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
- 来源:
- 关键词:AbstinenceAccident and Emergency departmentAddressAffectAlcohol consumptionAlcoholsChronicClientCommunitiesCriminal JusticeDevelopmentDoseEmergency CareEmergency medical serviceEvaluationFundingHarm ReductionHealthHealthcareHomeless personsHomelessnessHousingIndividualInterventionJailLeadershipLifeMediator of activation proteinMedicalMorbidity - disease rateNeeds AssessmentNoiseOutcomeParticipantPathway interactionsPersonsPilot ProjectsPoliciesPopulationPositioning AttributeProcessProgram EffectivenessProgram EvaluationPublic HealthQuality of lifeRandomizedRandomized Controlled TrialsRecoveryReportingResearchResearch PersonnelRoleServicesSiteSubstance Use DisorderTestingTimeUrsidae FamilyUse EffectivenessVulnerable PopulationsWorkalcohol abstinencealcohol abuse therapyalcohol related problemalcohol use disorderarmattributable mortalitybasecommunity based participatory researchcosteffectiveness testingepidemiologic dataevidence baseexperienceflexibilityfollow up assessmentfollow-uphigh risk drinkingimprovedinnovationinterestintrinsic motivationmarginalized populationpatient engagementpersonalized approachphysical assaultprogramspublic health relevancereduced alcohol useresponseservice utilizationservices as usualsexual assaultsocialstemsubstance usesupported housing
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.
项目总结/摘要
经历长期无家可归的人构成了一个小而高发病率,高成本的子集,
无家可归的人更多,受酒精相关伤害的影响不成比例。不幸的是,
传统的基于禁欲的治疗不能充分接触或参与这一人群,
第一手(源于自己饮酒的问题)和第二手(源于他人饮酒的问题)
与酒精有关的伤害甚至在获得住房后仍然存在。因此,有人呼吁
更灵活和以客户为中心的方法适合这一人群的需要。住房优先,这意味着
提供即时、永久、低障碍、不禁欲的住房是对这一呼吁的回应。
研究表明,住房第一与减少酒精使用,酒精相关的伤害,
公共资金的使用。尽管如此,住房第一居民继续体验第一和第二,
二手酒的危害因此,有必要采取进一步的社区干预措施。为此目的,
进行了一个试点项目,研究人员以及住房第一居民,工作人员和管理人员
共同开发,实施,并初步评估生命增强酒精管理计划(LEAP)。
LEAP需要低障碍、社区级、全机构的驻地规划--包括领导力
机会、活动和恢复途径。在6个月的随访中,LEAP参与者报告
参与有意义的活动的人数显著多于对照组(p <0.001)。而且,高
LEAP计划参与水平(每月>2次活动)预测酒精使用显著减少
和酒精相关的伤害(ps < .01)。为了建立在这些有希望的发现,我们提出了一个更大的,集群-
LEAP(N=500)作为一种创新、基于社区和客户驱动的辅助治疗的随机对照试验
住房第一。在拟议的项目中,10个住房第一网站将得到最佳匹配和块
在滚动的基础上随机分配到LEAP或照常服务控制条件。在LEAP站点,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,
董事会,并制定和实施这一社区一级的干预措施。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个月随访时进行评估。分析
将测试LEAP在增加参与有意义的活动,减少饮酒,
改善第一手和二手酒精相关的伤害,提高生活质量。参与
有意义的活动也将作为LEAP对酒精和生活质量影响的中介进行测试
结果。最后,我们将评估LEAP是否与降低参与者的成本有关。
利用紧急医疗保健和刑事司法服务。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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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:
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:
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:
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: