A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents

一项整群随机对照试验,测试住房第一居民的生活改善酒精管理计划 (LEAP) 的有效性

基本信息

  • 批准号:
    10529057
  • 负责人:
  • 金额:
    $ 4.27万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2019
  • 资助国家:
    美国
  • 起止时间:
    2019-05-20 至 2024-02-29
  • 项目状态:
    已结题

项目摘要

PROJECT SUMMARY/ABSTRACT People experiencing chronic homelessness comprise a small yet high-morbidity, high-cost subset of the larger homeless population and are disproportionately impacted by alcohol-related harm. Unfortunately, traditional abstinence-based treatment does not adequately reach or engage this population, and both firsthand (problems stemming from one’s own alcohol use) and secondhand (problems stemming from others’ alcohol use) alcohol-related harm persists even after housing attainment. There have therefore been calls for more flexible and client-centered approaches tailored to this population’s needs. Housing First, which entails the provision of immediate, permanent, low-barrier, nonabstinence-based housing, is a response to this call. Research has shown that Housing First is associated with decreased alcohol use, alcohol-related harm, and publicly funded service utilization. Nonetheless, Housing First residents continue to experience both first- and secondhand alcohol-related harm. Thus, further community-based interventions are necessary. To this end, a pilot project was conducted in which researchers as well as Housing First residents, staff and management codeveloped, implemented, and initially evaluated the Life Enhancing Alcohol-management Program (LEAP). The LEAP entails low-barrier, community-level, house-wide resident programming—including leadership opportunities, activities, and pathways to recovery. At the 6-month follow up, LEAP participants reported significantly more engagement in meaningful activities than control participants (p < .001). Moreover, high levels of LEAP program engagement (>2 activities per month) predicted significant reductions in alcohol use and alcohol-related harm (ps < .01). To build on these promising findings, we propose a larger, cluster- randomized controlled trial of LEAP (N=500) as an innovative, community-based, and client-driven adjunct to Housing First. In the proposed project, 10 Housing First sites will be optimally matched and block randomized on a rolling basis to either LEAP or services-as-usual control conditions. At LEAP sites, research staff will work with housing staff and residents to conduct a needs assessment, form a community advisory board, and develop and implement this community-level intervention. Participants in the LEAP evaluation will meet criteria for at-risk drinking and will be assessed at baseline, 3-, 6-, and 12-month follow-ups. Analyses will test LEAP effectiveness in increasing engagement in meaningful activities, decreasing alcohol use, ameliorating both first- and secondhand alcohol-related harm, and improving quality of life. Engagement in meaningful activities will also be tested as a mediator of the LEAP effect on alcohol and quality-of-life outcomes. Finally, we will assess whether LEAP is associated with reduced costs stemming from participants’ use of emergency health-care and criminal justice services.
项目摘要/摘要 经历长期无家可归的人包括一小部分但高发病率、高成本的 更多的无家可归人口,而且受到与酒精有关的伤害的影响不成比例。不幸的是, 传统的以禁欲为基础的治疗无法充分接触到这一人群或使其参与,而且两者都 直接问题(源于自己饮酒的问题)和二手问题(源于他人的问题 酒精使用)即使在获得住房之后,与酒精有关的伤害仍然存在。因此,有人呼吁 更灵活、更以客户为中心的方法,以满足这一群体的需求。住房优先,这需要 提供即时、永久、低门槛、不节制的住房,就是对这一呼吁的回应。 研究表明,住房优先与减少饮酒、酒精相关的伤害和 公共资助的服务利用率。尽管如此,住房优先居民继续经历首次和 与酒精有关的二手伤害。因此,有必要进一步采取以社区为基础的干预措施。为此, 开展了一项试点项目,研究人员以及住房优先居民、工作人员和管理人员 共同开发、实施和初步评估增强生命的酒精管理计划(LEAP)。 这一飞跃需要低门槛、社区级别、全屋范围的居民规划--包括领导力 复苏的机会、活动和途径。在6个月的随访中,LEAP参与者报告说 与对照组参与者相比,他们更多地参与有意义的活动(p&lt;.001)。此外,高 LEAP计划的参与度(每月2次活动)预示着酒精使用量的显著减少 和与酒精有关的伤害(PS&lt;.01)。为了在这些有希望的发现的基础上,我们提出了一个更大的集群- LEAP(N=500)的随机对照试验,作为一种创新、基于社区和客户驱动的附属设备 首先是住房问题。在拟议的项目中,将对10个首置房屋用地进行最佳匹配和区块 在滚动的基础上随机选择LEAP或服务照常的控制条件。在Leap网站上,研究 工作人员将与房屋工作人员和居民一起进行需求评估,形成社区咨询 董事会,并制定和实施这一社区层面的干预。LEAP评估的参与者将 符合危险饮酒的标准,并将在基线、3个月、6个月和12个月的随访中进行评估。分析 将测试Leap在增加有意义的活动、减少饮酒、 改善与酒精有关的一手和二手伤害,提高生活质量。参与 有意义的活动也将作为酒精和生活质量飞跃效应的中介进行测试 结果。最后,我们将评估LEAP是否与参与者的 使用紧急保健和刑事司法服务。

项目成果

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Seema Lisa Clifasefi其他文献

Seema Lisa Clifasefi的其他文献

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{{ truncateString('Seema Lisa Clifasefi', 18)}}的其他基金

Social-Ecological Resilience: Adapting a Measure for Individuals with Lived Experience of AUD and Homelessness.
社会生态复原力:针对有澳元和无家可归经历的个人采取措施。
  • 批准号:
    10402620
  • 财政年份:
    2021
  • 资助金额:
    $ 4.27万
  • 项目类别:
A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents
一项整群随机对照试验,测试住房第一居民的生活改善酒精管理计划 (LEAP) 的有效性
  • 批准号:
    10578691
  • 财政年份:
    2019
  • 资助金额:
    $ 4.27万
  • 项目类别:
A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents
一项整群随机对照试验,测试住房第一居民的生活改善酒精管理计划 (LEAP) 的有效性
  • 批准号:
    10357932
  • 财政年份:
    2019
  • 资助金额:
    $ 4.27万
  • 项目类别:
A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents
一项整群随机对照试验,测试住房第一居民的生活改善酒精管理计划 (LEAP) 的有效性
  • 批准号:
    10116236
  • 财政年份:
    2019
  • 资助金额:
    $ 4.27万
  • 项目类别:
Development of LEAP for the Homeless with Alcohol Problems
为有酗酒问题的无家可归者开发 LEAP
  • 批准号:
    9000079
  • 财政年份:
    2013
  • 资助金额:
    $ 4.27万
  • 项目类别:
Development of LEAP for the Homeless with Alcohol Problems
为有酗酒问题的无家可归者开发 LEAP
  • 批准号:
    8440268
  • 财政年份:
    2013
  • 资助金额:
    $ 4.27万
  • 项目类别:
Development of LEAP for the Homeless with Alcohol Problems
为有酗酒问题的无家可归者开发 LEAP
  • 批准号:
    9210029
  • 财政年份:
    2013
  • 资助金额:
    $ 4.27万
  • 项目类别:
Development of LEAP for the Homeless with Alcohol Problems
为有酗酒问题的无家可归者开发 LEAP
  • 批准号:
    8817220
  • 财政年份:
    2013
  • 资助金额:
    $ 4.27万
  • 项目类别:
The Effects of Alcohol & Placebos on Eyewitness Memory
酒精的影响
  • 批准号:
    7000116
  • 财政年份:
    2005
  • 资助金额:
    $ 4.27万
  • 项目类别:
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