The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities.
The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities.
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DOI：
10.1136/bmjopen-2011-000323
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发表时间：
2011
期刊：
影响因子：
2.9
通讯作者：
Zabkiewicz DM
中科院分区：
文献类型：
--
作者：
Goering PN;Streiner DL;Adair C;Aubry T;Barker J;Distasio J;Hwang SW;Komaroff J;Latimer E;Somers J;Zabkiewicz DM
住房第一是为有心理健康问题的无家可归者提供的一项复杂的住房和支助干预措施。它有足够的知识基础和兴趣，值得在各种情况下进行大规模执行测试。该协议描述了加拿大五个城市，1.1亿美元的示范项目的定量设计，并提供了关键的科学决策的理由。在温哥华、温尼伯、多伦多、蒙特利尔和蒙克顿对“住房第一”的有效性进行了一项务实的、混合方法的多地点实地试验，将大约2500名参与者随机分为高需求和中等需求两组，并照常进行干预和治疗。目前正在收集两年期间的定量成果计量，并正在完成定性过程评价。主要成果是住房稳定性、社会功能，以及经济分析中的生活质量。分层线性模型是主要的数据分析策略。已获得11个机构的研究伦理委员会批准，并成立了安全和不良事件委员会。12个月和2年时结局的多中心分析结果将在一系列核心科学期刊论文中报告。 在整个项目期间，将与非学术受众开展广泛的知识交流活动。本研究已在国际标准随机对照试验编号注册中心注册，并分配ISRCTN42520374。对“住房第一”方案与加拿大五个城市中患有精神疾病的无家可归成年人正常治疗方案的成本效益进行评价，并进行为期两年的随访。主要成果包括住房稳定、生活质量和社会功能。还将调查不同轨迹的相关性和针对亚群体的干预措施的关键成分。这一复杂的住房和支持干预措施的第一个也是最大的多地点试验将提供有关实施和结果的信息。在核心共同方案中增加特定部位的干预措施，将允许研究针对当地情况的创新适应措施。纳入更广泛的无家可归者接受不太密集的服务模式将增加调查结果的政策相关性。与以往试验相比，本研究的优势在于样本量更大（n=2500）和结局变量范围更广。本研究采用了伴随的混合方法过程评价，包括保真度评估。五个城市的样本特征和通常的治疗方法的差异可能会限制综合分析的机会。
Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. A pragmatic, mixed methods, multi-site field trial of the effectiveness of Housing First in Vancouver, Winnipeg, Toronto, Montreal and Moncton, is randomising approximately 2500 participants, stratified by high and moderate need levels, into intervention and treatment as usual groups. Quantitative outcome measures are being collected over a 2-year period and a qualitative process evaluation is being completed. Primary outcomes are housing stability, social functioning and, for the economic analyses, quality of life. Hierarchical linear modelling is the primary data analytic strategy. Research ethics board approval has been obtained from 11 institutions and a safety and adverse events committee is in place. The results of the multi-site analyses of outcomes at 12 months and 2 years will be reported in a series of core scientific journal papers. Extensive knowledge exchange activities with non-academic audiences will occur throughout the duration of the project. This study has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374. An evaluation of the cost-effectiveness of Housing First in comparison to treatment as usual for homeless adults with mental illness in five Canadian cities with a 2-year follow-up. Primary outcomes include housing stability, quality of life and social functioning. The correlates of different trajectories and the critical ingredients of the intervention for sub-populations will also be investigated. The first and largest multi-site trial of this complex housing and support intervention will provide information about implementation and outcomes. The addition of site specific intervention arms to a core common protocol will allow investigation of innovative adaptations that are tailored to local context. The inclusion of a broader homeless population receiving a less intensive service model will increase the policy relevance of findings. A larger sample size (n=2500) and a wider range of outcome variables than in previous trials are strengths of this study. This study utilises a concomitant mixed methods process evaluation that includes fidelity assessments. Variation in sample characteristics and in treatment as usual across five cities may limit opportunities for aggregate analyses.
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影响因子：
2.8
作者：
Hoch JS;Rockx MA;Krahn AD
通讯作者：
Krahn AD
影响因子：
3.3
作者：
Brooks, R
通讯作者：
Brooks, R
影响因子：
3.1
作者：
Greenwood, RM;Schaefer-McDaniel, NJ;Tsemberis, SJ
通讯作者：
Tsemberis, SJ
影响因子：
3
作者：
Brazier, JE;Roberts, J
通讯作者：
Roberts, J
影响因子：
4.4
作者：
Hoch, Jeffrey S.;Dewa, Carolyn S.
通讯作者：
Dewa, Carolyn S.