CRA AND ENHANCED JOB TRAINING FOR HOMELESS WOMEN

CRA 和针对无家可归妇女的强化职业培训

• 批准号: 6785237
• 负责人: JANE ELLEN SMITH
• 金额: $ 19.99万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-27 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6785237
• 关键词: adult human (21+); alcoholism /alcohol abuse; alcoholism /alcohol abuse prevention; alcoholism /alcohol abuse therapy; behavior therapy; blood tests; clinical trials; eating disorders; employment /unemployment; family structure /dynamics; female; homeless; human subject; human therapy evaluation; interview; longitudinal human study; patient care management; patient oriented research; psychological reinforcement; questionnaires; sex abuse; social support network; statistics /biometry; training; urinalysis; women' s health

Women and families now comprise about 30 percent of the homeless population and they are viewed as the fastest rising subgroup. Alcoholism is their most widespread health problem It is unfortunate, then, that despite the availability of efficacious treatment programs, women enter and remain in them at much lower rates than do men. Some suggest that women will only seek treatment if women's issues are addressed or when they have options other than predominantly male programs. Since the proposed study will attempt to recruit a large sample of homeless women, an all-female program will be conducted utilizing a treatment that has been modified to take women's issues into consideration. Ninety-nine alcohol-dependent or alcohol-abusive homeless women will be randomly assigned to one of three conditions: case management (CM), the Community Reinforcement Approach (CRA), or an enhanced CRA program called CREATE (Community Reinforcement, Employment, and Training Enhancement). It is considered essential to investigate a CM program, both due to its widespread popularity, and the fact that it has only inconsistent empirical backing. The behavioral intervention, CRA, has proven to be efficacious for treating alcoholics and was listed as the most cost-effective treatment in the latest meta- analytic review. In its recent successful application to a homeless population, promising preliminary outcomes were detected for the small sample of female participants. However, two limitations were apparent. First, a considerable number of women relapsed when both their treatment and their stay in the abstinence-contingent, free housing ended. Consequently, the current proposal is an attempt to provide aftercare services during this high-risk period. It also will specifically address critical issues for these women (e.g. sexual victimization) from the start. A second problem was the high rate of unemployment posttreatment. In response, this project will offer basic computer skills training to the CREATE group through an empirically-based contingency management (voucher) program proven to enhance job-training attendance. The CREATE condition also will receive motivational CRA procedures called Systematic Encouragement to bolster job-training attendance and to make the work environment a reinforcing community. It is predicted that both of the CRA conditions will result in significant improvement in alcohol use, employment, and housing stability compared to CM, and that the CREATE group will obtain employment outcomes superior to the regular CRA group.

妇女和家庭现在占无家可归人口的30%左右，她们被视为增长最快的亚群体。 酗酒是他们最普遍的健康问题。不幸的是，尽管有有效的治疗方案，妇女进入和留在这些方案中的比例比男子低得多。 一些人认为，只有在妇女的问题得到解决或在除男性占主导地位的方案之外还有其他选择时，妇女才会寻求治疗。 由于拟议的研究将试图招募大量无家可归的妇女，因此将实施一项全女性方案，采用经过修改的治疗方法，以考虑到妇女问题。 99名酗酒或酗酒的无家可归的妇女将被随机分配到三个条件之一：个案管理（CM），社区强化方法（CRA），或一个增强的CRA计划称为创建（社区强化，就业和培训增强）。它被认为是必不可少的调查CM程序，由于其广泛的普及，以及它只有不一致的经验支持的事实。 行为干预，CRA，已被证明是有效的治疗酗酒者，并被列为最具成本效益的治疗在最新的Meta分析审查。 在最近成功应用于无家可归人口的过程中，在一小部分女性参与者中发现了有希望的初步结果。 然而，有两个局限性是显而易见的。 第一，相当多的妇女在治疗结束和在禁欲条件下的免费住房中的停留结束后复发。 因此，目前的建议是试图在这一高风险时期提供善后服务。 它还将从一开始就具体处理这些妇女的关键问题（如性受害）。 第二个问题是治疗后的高失业率。 作为回应，该项目将通过一个以实践为基础的应急管理（凭单）方案，向CREATE集团提供基本的计算机技能培训，该方案已被证明可以提高就业培训的出勤率。 创造条件也将收到激励CRA程序称为系统的鼓励，以加强就业培训出勤率，使工作环境成为一个加强社区。 据预测，这两个CRA条件将导致显着改善酒精使用，就业和住房稳定性相比，CM，和CREATE组将获得就业成果优于常规CRA组上级。