Building Social and Structural Connections for the Prevention of OUD among Youth Experiencing Homelessness: An RCT Examining Biopsychosocial Mechanisms

建立社会和结构联系以预防无家可归青年中的 OUD：一项检验生物心理社会机制的随机对照试验

• 批准号: 10775030
• 负责人: Jodi Ford
• 金额: $ 144.62万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10775030
• 关键词: Accident and Emergency department; Address; Adolescence; Adult; Advocacy; Advocate; Affect; Age; Automobile Driving; Biological; Child Abuse; Child Abuse and Neglect; Communities; Complex; Cost Effectiveness Analysis; Country; Diagnosis; Discrimination; Disease; Drops; Drug usage; Education; Effectiveness of Interventions; Emotional; Employment; Ethnic Origin; Exposure to; Face; Forcible intercourse; Goals; Health; Health Services Accessibility; Home; Homelessness; Hormones; Hospitals; Housing; Hydrocortisone; Income; Individual; Inflammation; Inflammatory; Intervention; Mediation; Mental Depression; Mental Health; Mental disorders; Motivation; Opioid; Outcome; Overdose; Pain; Pathway interactions; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population; Prevention; Process; Psychological reinforcement; Public Health; Race; Randomized; Recording of previous events; Reporting; Research; Risk; Safety; Self Efficacy; Sexual and Gender Minorities; Social Environment; Social Work; Social isolation; Social support; Stress; Subgroup; Substance Use Disorder; System; Testing; Trauma; Victimization; Youth; adverse childhood events; aged; assault; biopsychosocial; biopsychosocial factor; child neglect; comorbidity; comparison intervention; coping; cost; cost effectiveness; cost estimate; design; disorder prevention; experience; food security; future implementation; help-seeking behavior; human capital; hypothalamic-pituitary-adrenal axis; implementation efforts; improved; innovation; marginalization; motivational enhancement therapy; multiple drug use; opioid epidemic; opioid misuse; opioid use; opioid use disorder; outreach; pragmatic intervention; prevent; preventive intervention; psychosocial resources; resilience; response; service intervention; services as usual; sex; skills; social; social health determinants; societal costs; sociodemographics; substance misuse; substance use; substance use prevention; suicidal behavior; suicidal morbidity

Project Summary/Abstract Homelessness severely affects health and well-being and is particularly negative for youth. Between 70-95% of youth experiencing homelessness (YEH) report problem substance use and 66-89% have a mental health disorder. Youth appear to be at greater risk for living on the streets or being homeless than adults and are more vulnerable to long term consequences of homelessness. Multiple social determinants of health (SDOH) are uniquely associated with homelessness, driving substance use and adverse mental health consequences. However, limited research has identified pragmatic interventions that have a long-term ameliorating impact on the complex, multi-symptomatic issues among these youth. This study overcomes prior gaps in research through testing a multi-component comprehensive prevention intervention targeting SDOH that may affect biopsychosocial health indicators and longer-term health outcomes. In partnership with Star House, a drop-in center for YEH, youth between the ages of 14 to 24 years, will be engaged and randomly assigned to conditions using a dismantling design so that essential intervention components can be efficiently identified. In particular, youth (N = 300) will be randomly assigned to a) Motivational Interviewing/Community Reinforcement Approach + Services as Usual (MI/CRA + SAU, n = 80), b) Strengths-Based Outreach and Advocacy + SAU (SBOA + SAU, n = 80), c) MI/CRA + SBOA + SAU (n = 80) or d) SAU (n=60) through the drop-in center. In order to assess the longer-term prevention effects on substance use, mental health and other outcomes, all youth will be assessed at baseline and at 3, 6, 12, 18 and 24-months post-baseline. The primary goal of this study is to establish the impact of a comprehensive intervention embedded within a system that serves YEH, a community drop-in center, on youth’s opioid misuse and disorder, other substance misuse and disorders, mental health diagnoses, and other targeted outcomes. This study will offer unique information on pathways underlying change for specific subgroups of youth along with cost estimates to inform future implementation efforts in drop-in centers around the country.

项目总结/文摘