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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)：一项关于废弃房屋补救、物质滥用和暴力的随机试验房屋废弃构成了一个主要的健康负担，在过去几十年里，这种负担在美国显著增加。作为一个典型的美国城市，费城有大约4万处空置物业，其中相当一部分是废弃的住宅楼或结构。包括我们自己在内的研究表明，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，并将这些不受欢迎的建筑描述为对社区健康最重要、最明显的诋毁者，降低了社区凝聚力，制造了垃圾、啮齿动物、犯罪、恐惧、压力，以及暂住者、吸毒和性工作的避风港。多种理论认为，可见的环境紊乱，如废弃的建筑，通过发出社区无人照管、容忍无礼行为以及居民参与社会共同期望的能力，从而导致社区衰落对社区问题的控制受到了侵蚀。其结果是，居民被阻止从事积极的健康行为，而不健康的行为，如药物滥用和暴力，变得更加普遍和庇护。因此，对废弃房屋的直接补救可能是一种强有力的干预措施，可以中断长期存在的药物滥用和暴力行为。拟议的研究团队已经完成了几项初步/试点研究，证明其有能力完成拟议的研究：(1)根据2011年《费城门窗条例》发布的全市范围内关于废弃建筑补救协议对健康和安全影响的准实验研究；(2)关于废弃和空置物业补救对健康和安全影响的多项已发表的试点随机对照试验(RCT)；以及(3)涉及超过60万平方英尺的土地和5波随机抽样调查的全市范围内的大型空地绿化随机对照试验(RCT)。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。这项提案的广泛目标是通过在全市范围内对废弃住房补救对药物滥用结果、与酒精和毒品有关的影响以及暴力结果，特别是枪支暴力的影响，解决这一认识上的差距。总共随机选择的320所废弃房屋，分层到费城的四个地理区段，将被随机分配到四个试验臂：完全废弃房屋补救(n=80，完全处理)，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)，以及不进行房屋补救或清理(n=80，不处理)。将在治疗前和治疗后的18个月内对废弃房屋及其附近的纵向结果进行测量。将使用混合的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具有成本效益的办法。