Housing, opportunities, motivation and engagement (HOME) for homeless youth at-risk for opioid use disorder: study protocol for a randomized controlled trial.
Housing, opportunities, motivation and engagement (HOME) for homeless youth at-risk for opioid use disorder: study protocol for a randomized controlled trial.
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DOI：
10.1186/s13722-021-00237-7
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发表时间：
2021-05-12
影响因子：
3.7
通讯作者：
Kelleher K
中科院分区：
文献类型：
--
作者：
Slesnick N;Chavez L;Bunger A;Famelia R;Ford J;Feng X;Higgins S;Holowacz E;Jaderlund S;Luthy E;Mallory A;Martin J;Walsh L;Yilmazer T;Kelleher K
无家可归的青年患药物使用障碍、遭受暴力、精神和身体健康状况以及死亡率很高。他们尤其受到阿片类药物危机的影响。然而，迄今为止还没有研究使用随机对照设计来测试阿片类药物和其他药物使用的预防性干预措施。通过住房和包括预防服务在内的支持性服务解决青年无家可归问题，通常被称为“住房第一”，具有很大的潜力，可以减少阿片类药物使用障碍以及与街头生活相关的其他问题行为的可能性。Housing First已通过随机试验在患有精神健康和物质使用障碍的无家可归成年人中进行了测试，但尚未在无家可归青年中进行阿片类药物预防的实证测试。无家可归的青年将从一个经常被断开连接的青年光顾的收容所招募;他们将接受资格筛选，包括目前无家可归，年龄18-24岁，目前不符合阿片类药物使用障碍（OUD）的标准。在一项对照试验中，240名青少年将被随机分配到两种条件之一：（1）住房+阿片类药物和相关风险预防服务，或（2）单独使用阿片类药物和相关风险预防服务。该项目利用现有的有效预防模式来应对阿片类药物相关风险，包括动机访谈、基于优势的外联和宣传以及艾滋病毒风险预防干预。将在基线后3、6、9和12个月进行随访。将确定每项干预措施的经济成本，以支持其他提供者及其供资者的实施决定。这项研究将为研究人员和提供者提供关于住房+阿片类药物和相关风险预防服务在RCT中对阿片类药物使用的影响和潜在变化机制的有效性的重要信息。由于经历无家可归的青年面临各种不良后果的风险增加，因此拟议的干预措施可能会对青年和整个社会产生重大的医疗保健效益。试用注册ClinicalTrials.gov，NCT 04135703，注册日期2019年10月13日，https://clinicaltrials.gov/ct2/show/NCT04135703? term=NCT04135703&draw=2&rank=1#contacts
Homeless youth experience high rates of substance use disorders, exposures to violence, mental and physical health conditions, and mortality. They have been particularly affected by the opioid crisis. However, no study to date has used a randomized controlled design to test preventive interventions of opioid and other drug use among this vulnerable population. Resolution of youth homelessness through housing and supportive services including prevention services, often referred to as “Housing First,” 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. Housing First has been tested through randomized trials among homeless adults with mental health and substance use disorders, but has not been empirically tested for opioid prevention among homeless youth. Homeless youth will be recruited from a drop-in shelter site frequented by disconnected youth; they will be screened for eligibility, including current homelessness, age 18–24 years, and not currently meeting criteria for opioid use disorder (OUD). In a controlled trial, 240 youth will then be randomized to one of two conditions, (1) housing + opioid and related risk prevention services, or (2) opioid and related risk prevention services alone. This project utilizes existing efficacious models of prevention to address opioid-related risks, including motivational interviewing, strengths-based outreach and advocacy, and an HIV risk preventive intervention. Follow-up will be conducted at 3, 6, 9 and 12-months post-baseline. The economic cost of each intervention will be determined to support implementation decisions with other providers and their funders. This study will provide essential information for researchers and providers on the efficacy of housing + opioid and related risk prevention services in an RCT for effects on opioid use and mechanisms underlying change. 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. Trial registration ClinicalTrials.gov, NCT04135703, Registered October 13, 2019, https://clinicaltrials.gov/ct2/show/NCT04135703?term=NCT04135703&draw=2&rank=1#contacts
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