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A randomized trial of abandoned housing remediation, substance abuse and violence

废弃房屋整治、药物滥用和暴力的随机试验

基本信息

批准号：
9894636
负责人：
CHARLES C. BRANAS
金额：
$ 61.81万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-04-20 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9894636
关键词：
Address Aftercare Alcohol abuse Alcoholic Intoxication Alcohols Behavior Centers for Disease Control and Prevention (U.S.)Cities Collaborations Communities Community Health Consumption Crime Data Disease Drug Addiction Drug usage Economics Environment Fright Funding Geography Government Health Health behavior Housing Interruption Intervention Knowledge Lead Letters Maintenance Measures Modeling Morbidity - disease rate Municipalities Neighborhoods Outcome Outcome Measure Pharmaceutical Preparations Philadelphia Pilot Projects Premature Mortality Program Development Proliferating Property Protocols documentation Publishing Qualitative Methods Randomized Randomized Controlled Trials Reproducibility Research Respondent Risk Rodent Safety Sampling Schools Secure Sexually Transmitted Diseases Signal Transduction Social Controls Stress Structure Substance abuse problem Surveys Taxes Testing United States National Institutes of Health Universities Urban Developments Urban Health Violence Vision Work base cohesion cost cost effective disability drinking experience experimental study four-arm trial gun violence incremental cost-effectiveness mortality novel prevent programs public health relevance randomized trial remediation residence sex social expectations stem theories trafficking welfare

项目摘要

DESCRIPTION (provided by applicant): A randomized trial of abandoned housing remediation, substance abuse and violence Housing abandonment poses a major health burden that has grown significantly over the past several decades in the US. As a typical US city, Philadelphia has some 40,000 vacant properties, a significant number with abandoned residential buildings or structures. Research, including our own, has shown that vacant and abandoned properties are associated with drug- dependence, firearm violence, stress, sexually transmitted diseases, and premature mortality. Our prior research also shows that urban residents see abandoned buildings every day on their way to work or school and describe these undesirable structures as foremost, hypervisible detractors to community health, reducing community cohesion and creating trash, rodents, crime, fear, stress, and havens for transients, drug use, and sex work. Multiple theories posit that visible, environmental disorders, such as abandoned buildings, lead to community decline by signaling that a community is uncared-for, incivilities are tolerated, and the ability of residents to engage in shared expectations of social control over neighborhood problems is eroded. As a result, residents are prevented from engaging in positive health behaviors while unhealthy behaviors, such as substance abuse and violence, become sheltered and more prevalent. Direct remediation of abandoned housing could thus be a potent intervention to interrupt longstanding substance abuse and violence. The proposed research team has produced several preliminary/pilot studies that demonstrate its capacity to complete the proposed study: (1) a published, citywide quasi-experimental study of the health and safety effects of a novel abandoned building remediation protocol stemming from the 2011 Philadelphia Doors and Windows Ordinance; (2) multiple published pilot randomized controlled trials (RCTs) of the effects of abandoned and vacant property remediation on health and safety; and (3) a large, citywide RCT of vacant lot greening involving over 600,000 ft2 of land and a 5-wave, random sample survey of over 600 Philadelphians. There have been no RCTs that test the health and safety effects of abandoned housing remediation. The broad objective of this proposal addressed this gap in knowledge by conducting a citywide RCT of the effects of abandoned housing remediation on substance abuse outcomes, both alcohol and drug related, and violence outcomes, particularly firearm violence. A total of 320 randomly selected abandoned houses, stratified into four geographic sections of Philadelphia, will be randomly assigned to four trial arms: full abandoned housing remediation (n=80, full treatment), graffiti and trash clean-up only (n=80, graffiti treatment), trash clean-up only (n=80, contact control), and no housing remediation or clean-up (n=80, no treatment). Longitudinal outcomes on and near the abandoned houses will be measured in the 18 months before and after treatment. Mixed, quantitative and qualitative methods, will be used to achieve the proposed specific aims in determining if abandoned housing remediation is a cost-effective approach to substance abuse and firearm violence.

描述（由申请人提供）：一项关于废弃住房补救、药物滥用和暴力的随机试验废弃住房造成了重大的健康负担，在美国，这种负担在过去几十年中显着增加。作为一个典型的美国城市，费城拥有约 40,000 处空置房产，其中相当一部分是废弃的住宅建筑或构筑物。研究（包括我们自己的研究）表明，空置和废弃的房产与药物依赖、枪支暴力、压力、性传播疾病和过早死亡有关。我们之前的研究还表明，城市居民每天在上班或上学的路上都会看到废弃的建筑物，并将这些不良建筑描述为对社区健康最明显的破坏者，降低社区凝聚力，并制造垃圾、啮齿动物、犯罪、恐惧、压力以及临时住所、吸毒和性工作的避难所。多种理论认为，可见的环境紊乱，例如废弃的建筑物，会导致社区衰落，因为这表明社区无人照顾，不文明行为得到容忍，居民无法实现对社会的共同期望。对邻里问题的控制受到削弱。结果，居民无法采取积极的健康行为，而药物滥用和暴力等不健康行为则受到庇护并更加普遍。因此，对废弃房屋的直接修复可能是阻止长期存在的药物滥用和暴力的有效干预措施。拟议的研究团队已经进行了几项初步/试点研究，证明其完成拟议研究的能力：（1）一项已发表的全市准实验研究，研究源于 2011 年《费城门窗条例》的新型废弃建筑修复协议的健康和安全影响； (2) 多项已发表的关于废弃和空置财产修复对健康和安全影响的试点随机对照试验 (RCT)； (3) 一项针对空地绿化的大型全市随机对照试验，涉及超过 600,000 平方英尺的土地，并对 600 多名费城人进行了 5 波随机抽样调查。目前还没有随机对照试验来测试废弃房屋修复对健康和安全的影响。该提案的总体目标是通过开展全市范围的随机对照试验来解决这一知识差距，研究废弃住房补救措施对药物滥用结果（包括酒精和毒品相关）以及暴力结果（特别是枪支暴力）的影响。总共 320 栋随机选择的废弃房屋，分为费城的四个地理区域，将被随机分配到四个试验组：完全废弃房屋修复（n = 80，全面处理）、仅涂鸦和垃圾清理（n = 80，涂鸦处理）、仅垃圾清理（n = 80，接触控制）和不进行房屋修复或清理（n = 80，不处理）。将在治疗前后 18 个月内测量废弃房屋及其附近的纵向结果。将使用混合、定量和定性方法来实现拟议的具体目标，以确定废弃住房补救是否是解决药物滥用和枪支暴力的一种具有成本效益的方法。