Supplement to HOME Trial: Role of Justice Involvement in Implementation and Effectiveness of Housing First for Youth Experiencing Homelessness

HOME 审判的补充：司法参与在无家可归青年住房优先的实施和有效性中的作用

• 批准号: 10731903
• 负责人: Kelly J Kelleher
• 金额: $ 16.92万
• 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: 2023-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10731903
• 关键词: Administrative Supplement; Adult; Advocate; Age; Attention; Award; Cause of Death; Collection; Communities; Consolidated Framework for Implementation Research; Criminal Justice; Data; Deposition; Development; Effectiveness; Equity; Exclusion; Fright; General Population; Health; Helping to End Addiction Long-term; Home; Homeless Youth; Homelessness; Housing; Impairment; Imprisonment; Incentives; Individual; Intervention; Interview; Jail; Justice; Legal; Legal system; Life; Literature; Marketing; Measurement; Measures; Mental Health; Methods; Monitor; Motivation; National Institute of Drug Abuse; Opioid; Outcome; Outcome Study; Overdose; Parents; Pharmaceutical Preparations; Phase; Population; Premature Mortality; Prevention program; Preventive; Preventive service; Prisons; Privatization; Problem behavior; Property; Randomized; Recording of previous events; Records; Reporting; Research; Resolution; Risk; Role; Schools; Secure; Security; Services; Stress; Suicide; Surveys; System; Testing; Time; U.S. Department of Housing and Urban Development; Violence; Vulnerable Populations; Youth; adolescent substance use; adverse outcome; alcohol use disorder; contextual factors; court; design; development policy; disorder risk; effective intervention; evidence base; experience; high risk; illicit drug use; implementation facilitators; implementation strategy; improved; insight; interest; medical specialties; meetings; mortality; opioid overdose; opioid use; opioid use disorder; parole; physical conditioning; prevent; prevention service; primary outcome; probation; programs; reduced substance use; secondary outcome; stakeholder perspectives; substance use; substance use prevention; tool; treatment arm; treatment effect; voucher

PROJECT SUMMARY While opioid use in the general population has received significant media and scholarly attention in recent years, very little research exists on opioid use among youth experiencing homelessness (YEH), despite nearly 70% of these youth meeting criteria for illicit drug or alcohol use disorders (SUD), and drug overdose and suicide being the leading causes of death. Our UG3/UH3 Heal Initiative study is the first to test whether a “housing first” (HF) intervention can reduce opioid use among YEH. Specifically, the ongoing UH3 phase of the “Housing, Opportu- nities, Motivation and Engagement” (HOME) study is randomizing 240 YEH ages 18-24 at high risk for opioid use disorder (OUD) to housing + opioid and related risk prevention services (n=120), or opioid and related risk prevention services alone (n=120). However, HF implementation is challenging on scale because justice system involvement often prevents or delays housing acquisition for YEH. In the increasingly tight housing market, land- lord barriers to housing YEH with criminal justice involvement (CJI) present numerous obstacles to the imple- mentation of HF (e.g., criminal background checks to screen out applicants with prior CJI, unwillingness to ap- prove applications or rent to individuals with a CJI record) and have delayed HF for youth with CJI. Consistent with NIDA's interest in supporting additional justice measures for existing awards (NOT-DA-23-011), we will capitalize on a unique opportunity to add a mixed-methods study focused on exploring the role of CJI in the HOME trial. Specifically, we will first collect new in-depth qualitative interview data from key stakeholders (land- lords, advocates, and YEH) to explore the contextual determinants (i.e., barriers and facilitators) related to the implementation of HF for YEH with CJI. This new data will provide first insights, including how specific types of CJI (e.g., number of incidents and types including incarceration, probation, warrants) influence HF participation and housing decisions, why landlords did and did not rent to YEH with CJI, and what various incentives and methods (e.g., increased deposits, rental vouchers, damage protection) could overcome the barriers to imple- menting HF with YEH with CJI. Next, we will complete supplemental quantitative analyses of new variables related to prior CJI and delayed time to housing acquisition to test the effect of CJI on main study outcomes. Our central hypotheses, based on prior literature among HF programs for adults, are that the HF intervention will have differential effects for YEH with and without CJI and that housing delays may worsen outcomes. Our results will contribute to a better understanding of barriers and facilitators of HF implementation for YEH with CJI, as well as the effects of CJI on outcomes of HF interventions among YEH. Our results will have significant impact on reducing opioid use and OUD and preventing loss of life, given the burden of OUD and high risk for opioid overdose in this population and their heightened risk for experiencing longer periods of homelessness.

项目摘要 虽然近年来普通人群中类阿片的使用受到了媒体和学术界的极大关注， 关于无家可归青年（YEH）中阿片类药物使用的研究很少，尽管近70%的人 这些青少年符合非法药物或酒精使用障碍（SUD）的标准，药物过量和自杀是 死亡的主要原因我们的UG 3/UH 3 Heal Initiative研究首次测试了“住房优先”（HF） 干预可以减少YEH中阿片类药物的使用。具体而言，正在进行的UH 3阶段的“住房，机会， 一项名为“家庭、动机和参与”的研究随机抽取了240名年龄在18-24岁之间的阿片类药物高危人群 使用障碍（OUD）到住房+阿片类药物和相关风险预防服务（n=120），或阿片类药物和相关风险 仅预防服务（n=120）。然而，HF的实施在规模上具有挑战性，因为司法系统 参与往往妨碍或拖延YEH获得住房。在日益紧张的房地产市场，土地- 主障碍住房YEH与刑事司法参与（CJI）提出了许多障碍，以实现- HF的分段（例如，刑事背景调查，以筛选出申请人与先前的CJI，不愿意ap- 证明申请或出租给有CJI记录的个人），并推迟了患有CJI的青少年的HF。一致 随着NIDA对支持现有裁决的额外司法措施（NOT-DA-23-011）的兴趣，我们 将利用一个独特的机会，增加一个混合方法的研究，重点是探索CJI在 家庭审判。具体而言，我们将首先从主要利益相关者（土地- 领主，倡导者和YEH）来探索上下文决定因素（即，障碍和促进因素）的问题 与CJI一起为YEH实施HF。这些新数据将提供第一批见解，包括特定类型的 CJI（例如，事件数量和类型（包括监禁、缓刑、逮捕令）影响HF参与 和住房决策，为什么房东没有和CJI一起租给YEH，以及有什么样的激励措施和 方法（例如，增加押金、租赁凭证、损害保护）可以克服实施的障碍， 将HF与YEH和CJI一起分割。接下来，我们将完成新变量的补充定量分析 与之前的CJI和延迟的住房收购时间相关，以测试CJI对主要研究结果的影响。我们 基于成人HF项目的先前文献，中心假设是HF干预将 有差异的影响，YEH与和没有CJI和住房延迟可能会恶化的结果。我们的结果 将有助于更好地了解与CJI一起为YEH实施HF的障碍和促进因素， 以及CJI对YEH患者HF干预结果的影响。我们的结果将产生重大影响 减少阿片类药物使用和OUD并防止生命损失，因为OUD负担和阿片类药物高风险 这一人群中的吸毒过量和他们经历更长时间无家可归的风险增加。

项目成果

Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative.

预防参与法律系统的青少年中阿片类药物的使用和紊乱：由 NIDA HEAL 倡议资助的四项研究的创新和实施。

• DOI: 10.1007/s11121-023-01566-6
• 发表时间: 2023
• 期刊: Prevention science : the official journal of the Society for Prevention Research
• 作者: Ahrens,Kym;Blackburn,Natalie;Aalsma,Matthew;Haggerty,Kevin;Kelleher,Kelly;Knight,DanicaK;Joseph,Elizabeth;Mulford,Carrie;Ryle,Ted;Tolou-Shams,Marina
• 通讯作者: Tolou-Shams,Marina

Housing First Combined with Suicide Treatment Education and Prevention (HOME + STEP): study protocol for a randomized controlled trial.

• DOI: 10.1186/s12889-021-11133-9
• 发表时间: 2021-06-12
• 期刊: BMC public health
• 影响因子: 4.5
• 作者: Chavez L;Kelleher K;Bunger A;Brackenoff B;Famelia R;Ford J;Feng X;Mallory A;Martin J;Sheftall A;Walsh L;Yilmazer T;Slesnick N
• 通讯作者: Slesnick N

Lessons learned from housing first, rapid rehousing trials with youth experiencing homelessness.

• DOI: 10.1186/s13722-023-00413-x
• 发表时间: 2023-09-30
• 期刊: ADDICTION SCIENCE & CLINICAL PRACTICE
• 影响因子: 3.7
• 作者: Slesnick, Natasha;Brakenhoff, Brittany;Bunger, Alicia;Chavez, Laura;Cuthbertson, Caleb;Famelia, Ruri;Feng, Xin;Fitzpatrick, Maggie;Ford, Jodi;Hatsu, Irene;Holowacz, Eugene;Jaderlund, Soren;Kelleher, Kelly;Luthy, Ellison;Mallory, Allen;Martin, Jared;Pizzulo, Alexis;Stone-Sabali, Steven;Yilmazer, Tansel;Wu, Qiong;Zhang, Jing
• 通讯作者: Zhang, Jing

Housing, opportunities, motivation and engagement (HOME) for homeless youth at-risk for opioid use disorder: study protocol for a randomized controlled trial.

• DOI: 10.1186/s13722-021-00237-7
• 发表时间: 2021-05-12
• 期刊: Addiction science & clinical practice
• 影响因子: 3.7
• 作者: Slesnick N;Chavez L;Bunger A;Famelia R;Ford J;Feng X;Higgins S;Holowacz E;Jaderlund S;Luthy E;Mallory A;Martin J;Walsh L;Yilmazer T;Kelleher K
• 通讯作者: Kelleher K

Application of the ecobiodevelopmental model for research among youth experiencing homelessness.

• DOI: 10.1111/phn.13183
• 发表时间: 2023-07
• 期刊: PUBLIC HEALTH NURSING
• 影响因子: 2.1
• 作者: Fitzpatrick, Margaret;Ford, Jodi L. L.;Slesnick, Natasha
• 通讯作者: Slesnick, Natasha