Evidence Based Sober Living Houses: A Multi-level Analysis

基于证据的清醒生活之家：多层次分析

基本信息

批准号：
10224153
负责人：
DOUGLAS L POLCIN
金额：
$ 58.74万
依托单位：
PUBLIC HEALTH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-01 至 2023-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10224153
关键词：
Abstinence Accreditation Affect Aftercare Alcohol consumption Alcohols Architecture Area Attention Back Biological California Certification Characteristics Chronic Disease Communities Conflict (Psychology)Consensus County Crime Data Development Drug Addiction Drug usage Employment Environment Environmental Risk Factor Family Fees Focus Groups Funding Goals Guidelines HIV risk Housing Individual Intervention Leadership Legal Literature Location Los Angeles Measures Medical Mental Health Services Methods Neighborhoods Outcome Outcome Measure Patient Self-Report Pharmaceutical Preparations Pharmacotherapy Positioning Attribute Predictive Factor Privatization Procedures Process Program Evaluation Property Psychometrics Public Health Recommendation Recovery Reporting Research Research Personnel Risk Behaviors Safety Sampling Services Severities Social Characteristics Social Environment Social Network Social Perception Social support Socioeconomic Status Substance Use Disorder System Time Transportation Urine acute care addiction alcohol abstinence alcohol measurement alcohol outlet density base contextual factors cost density evidence base expectation experience follow-up indexing meetings multilevel analysis neglect operation organizational structure outcome prediction primary outcome recruit residence secondary outcome sobriety social social organization substance abuse treatment substance use treatment program treatment services

项目摘要

ABSTRACT Treatment for drug dependence is undergoing a paradigmatic shift that recognizes the limitations of acute care interventions. There is a growing consensus that drug dependence represents a chronic disease process that requires ongoing attention beyond formal treatment. Long-term professional treatment is prohibitive in part because reduction of cost continues to be an important goal among private and public funders. There is therefore an urgent need to identify non-professional interventions that can help sustain recovery after treatment, or in some cases, serve as an alternative to it. This application builds upon our ongoing and previous research assessing longitudinal outcomes of individuals residing in sober living houses (SLHs). The essential characteristics of SLHs include an alcohol and drug free living environment and social support for abstinence. SLHs are primarily financed through resident fees and residents in most houses can stay as long as they wish. There are over 800 SLHs in California alone, yet there are few studies assessing outcomes. Our research on SLHs shows that residents make significant, sustained (18-month) improvement on a variety of outcomes, including alcohol and drug use, arrests, employment, and other areas of functioning. This application proposes to study contextual factors neglected by our research to date, including how physical, social, and organizational characteristics among a heterogeneous sample of SLHs and the neighborhoods where they are located affect outcome. Factors assessed will include the social environment of houses, organizational and leadership characteristics, and architecture (e.g., size, spatial layout, proximity to neighbors, safety, use of rooms, and upkeep of the facility). We also examine the influence of neighborhood characteristics such as alcohol outlet density and proximity, activity spaces, crime, socioeconomic status, density and proximity of 12-step meetings, density and proximity of treatment services, and interactions between neighbors and SLH residents. Focus groups with residents and house managers will inform implementation of study procedures and understanding of quantitative findings. Procedures will include recruiting a sample of 600 individuals entering 40 purposively selected SLHs in Los Angeles County. Primary outcomes will include substance use, HIV risk, arrests, and employment. Multilevel modeling will parse out relative influences of individual, house, and neighborhood factors on outcome at 6 and 12 months. Results will provide new data on house and neighborhood characteristics that are critical for describing evidence-based SLHs and developing new standards based on scientific findings. Current recovery house organizations, such as the National Alliance of Recovery Residences (NARR), have standards primarily based on practical experience and anecdotal reports. There is therefore an urgent need for research that can help them develop evidence-based house environments and neighborhood locations. Dissemination of findings will target researchers, SLH operators, and SLH organizations involved in the creation of standards.

抽象的药物依赖的治疗正在进行一种范式转移，该转移识别出急性护理的局限性干预措施。越来越多的共识是，药物依赖性代表了慢性疾病过程除了正式治疗外需要持续关注。长期专业待遇部分是过分的因为降低成本仍然是私人和公共资助者的重要目标。有因此，迫切需要确定可以帮助维持康复的非专业干预措施治疗或某些情况下，可以作为替代方法。此应用程序建立在我们正在进行的和以前的研究评估居住在清醒住宅（SLH）中的个人的纵向结果。必不可少的 SLH的特征包括酒精和无毒品的生活环境以及对禁欲的社会支持。 SLH主要是通过居民费用来资助的，大多数房屋的居民可以随心所欲。仅在加利福尼亚，就有超过800个SLH，但是很少有研究评估结果。我们的研究 SLHS表明，居民对各种结果进行了显着，持续的（18个月）的改善，包括酒精和吸毒，逮捕，就业和其他功能领域。此申请提出研究迄今为止我们的研究所忽略的上下文因素，包括身体，社会和组织如何 SLH的异质样本及其所在的社区的特征结果。评估的因素将包括房屋，组织和领导力的社会环境特征和建筑（例如，大小，空间布局，靠近邻居的距离，安全性，房间的使用和维护设施）。我们还检查了邻居特征（例如酒精出口）的影响密度和邻近，活动空间，犯罪，社会经济地位，12步会议的密度和接近性，治疗服务的密度和接近性，以及邻居与SLH居民之间的相互作用。重点与居民和房屋经理的团体将告知实施研究程序和理解定量发现。程序将包括招募600个人的样本，目的是进入40个在洛杉矶县选定的SLH。主要结果将包括药物使用，艾滋病毒风险，逮捕和就业。多级建模将解析个人，房屋和社区的相对影响 6和12个月的结果因素。结果将提供有关房屋和社区的新数据对于描述基于证据的SLH和基于基于证据的SLH和制定新标准至关重要的特征科学发现。当前的恢复房屋组织，例如国家恢复住所（NARR），主要基于实践经验和轶事报告的标准。因此有一个迫切需要研究可以帮助他们开发循证房屋环境和邻里的研究位置。调查结果的传播将针对研究人员，SLH操作员和SLH组织创建标准。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Outcomes Among Sober Living House Residents Who Relapse: Role of Recovery Capital.

清醒生活之家复发的居民的结果：恢复资本的作用。

DOI：
10.1080/02791072.2023.2225502
发表时间：
2023
期刊：
Journal of psychoactive drugs
影响因子：
2.8
作者：
Polcin,DouglasL;Mahoney,Elizabeth;Witbrodt,Jane;Subbaraman,Meenakshi;Mericle,AmyA
通讯作者：
Mericle,AmyA

House Manager Roles in Sober Living Houses.