Evaluation of EBT with Young, Substance Abusing Homeless Mothers

对年轻、滥用药物的无家可归母亲进行 EBT 评估

• 批准号: 9188535
• 负责人: NATASHA SLESNICK
• 金额: $ 61.07万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9188535
• 关键词: 6 year old; AIDS prevention; Address; Affect; Age; Alcohol consumption; Alcohol or Other Drugs use; Attention; Biological; Caring; Case Management; Child; Child Rearing; Child health care; Chronic; Cities; Communities; Developmental Delay Disorders; Drops; Drug usage; Ecosystem; Evaluation; Family; Goals; HIV; HIV risk; Healthcare; Homeless Youth; Homelessness; Housing; Institution; Intervention; Intervention Studies; Literature; Mediating; Mediator of activation protein; Mental Health; Mothers; Outcome; Participant; Population; Population Intervention; Process; Provider; Psyche structure; Psychological reinforcement; Randomized; Recruitment Activity; Reporting; Research; Residential Treatment; Risk; Self Efficacy; Self-control as a personality trait; Services; Shelter facility; Social support; Societies; Stress; Substance Use Disorder; System; Testing; Therapeutic; Time; Treatment outcome; Vulnerable Populations; Woman; Wood material; Youth; adverse outcome; base; cost effective; economic cost; economic evaluation; effective intervention; experience; health care availability; meetings; microsystems; physical conditioning; policy implication; prevent; prevention service; primary outcome; public health relevance; secondary outcome; service utilization; successful intervention; supported housing; therapy development; treatment as usual; young woman

DESCRIPTION (provided by applicant): Homeless mothers with young children in their care contend with high rates of substance use, HIV risk, physical and mental health problems and parenting stress. These struggles are in addition to homelessness and meeting the basic needs of themselves and their children. However, a very limited number of studies have examined mother and child outcomes associated with housing and supportive services. 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. A comprehensive intervention that can be offered outside the shelter setting may offer greater reach to those experiencing homelessness who do not make it in to the shelter system, and for those communities that do not have shelters available. Among the young homeless, those under age 25, research documents that the majority (70%) have never used shelter services. Research attention towards identifying efficacious interventions for this population which address the multiple needs of these families is thus considered an important focus. The proposed intervention (Ecologically-Based Treatment, EBT) includes housing and supportive services and utilizes an ecological systems approach as the theoretical base. It was rigorously developed in a Stage 1 treatment development study with substance use disordered homeless mothers who were engaged through a crisis shelter. EBT showed several outcomes superior to shelter services and is therefore considered a good fit for a population who avoids the shelter but is in great need of housing and support services. Two hundred forty (N = 240) substance use disordered homeless young women between the ages of 18 to 24 years with a biological child under the age of 6 years in their care will be randomly assigned to one of three conditions: (1) housing and support services (EBT) + Treatment as Usual (TAU) (N = 80), (2) housing only (HO) + TAU (N = 80), or (3) TAU only (N=80). EBT includes 6 months of supportive services (case management, HIV prevention and the Community Reinforcement Approach) in addition to 3 months of rental assistance. HO includes 3 months of rental assistance, but without supportive services. TAU is usual services offered by a homeless youth drop-in center. Participants will be re-assessed at 3, 6, 9 and 12 months post-baseline. Theoretically derived mediators of change as well as a formal economic evaluation will offer important policy implications. Since homeless substance use disordered mothers and their children are at increased risk for a variety of adverse outcomes, the intervention may produce substantial health-care benefits to their families and society at large.

描述（由申请人提供）：照顾幼儿的无家可归母亲面临着高物质使用率、艾滋病毒风险、身心健康问题和养育压力。这些挣扎除了无家可归和满足自己及其孩子的基本需求之外。然而，只有非常有限的研究调查了与住房和支持服务相关的母亲和儿童的结局。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。可以在庇护所环境之外提供的综合干预措施可以为那些无法进入庇护所系统的无家可归者以及那些没有庇护所的社区提供更大的覆盖范围。研究表明，在 25 岁以下的年轻无家可归者中，大多数人 (70%) 从未使用过收容所服务。因此，研究重点是确定针对该人群的有效干预措施，以满足这些家庭的多种需求。拟议的干预措施（基于生态的治疗，EBT）包括住房和支持服务，并利用生态系统方法作为理论基础。它是在一项第一阶段治疗开发研究中严格开发的，研究对象是通过危机庇护所参与的物质使用障碍无家可归的母亲。 EBT 显示出优于庇护所服务的多项成果，因此被认为非常适合那些避开庇护所但急需住房和支持服务的人群。 240 名 (N = 240) 年龄在 18 至 24 岁之间、有药物滥用障碍、无家可归的年轻女性，其照顾的亲生子女未满 6 岁，将被随机分配到以下三种情况之一：(1) 住房和支持服务 (EBT) + 照常治疗 (TAU) (N = 80)，(2) 仅住房 (HO) + TAU (N = 80)，或 (3) 仅 TAU (N = 80)。 EBT 包括 6 个月的支持服务（病例管理、艾滋病毒预防和社区强化方法）以及 3 个月的租金援助。 HO 包括 3 个月的租金援助，但不提供支持服务。 TAU 是无家可归青少年收容中心提供的常规服务。参与者将在基线后 3、6、9 和 12 个月重新评估。理论上得出的变革调解因素以及正式的经济评估将提供重要的政策影响。由于无家可归的药物滥用障碍母亲及其子女面临各种不良后果的风险增加，因此干预措施可能会给她们的家庭和整个社会带来巨大的医疗保健效益。