ED-Home: Pilot feasibility study of a targeted homelessness prevention intervention for emergency department patients with drug or unhealthy alcohol use.
ED-Home: Pilot feasibility study of a targeted homelessness prevention intervention for emergency department patients with drug or unhealthy alcohol use.
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DOI：
10.1111/acem.14610
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发表时间：
2022-12
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住房不安全在急诊患者中普遍存在。尽管人们对筛查患者的社会需求（包括住房不安全）的兴趣激增，但很少有研究探讨急诊科的社会需求干预措施。我们与政府和社区合作伙伴合作，针对吸毒或不健康饮酒的急诊科患者制定并试点了无家可归预防干预措施。我们于 2019 年 5 月至 8 月在一家城市公立医院急诊室随机抽取了患者。成年患者如果病情稳定、没有被监禁、会说英语、有不健康的饮酒或任何吸毒行为，并且目前没有无家可归，但使用先前开发的风险筛查工具对未来无家可归的风险进行了阳性筛查，则符合资格。参与者接受了由三部分组成的干预：1）通过现有的 ED 计划提供简短的咨询和转介药物使用治疗； 2) 转介至 Homebase，这是一项基于证据的社区无家可归预防计划； 3) 研究人员最多打三个故障排除电话。参与者在基线和 6 个月内完成了调查。在 2,183 名接受筛查的患者中，51 名符合资格，40 名（78.4%）参与；后来一名成员退出，只剩下 39 名参与者。参与者的年龄、性别、种族和民族各不相同。在 6 个月时接触的 32 名参与者中，大多数人表示在基线急诊就诊时与某人谈论他们的住房状况非常或极其有帮助（n=23，71.9%）。 13 人 (40.6%) 表示他们的住房状况在过去 6 个月内有所改善，16 人 (50.0%) 表示住房状况没有变化。 20 名参与者 (62.5%) 与 Homebase 办公室取得了联系。参与者分享了如何改进干预措施的想法。这种试点干预措施是可行的，并且受到参与者的好评，但需要大量的筛查来识别潜在的合格患者。我们的研究结果将为未来更大规模的试验提供信息，并可能为其他寻求开发类似干预措施的人提供信息。
Housing insecurity is prevalent among ED patients. Despite a surge of interest in screening for patients’ social needs including housing insecurity, little research has examined ED social needs interventions. We worked together with government and community partners to develop and pilot test a homelessness prevention intervention targeted to ED patients with drug or unhealthy alcohol use. We approached randomly sampled patients at an urban public hospital ED, May to August 2019. Adult patients were eligible if they were medically stable, not incarcerated, spoke English, had unhealthy alcohol or any drug use, and were not currently homeless but screened positive for risk of future homelessness using a previously-developed risk screening tool. Participants received a three-part intervention: 1) brief counseling and referral to treatment for substance use delivered through a pre-existing ED program; 2) referral to Homebase, an evidence-based community homelessness prevention program; 3) up to three troubleshooting phone calls by study staff. Participants completed surveys at baseline and 6 months. Of 2,183 patients screened, 51 were eligible and 40 (78.4%) participated; one later withdrew, leaving 39 participants. Participants were diverse in age, gender, race, and ethnicity. Of the 32 participants reached at 6 months, most said it was very or extremely helpful to talk to someone about their housing situation (n=23, 71.9%) at the baseline ED visit. Thirteen (40.6%) said their housing situation had improved in the past 6 months and 16 (50.0%) said it had not changed. Twenty participants (62.5%) had made contact with a Homebase office. Participants shared ideas of how to improve the intervention. This pilot intervention was feasible and well-received by participants, though required a large amount of screening to identify potentially eligible patients. Our findings will inform a larger future trial, and may be informative for others seeking to develop similar interventions.
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DOI：
10.1111/acem.14442
发表时间：
2022-05
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
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通讯作者：
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影响因子：
2.3
作者：
Maxwell, Annette E.;Jo, Angela M.;Bastani, Roshan
通讯作者：
Bastani, Roshan
影响因子：
4.4
作者：
D'Onofrio, G;Degutis, LC
通讯作者：
Degutis, LC
影响因子：
12.7
作者：
McCormack, Ryan P.;Hoffman, Lily F.;Goldfrank, Lewis R.
通讯作者：
Goldfrank, Lewis R.
DOI：
10.5811/westjem.2020.7.47796
发表时间：
2020-10-06
期刊：
The western journal of emergency medicine
影响因子：
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作者：
Molina MF;Li CN;Manchanda EC;White B;Faridi MK;Espinola JA;Ashworth H;Ciccolo G;Camargo CA Jr;Samuels-Kalow M
通讯作者：
Samuels-Kalow M