Testing longitudinal models of substance abuse recovery mechanisms among homeless

描述（由申请人提供）：物质使用障碍是无家可归者普遍存在的健康问题。在这一人群中，药物使用障碍不仅造成心理痛苦和严重的公共卫生负担；它们还为从无家可归中恢复带来了额外的障碍。一些研究表明，更健康的社会网络的发展可能是无家可归者从药物滥用和更广泛的功能结果中长期恢复的基础。然而，评估社会网络变化的中介作用需要收集纵向数据，这在这个人群中是非常困难的。在新英格兰最大的无家可归者日间服务提供者圣弗朗西斯之家（SFH）的私人资助下，成瘾司在克服对无家可归者进行纵向研究的常见障碍方面迈出了重要的一步。更具体地说，该部门已开发和实施了新的电脑软件，以便收集SFH客人在使用各种SFH计划和服务时的纵向数据。然而，私人资助仅限于科技发展，并不支持研究活动，而食物及卫生局的工作人员缺乏进行复杂研究项目的科学训练和经验。因此，我们寻求成瘾研究的支持机会（SOAR）支持，使用新的计算机软件进行系统的程序评估，并测试一个模型，该模型指定了该人群中潜在的社会网络变化机制。我们将通过在无家可归的成年人中进行药物滥用恢复机制的纵向研究来实现这些具体目标。我们将使用结构方程模型来检验社会网络质量和结构的变化在产生功能改进中的中介作用。这项研究将在六个月的时间内收集约144名SFH客人的数据。研究结果不仅具有实际意义，而且具有理论意义。

DESCRIPTION (provided by applicant): Substance use disorders are a pervasive health problem for homeless persons. Among this population, substance use disorders not only create psychological suffering and a serious public health burden; they also create additional barriers to recovery from homelessness. Some research indicates that the development of healthier social networks might underlie homeless persons' long-term recovery from substance abuse and broader functional outcomes. However, evaluating the mediational role of social network changes requires the collection of longitudinal data, which is extremely difficult with this population. With private funding from St. Francis House (SFH), the largest day-service provider for homeless individuals in New England, the Division on Addictions has taken an important step toward overcoming common obstacles to longitudinal research on homelessness. More specifically, the Division has created and implemented new computer software that enables the collection of longitudinal data on SFH guests as they access a wide range of SFH programs and services. However, private funding is limited to technology development and does not support research activities, and SFH staff lack the scientific training and experience to conduct sophisticated research projects. Therefore, we seek Support Opportunity for Addiction Research (SOAR) support to use the new computer software to conduct a systematic program evaluation and to test a model specifying potential social network mechanisms of change among this population. We will accomplish these Specific Aims by conducting a longitudinal study of substance abuse recovery mechanisms among homeless adults. We will use structural equation modeling to test the mediating role of changes in social network quality and structure in producing functional improvements. The study will draw upon data from approximately 144 SFH guests over a data- collection period of six months. Results will have theoretical implications as well as practical significance beyond SFH. PUBLIC HEALTH RELEVANCE: People with substance abuse are overrepresented among those who experience homelessness in the United States. Beyond creating psychological suffering and a substantial public health burden, substance use disorders create barriers to homeless persons' self-sustainability. The proposed research will seek to uncover mechanisms that underlie homeless persons' long-term recovery from substance abuse.