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Addressing Homelessness and Substance Use in Emergency Department Patients

解决急诊科患者的无家可归和药物滥用问题

基本信息

批准号：
9922884
负责人：
Kelly Doran
金额：
$ 20.14万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
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：
2016-05-01 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9922884
关键词：
Accident and Emergency department Address Alcohol consumption Alcohol or Other Drugs use Alcohols American Caring Cause of Death Chronic Chronic Disease Clinical Investigator Data Diagnosis Drug usage Effectiveness Emergency Department patient Emergency Department-based Intervention Emergency department visit Feasibility Studies Feedback Fostering Foundations Frequencies Funding Future General Population Goals Health Health Care Costs Health Services Research Health Status Healthcare Healthcare Systems Homelessness Hospitals Housing Individual Intervention Interview K-Series Research Career Programs Learning Life Mentored Patient-Oriented Research Career Development Award Mentors Methods Morbidity - disease rate New York New York City Outcome Patients Pharmaceutical Preparations Policies Prevention Prevention program Preventive Intervention Preventive care Psychometrics Published Comment Research Research Methodology Research Personnel Research Training Risk Risk Factors Schools Science Screening procedure Sensitivity and Specificity Series Service setting Services Severities Shelter facility Social Work Structure Substance Use Disorder Substance abuse problem Surveys Time Training United States Universities Work addiction alcohol misuse base brief screening career design drug misuse experience health care service health service use high risk medical schools mortality patient screening prevent prospective public health relevance safety net screening skills skills training theories therapy development treatment services

项目摘要

DESCRIPTION (provided by applicant): This mentored patient-oriented research career development award (K23) will support Dr. Kelly Doran's training and research on the interrelated problems of substance use and homelessness. More than 1.5 million Americans experience homelessness each year. Alcohol and drug use are both risk factors for homelessness, and the problems of substance use and homelessness can each exacerbate the other. Both substance use and homelessness are associated with poor health outcomes, including increased morbidity and mortality, and frequent use of expensive health care services. Homelessness policy in the U.S. is increasingly focused on prevention, yet ideal methods for targeting prevention interventions to at-risk people have been sparsely researched. Furthermore, prevention interventions only reach a small and self-selected subset of people. As the safety net of the health care system, emergency departments (EDs) serve large numbers of patients with unhealthy alcohol or drug use who are at risk for homelessness and may not access services elsewhere. The overall goal of the proposed research is to identify optimal approaches to risk screening and prevention of homelessness in ED patients with unhealthy alcohol or drug use. The specific research aims are: 1) to develop a brief screening tool that will identify ED patients with unhealthy alcohol or drug use who are at significant risk for future homelessness, 2) to use in-depth, qualitative interviews to inform the development of an intervention to prevent homelessness among ED patients with unhealthy alcohol or drug use, and 3) to conduct a feasibility study of an ED-based intervention to prevent homelessness among patients with unhealthy alcohol or drug use. The results of this research will inform a future R-series application to conduct a trial of homelessness prevention and substance use interventions among unhealthy alcohol or drug using ED patients at risk for homelessness. Dr. Doran will be mentored by a transdisciplinary team of experts in health services research, qualitative and mixed methods, prevention and intervention science, substance abuse, and homelessness. The proposed research and training will be conducted at Bellevue Hospital Center, the oldest public safety net hospital in the United States, and at New York University, whose School of Medicine and multiple other professional schools boast unparalleled opportunities for collaborative work and learning. Dr. Doran's training goals for this career development award are to develop and enhance skills in: 1) survey design and psychometric theory, 2) advanced health services research methods, 3) advanced qualitative and mixed methods, 4) intervention and prevention science, and 5) substance abuse, addiction, and homelessness. The proposed research and training plans will provide a strong foundation for Dr. Doran's career as an independently funded clinical investigator dedicated to the interconnected problems of substance use and homelessness.

描述（由申请人提供）：这个指导以病人为导向的研究职业发展奖（K23）将支持凯利多兰博士的培训和研究的物质使用和无家可归的相互关联的问题。每年有超过150万美国人无家可归。酗酒和吸毒都是造成无家可归的危险因素，而吸毒和无家可归的问题会使彼此更加恶化。药物使用和无家可归都与不良的健康结果有关，包括发病率和死亡率增加，以及经常使用昂贵的保健服务。美国的无家可归政策越来越注重预防，但对高危人群进行针对性预防干预的理想方法却鲜有研究。此外，预防干预措施只惠及一小部分自我选择的人。作为卫生保健系统的安全网，急诊科为大量使用不健康酒精或药物的患者提供服务，这些患者有无家可归的风险，并且可能无法在其他地方获得服务。拟议研究的总体目标是确定风险筛查和预防不健康酒精或药物使用的艾德患者无家可归的最佳方法。本研究的具体目标是：1）开发一种简单的筛选工具，用于识别艾德患者 2）使用深入的定性访谈，为制定干预措施提供信息，以防止使用不健康酒精或药物的艾德患者无家可归，以及3）进行基于ED的干预措施的可行性研究，以防止使用不健康酒精或药物的患者无家可归。这项研究的结果将为未来的R系列应用提供信息，以便在有无家可归风险的不健康酒精或药物使用艾德患者中进行无家可归预防和物质使用干预试验。多兰将由一个跨学科的专家小组在卫生服务研究，定性和混合方法，预防和干预科学，药物滥用和无家可归的指导。拟议的研究和培训将在美国最古老的公共安全网医院贝尔维尤医院中心和纽约大学进行，纽约大学的医学院和其他多个专业学校拥有无与伦比的合作工作和学习机会。Doran博士的职业发展奖的培训目标是发展和提高以下方面的技能：1）调查设计和心理测量理论，2）先进的卫生服务研究方法，3）先进的定性和混合方法，4）干预和预防科学，5）药物滥用，成瘾和无家可归。拟议的研究和培训计划将为Doran博士的职业生涯提供坚实的基础，作为一名独立资助的临床研究人员，致力于解决物质使用和无家可归的相互关联的问题。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

DOI：
10.1007/s10461-020-03126-3
发表时间：
2021-06
期刊：
AIDS AND BEHAVIOR
影响因子：
4.4
作者：
Gerber, Evan;Gelberg, Lillian;Cowan, Ethan;Mijanovich, Tod;Shelley, Donna;Gulati, Rajneesh;Wittman, Ian;Doran, Kelly M.
通讯作者：
Doran, Kelly M.

Opioid Overdose Protocols in the Emergency Department: Are We Asking the Right Questions?

急诊科的阿片类药物过量方案：我们是否提出了正确的问题？

DOI：
10.1016/j.annemergmed.2018.05.024
发表时间：
2018
期刊：
Annals of emergency medicine
影响因子：
6.2
作者：
Doran,KellyM;Raja,AliS;Samuels,ElizabethA
通讯作者：
Samuels,ElizabethA

Association of substance use characteristics and future homelessness among emergency department patients with drug use or unhealthy alcohol use: Results from a linked data longitudinal cohort analysis.

DOI：
10.1080/08897077.2022.2060445
发表时间：
2022
期刊：
SUBSTANCE ABUSE
影响因子：
3.5
作者：
Yoo, Ruth;Krawczyk, Noa;Johns, Eileen;McCormack, Ryan P.;Rotrosen, John;Mijanovich, Tod;Gelberg, Lillian;Doran, Kelly M.
通讯作者：
Doran, Kelly M.

Cross-sectional Analysis of Food Insecurity and Frequent Emergency Department Use.

DOI：
10.5811/westjem.2021.3.50981
发表时间：
2021-07-14
期刊：
The western journal of emergency medicine
影响因子：
0
作者：
Estrella A;Scheidell J;Khan M;Castelblanco D;Mijanovich T;Lee DC;Gelberg L;Doran KM
通讯作者：
Doran KM

Patient views on emergency department screening and interventions related to housing.