Prevention of OUD: The HOME (Housing, Opportunities, Motivation and Engagement) Randomized Trial

OUD 的预防：HOME（住房、机会、动机和参与）随机试验

• 批准号: 10168176
• 负责人: Kelly J Kelleher
• 金额: $ 492.29万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10168176
• 关键词: AIDS prevention; Address; Adopted; Adoption; Adult; Advocacy; Advocate; Affect; Age; Alcohol or Other Drugs use; Attention; Centers for Disease Control and Prevention (U.S.); Child Abuse; Communities; Country; Data; Development; Disease; Drops; Drug usage; Ecosystem; Epidemic; Evaluation; Future; General Population; Goals; HIV; HIV risk; Health; Healthcare; Heterogeneity; Home environment; Homeless Youth; Homelessness; Housing; Human Rights; Individual; Injections; Intervention; Interview; Link; Mediator of activation protein; Mental Health; Mental Health Services; Methods; Modeling; Motivation; Names; Ohio; Opioid; Outcome; Overdose; Patient Self-Report; Pharmaceutical Preparations; Phase; Physiological; Pilot Projects; Prevention; Preventive Intervention; Problem behavior; Provider; Psyche structure; Race; Randomized; Randomized Clinical Trials; Reporting; Research; Research Personnel; Resolution; Resources; Risk; Risk Behaviors; Risk Reduction; Sampling; Self Efficacy; Services; Sex Orientation; Shelter facility; Social Work; Societies; Stress; Subgroup; System; Systems Theory; Testing; Ursidae Family; Vulnerable Populations; Youth; adverse outcome; alcohol and other drug; base; biopsychosocial; comorbidity; comparative; economic cost; emerging adult; evidence base; experience; follow-up; heroin use; high risk; individual response; intervention effect; meetings; mortality; motivational enhancement therapy; named group; older patient; opioid epidemic; opioid overdose; opioid use; opioid use disorder; outreach; overdose death; peer; phase 1 study; phase 2 study; physical conditioning; prevent; prevention service; primary outcome; randomized controlled design; randomized trial; recruit; response; secondary outcome; service delivery; severe mental illness; sex; social; social cognitive theory; supported housing; time use; trend; violence exposure

Abstract While opioid use in the general population has received significant media and scholarly attention in recent years, very little research exists on opioid use among homeless or street-involved youth. Homeless youth have a much higher rate of substance use than non-homeless peers with evidence suggesting that homeless youth have the highest rates of opioid use among youth subgroups in the country (Brands et al., 2005); heroin using homeless youth also appear to have the highest rates of IV drug use and HIV (Rhoades et al., 2014). Given the high rates of opioid use, exposure to violence, mental and physical health challenges, and high rates of mortality in homeless youth, it is surprising that no study to date utilizes a randomized controlled design to test prevention of opioid and other drug use among this vulnerable population. Even among those receiving risk reduction interventions, lack of stable housing appears to be a barrier to reducing risk behaviors (DesJarlais et al., 2007). Resolution of youth homelessness through housing and prevention services, often referred to as “Housing First”, as proposed in the current study, has great potential to reduce the likelihood for the development of an opioid use disorder as well as other problem behaviors associated with living on the streets. However, only 20-30% of homeless youth samples report ever having stayed at a crisis shelter, 9% report having ever accessed mental health services, and 15% report ever having received substance use treatment (Ray, 2006) indicating a need to reach and engage youth in services that are feasible and acceptable. This study will provide essential information for researchers and providers on the efficacy of housing + opioid and related risk prevention services in an RCT on opioid use, how moderators affect the response, and mechanisms underlying change. Our intervention and hypotheses are guided by our conceptual model incorporating the biopsychosocial model (Fordyce et al., 1973) with social ecological systems theory (Bronfenbrenner, 1979) and Bandura’s Social-Cognitive Theory (1977; 1986). Interview, physiological, and self-report methods will be used for data gathering. Phase I (UG3) of the study includes a pilot study with 21 youth to assess initial efficacy, feasibility of recruitment and acceptability of the manualized housing + opioid and related risk prevention services. Upon meeting transition milestones, 240 youth will then be recruited for a larger randomized clinical trial testing housing + opioid and related risk prevention services versus opioid and related risk prevention services alone (Phase II, UH3). Follow-up will be conducted at 3, 6, 9 and 12-months post-baseline. The economic cost of each intervention will be determined to inform future providers and their funders. This project utilizes existing efficacious models of prevention to generate valuable new information critical to prevention services delivery for a special population of highly vulnerable youth. Because youth experiencing homelessness are at increased risk for a variety of adverse outcomes, the proposed intervention may produce substantial health-care benefits to the youths and society at large.

抽象的 虽然普通人群中的阿片类药物使用在最近受到了媒体和科学的关注 多年来，关于无家可归者或涉及街头的青年的阿片类药物使用的研究很少。无家可归的青年 与非无亲本的同伴相比，物质使用率要高得多，证据表明无家可归 青年在该国青年亚组中使用阿片类药物的率最高（Brands等，2005）；海洛因 使用无家可归的青年似乎也具有最高的IV药物使用率和HIV（Rhoades等，2014）。 鉴于阿片类药物使用率很高，暴力暴力，身心健康挑战以及高度 无家可归青年的死亡率率，令人惊讶的是，迄今为止尚无研究使用随机控制 在该脆弱人群中测试预防阿片类药物和其他药物使用的设计。甚至在其中 接受降低风险的干预措施，缺乏稳定的住房似乎是降低风险行为的障碍 （Desjarlais等，2007）。通过住房和预防服务来解决青年无家可归者，通常 当前研究中提出的那样，称为“首先是住房”，具有降低可能性的巨大潜力 阿片类药物使用障碍的发展以及与生活在 街道。但是，只有20％至30％的无家可归青年样本报告曾在危机庇护所中呆在危机庇护所中，有9％ 报告曾经访问过心理健康服务，有15％的报告曾经收到过毒品的使用 治疗（Ray，2006年）表明需要吸引并吸引青年参与可行的服务， 可以接受。这项研究将为研究人员和提供者提供有关效率的重要信息 住房 +阿片类药物和相关风险预防服务在RCT上有关阿片类药物的使用，主持人如何影响 响应和基础变化的机制。我们的干预和假设由我们的指导 用社会生态学编码生物心理社会模型（Fordyce等，1973）的概念模型 系统理论（Bronfenbrenner，1979）和Bandura的社会认知理论（1977; 1986）。面试， 研究的第一阶段（UG3）包括 对21名青年进行试点研究，以评估初始效率，招聘的可行性和手动的可接受性 住房 +阿片类药物和相关风险预防服务。达到过渡里程碑后，将有240名青年 被招募用于更大的随机临床试验测试外壳 +阿片类药物和相关风险预防服务 与阿片类药物和相关风险预防服务相比（II阶段，UH3）。随访将在3、6， 基线后9和12个月。每种干预的经济成本将确定为未来提供信息 提供者及其资金。该项目利用现有的有效预防模型来产生价值 对于特殊脆弱的青年人群提供的预防服务至关重要的新信息。 因为经历无家可归的青年会增加各种不良后果的风险，所以 拟议的干预措施可能会为整个年轻人和社会带来可观的医疗保健福利。

项目成果

Hair Collection for Cortisol Among Youth Experiencing Homelessness.

为无家可归的青少年收集皮质醇的头发。

• DOI: 10.1097/nnr.0000000000000664
• 发表时间: 2023
• 期刊: Nursing research
• 影响因子: 2.5
• 作者: Ford,JodiL;Slesnick,Natasha;Kelleher,Kelly;Brakenhoff,Brittany;Chavez,Laura;Feng,Xin;Mallory,Allen;Moore,Laura;O'Connor,Rachel;Pinkus,Lia;Sullenbarger,Brent;Yilmazer,Tansel;Zavarella,Haylie
• 通讯作者: Zavarella,Haylie

"Prevention of opioid use disorder: the HOME (housing, opportunities, motivation and engagement) feasibility study".

• DOI: 10.1186/s12954-021-00560-x
• 发表时间: 2021-11-08
• 期刊: Harm reduction journal
• 影响因子: 4.4
• 作者: Kelleher KJ;Famelia R;Yilmazer T;Mallory A;Ford J;Chavez LJ;Slesnick N
• 通讯作者: Slesnick N