Engaging Substance Using Homeless Youth in Drop-in Center Services

 描述（由申请人提供）：救助中心为无家可归的年轻人提供了一个宝贵的安全网，解决了他们对食物、卫生和衣服的基本需求。此外，救助中心还提供个案管理和其他“更高级别”的服务，以解决无家可归的青少年使用物质的相互关联的健康和社会服务需求（例如，药物滥用和艾滋病毒预防方案）。研究表明，无家可归的青少年谁获得药物滥用，心理健康和案件管理服务，通过一个下拉中心更有可能显示减少药物使用，改善心理健康，并过渡到稳定的住房相比，青年谁不访问这些服务。然而，近40%的无家可归青年没有利用救助中心，在那些利用救助中心的人中，估计有50%没有利用更高级别的服务，如病例管理和降低风险方案。事实上，我们对这一弱势群体利用救助中心的障碍和促进因素一无所知，无法更好地让无家可归的青少年参与所需的服务。拟议项目的总体目标是促进对使用救助中心服务的主要障碍和促进因素的理解，并制定一套可供服务提供者使用的建议，以鼓励无家可归的青年不仅利用救助中心，而且利用更高水平的服务，减少药物使用和艾滋病毒风险行为。本研究的具体目的是：目的1）通过对无家可归青年和服务提供者的半结构式访谈，以及对现有的关于无家可归者利用服务的文献的系统回顾，建立一个关于无家可归者利用救助中心的促进者和障碍的初步概念模型;目的2）对200名随机抽样的无家可归青年进行调查，以检查假设的促进者和障碍是否与（a）任何救助中心的出勤率和（B）用户之间相关，出席的频率和使用的服务类型（例如，基本服务与更高级别的服务，包括药物滥用和艾滋病毒预防计划）;以及目标3）通过与服务提供者的半结构化访谈获得对我们调查结果的反馈，以帮助确保我们提出的建议是可接受的和可行的。

 DESCRIPTION (provided by applicant): Drop-in centers provide an invaluable safety net for homeless youth, addressing their basic needs for food, hygiene, and clothing. In addition, drop-in centers offer case management and other "higher level" services to address the interrelated health and social service needs of substance using homeless youth (e.g., substance abuse and HIV prevention programs). Research shows that homeless youth who access substance abuse, mental health, and case management services through a drop-in center are more likely to show reductions in substance use, improvements in mental health, and transitions to stable housing compared to youth who do not access these services. Yet nearly 40% of homeless youth do not utilize drop-in centers and, among those who do, an estimated 50% do not take advantage of higher level services such as case management and risk reduction programs. Virtually nothing is known about the barriers and facilitators of drop-in center utilization in this vulnerable population to better engage substance using homeless youth in needed services. The overall aim of the proposed project is to advance an understanding of key barriers and facilitators to the use of drop-in center services and develop a set of recommendations that can be used by service providers to encourage homeless youth to not only utilize drop-in centers, but to take advantage of higher level services that can reduce substance use and HIV risk behaviors. The specific aims of this project are: Aim 1) To develop a preliminary conceptual model of the facilitators and barriers of drop-in center utilization based on semi-structured interviews with homeless youth and service providers, and a systematic review of the existing literature on service utilization among homeless individuals; Aim 2) To conduct a survey with 200 randomly sampled homeless youth to examine whether hypothesized facilitators and barriers are associated with (a) any drop-in center attendance and (b) among users, frequency of attendance and types of services utilized (e.g., basic services vs. higher level services, includin substance abuse and HIV prevention programs); and Aim 3) To obtain feedback on our findings through semi-structured interviews with service providers to help ensure that the recommendations we develop are acceptable and feasible.