various locations throughout the country, but this is the first time the model has been used in the U. S. with a population besides adults.

“Teenagers are very focused on what's going on in their lives at the present time as this is part of their developmental state,” said Arnold. “That's why focusing on their strengths and tying them into their future goals shows kids that putting themselves at risk for HIV or other health problems can jeopardize reaching those goals. All youth have strengths, but it's about tapping into these and using them to empower the youth to realize their potential.”

Arnold and her colleagues used the SBCM model and specifically focused on the youth as the primary target of intervention, as opposed to the family.

“Typical programs involve family-focused intervention, and these have met with limited success. With our project, the family is involved to the degree that they are receptive to being involved in the program, but it's really focused on helping the adolescent, and then letting those positive changes filter down to the family,” said Arnold.

Other components of this model include collaborating with law enforcement to recruit participants so that they can target the teens before they become homeless.

“Once the teen is homeless, their chances of HIV risk greatly increase,” said Arnold. “Because this model focuses on early intervention -- when they've only run away one to three times -- it was really important to work with the officers who would talk to the kids and their families and refer them to us early into the trajectory of runaway behavior. We operated under the assumption that early intervention is better than waiting until the problems escalate to the point where successful intervention becomes more difficult.”

Arnold and her colleagues recruited participants ages 12 to 15 who had run away but returned home. It involved 12 months of intervention with three months of follow-up. The researchers met the participants out in the community as opposed to an office setting, and recruited staff with strong interpersonal and clinical skills.

“The kids were very receptive to having an adult role model. That connection with their case manager was a pivotal piece,” said Arnold.

“The goal of the study was to see if you can actually use this model with this population. Is it something that's feasible to use and acceptable to adolescent runaways" The answer is yes.”