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

基本信息

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
项目类别：
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

项目摘要

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.

抽象的尽管近年来阿片类药物在普通人群中的使用受到了媒体和学术界的广泛关注多年来，关于无家可归或无家可归青少年使用阿片类药物的研究很少。与非无家可归者相比，他们的物质使用率要高得多，有证据表明无家可归者在该国青年群体中，青少年使用阿片类药物的比例最高（Brands 等人，2005 年）；使用无家可归的青少年似乎也具有最高的静脉注射毒品使用率和艾滋病毒感染率（Rhoades 等人，2014 年）。鉴于阿片类药物使用率高、遭受暴力、精神和身体健康挑战以及高尽管无家可归青少年的死亡率令人惊讶，但令人惊讶的是，迄今为止还没有研究采用随机对照方法旨在测试在这些弱势群体中预防阿片类药物和其他药物的使用。在接受减少风险干预措施时，缺乏稳定的住房似乎是减少风险行为的障碍（DesJarlais 等人，2007 年）通常通过住房和预防服务解决青少年无家可归问题。正如当前研究中提出的，被称为“住房优先”，有很大潜力减少住房优先的可能性阿片类药物使用障碍的发展以及与依赖生活相关的其他问题行为然而，只有 20-30% 的无家可归青年样本表示曾经住在危机庇护所，这一比例为 9%。报告曾接受过心理健康服务，15% 的人报告曾吸毒治疗（Ray，2006）表明需要让青年接触并让他们参与可行且可行的服务这项研究将为研究人员和提供者提供有关有效性的重要信息。关于阿片类药物使用的随机对照试验中的住房+阿片类药物和相关风险预防服务，主持人如何影响我们的干预和假设以我们的指导为指导。将生物心理社会模型（Fordyce et al., 1973）与社会生态模型相结合的概念模型系统理论（Bronfenbrenner，1979）和班杜拉的社会认知理论（1977；1986）。该研究的第一阶段（UG3）将使用生理学和自我报告方法进行数据收集。对 21 名青少年进行试点研究，以评估手动化培训的初步效果、招募可行性和可接受性住房+阿片类药物和相关风险预防服务达到过渡里程碑后，240 名青少年将获得资助。被招募进行更大规模的随机临床试验，测试住房+阿片类药物和相关风险预防服务阿片类药物与单独的相关风险预防服务（第二阶段，UH3）将在 3、6、基线后 9 个月和 12 个月将确定每次干预的经济成本，以便为未来提供信息。该项目利用现有有效的预防模式来产生有价值的成果。新信息对于为高度脆弱的青年这一特殊群体提供预防服务至关重要。由于无家可归的青少年面临各种不良后果的风险增加，拟议的干预措施可能会给青年和整个社会带来巨大的保健益处。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

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

“预防阿片类药物使用障碍：HOME（住房、机会、动机和参与）可行性研究”。

DOI：
发表时间：
2021
期刊：
影响因子：
4.4
作者：
Kelleher, Kelly J;Famelia, Ruri;Yilmazer, Tansel;Mallory, Allen;Ford, Jodi;Chavez, Laura J;Slesnick, Natasha
通讯作者：
Slesnick, Natasha

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：
发表时间：
2023-09-01
期刊：
影响因子：
2.5
作者：
Ford, Jodi L;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

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：
发表时间：
2023-04-17
期刊：
影响因子：
2.5
作者：
Ford, Jodi L;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