Stage 1 Treatment Development with Homeless Mothers and their 2-6 Year Old Childr

无家可归的母亲及其 2-6 岁儿童的第一阶段治疗发展

基本信息

批准号：
8037547
负责人：
NATASHA SLESNICK
金额：
$ 49.87万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-04-01 至 2013-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8037547
关键词：
6 year old Accounting Address Age Alcohol or Other Drugs use Attention Caring Case Management Child Child Mental Health Chronic Cities Communities Data Developmental Delay Disorders Domestic Violence Drug abuse Ecosystem Effectiveness Ethnic Origin Evaluation Family Focus Groups Food Safety Foundations Goals Head Health Healthcare Homeless Youth Homelessness Housing Individual Intervention Interview Length Life Literature Manuals Mediator of activation protein Mental Health Methods Modeling Modification Mothers Ohio Outcome Participant Patient Self-Report Phase Pilot Projects Population Population Intervention Process Psychological reinforcement Questionnaires Randomized Recruitment Activity Reporting Research Risk Services Shelter facility Societies Staging Stress Substance abuse problem Testing Translating Treatment Efficacy Treatment outcome Vulnerable Populations Woman adverse outcome base cost drug addict effective intervention efficacy testing experience follow-up improved medical food meetings named group novel physical conditioning prevent randomized trial response social substance abuser success successful intervention therapy development treatment as usual treatment effect treatment response

项目摘要

DESCRIPTION (provided by applicant): Even with increased focus on those experiencing homelessness, the number of homeless families continues to rise, with the demand for temporary shelter so high that many cities are unable to meet the needs of these families. The majority of these families are headed by single mothers, many of whom struggle with substance use and mental health issues. These struggles are in addition to meeting the basic needs of themselves and their children. No study has documented an effective approach for intervening with homeless substance abusing mothers with children. Research attention towards identifying efficacious interventions for this population which address the multiple needs of these families is thus considered an important focus for reducing significant individual and social costs associated with substance use and homelessness. The current study utilizes an ecological systems approach as the theoretical base for the proposed treatment. The overarching goals of the current treatment development study are to first identify targets and processes of intervention desired by homeless mothers and then pilot test a novel manualized intervention focused on improving treatment success of this special population. In Stage 1a, information from the multi-method assessment and focus groups with N=30 homeless mothers will guide modifications to an integrated intervention that includes housing, case management and the Community Reinforcement Approach. The final manual resulting from this important study will address the multiple needs of homeless mothers, including basic needs and substance use/mental health problems. The intervention will be tested in a nonrandomized pilot (N = 15) in which interview and self-report methods will be used for data gathering. Follow-up will be conducted at 3 and 6 months post baseline and the intervention will be modified based upon the process and outcome analyses. Finally, the revised intervention will be tested in Stage 1b in a randomized pilot study involving 60 women and children assigned to the project intervention (N = 30) or treatment as usual (N=30) and followed at 3, 6, and 9 months post- baseline. In the randomized pilot study an effect size will be computed for use in informing a larger, randomized Stage II trial. This project utilizes existing efficacious models of drug abuse treatment to generate valuable new information critical to treatment services delivery for a special population of substance abusers. Since homeless substance abusing women and their children are at increased risk for a variety of adverse outcomes, improved maternal and child outcomes may produce substantial health-care benefits to the women, their children, and society at large. The findings from this study will serve as the foundation for the refinement and implementation of a promising intervention for drug-addicted homeless women and children that can then be tested for efficacy in a Stage II trial. PUBLIC HEALTH RELEVANCE: Effective interventions are critically needed to improve the lives of substance abusing homeless mothers and children in their care. The current proposal seeks to address this gap through modifying and evaluating an ecologically based treatment that includes housing, case management and the Community Reinforcement Approach. Such research attention is needed in order to reduce the significant individual and social costs of continued substance use, mental health and homelessness among these vulnerable women and children.

描述（由申请人提供）：尽管人们越来越关注无家可归者，但无家可归家庭的数量仍在持续增加，对临时住所的需求如此之高，以至于许多城市无法满足这些家庭的需求。这些家庭大多数由单身母亲担任户主，其中许多人都在与药物滥用和心理健康问题作斗争。这些挣扎是为了满足自己和孩子的基本需求之外的。尚无研究记录了干预有孩子的无家可归的滥用药物的母亲的有效方法。因此，研究关注为该人群确定有效的干预措施，满足这些家庭的多种需求，被认为是减少与药物使用和无家可归相关的重大个人和社会成本的重要焦点。目前的研究利用生态系统方法作为拟议处理的理论基础。当前治疗开发研究的总体目标是首先确定无家可归母亲所需的干预目标和过程，然后试点测试一种新型手动干预措施，重点是提高这一特殊人群的治疗成功率。在第 1a 阶段，来自多方法评估和 N=30 位无家可归母亲的焦点小组的信息将指导对综合干预措施的修改，其中包括住房、案件管理和社区强化方法。这项重要研究得出的最终手册将解决无家可归母亲的多种需求，包括基本需求和物质使用/心理健康问题。干预措施将在非随机试点（N = 15）中进行测试，其中将使用访谈和自我报告方法收集数据。随访将在基线后 3 个月和 6 个月进行，干预措施将根据过程和结果分析进行修改。最后，修订后的干预措施将在 1b 阶段的随机试点研究中进行测试，该研究涉及 60 名妇女和儿童，他们被分配到项目干预组 (N = 30) 或照常治疗 (N = 30)，并在第 3、6 和 9 个月进行随访基线后。在随机试点研究中，将计算效应大小，以便为更大规模的随机 II 期试验提供信息。该项目利用现有有效的药物滥用治疗模型来生成宝贵的新信息，这对于为特殊的药物滥用者群体提供治疗服务至关重要。由于无家可归的滥用药物的妇女及其子女面临各种不良后果的风险增加，因此改善孕产妇和儿童结局可能会给妇女、她们的子女和整个社会带来巨大的医疗保健效益。这项研究的结果将作为完善和实施一项针对吸毒成瘾的无家可归妇女和儿童的有希望的干预措施的基础，然后可以在第二阶段试验中测试其有效性。公共卫生相关性：迫切需要采取有效的干预措施来改善滥用药物的无家可归母亲及其照顾的儿童的生活。当前的提案旨在通过修改和评估基于生态的治疗方法来解决这一差距，其中包括住房、病例管理和社区强化方法。需要对研究进行关注，以减少这些弱势妇女和儿童因持续吸毒、心理健康和无家可归而造成的重大个人和社会成本。