Homeless Persons' Use of Addiction Treatment Services

描述（由申请人提供）：Stefan G. Kertesz，医学博士是一名普通内科学术医师，拥有五年照顾吸毒和酗酒的无家可归者的临床经验，以及药物滥用研究培训经验。作为他的K23职业发展奖的一部分，他将寻求确定与吸毒和/或酗酒的无家可归者成瘾治疗利用和成瘾结果相关的因素（目标1）。考虑到无家可归人口的异质性，特别是无家可归的持续时间可能从几个晚上到多年不等的方式，拟议的研究还试图确定与成瘾治疗利用相关的因素是否根据无家可归的持续性而有所不同（目标2）。该研究计划将使用两个现有的数据集来实现这些目标。在第一部分，数据从1996年全国调查无家可归者援助提供者和客户将允许评估的因素与治疗利用率在全国代表性的横断面调查无家可归者。在第2部分中，数据从一个完整的2年前瞻性随访研究的470无家可归者和居住的人成瘾的药物和/或酒精将允许评估的因素与持续的治疗利用，并评估治疗利用和成瘾的结果之间的关系。治疗本身的价值已在临床试验中得到证实。这项拟议研究的重要性在于它有可能帮助决策者和治疗规划者了解如何改善吸毒和/或酗酒的无家可归者的实际治疗机会和治疗利用。 该职业发展奖的职业发展活动包括研究本身，由在成瘾和无家可归方面具有丰富研究经验的个人指导，以及开发与使用大型复杂数据集相关的方法专业知识的课程，成瘾，成瘾治疗理论，住房政策和无家可归者社会学领域的内容专业知识，以及研究伦理。拟议工作的完成将使Kertesz博士能够独立调查无家可归者滥用药物和酒精的治疗。

DESCRIPTION (provided by applicant): Stefan G. Kertesz, M.D. is an academic physician in general internal medicine with five years of clinical experience caring for homeless persons addicted to drugs and alcohol, and drug abuse research training experience. As part of his K23 career development award, he will seek to identify factors associated with addiction treatment utilization and addiction outcomes among homeless persons who abuse drugs and/or alcohol (Aim 1). Given the heterogeneity of the homeless population, in particular the ways in which the duration of homelessness can vary from a few nights to many years, the proposed research also seeks to determine whether factors associated with addiction treatment utilization differ according to the persistence of homelessness (Aim 2). The research program will use two existing datasets to address these aims. In Part 1, data from the 1996 National Survey of Homeless Assistance Providers and Clients will permit evaluation of factors associated with treatment utilization in a nationally representative cross-sectional survey of homeless persons. In Part 2, data from a completed 2-year prospective follow-up study of 470 homeless and housed persons addicted to drugs and/or alcohol will permit evaluation of factors associated with sustained treatment utilization, and evaluation of the relationship between treatment utilization and addiction outcomes. The value of treatment itself has been documented in the context of clinical trials. The importance of this proposed research lies in its potential to assist policymakers and treatment planners who wish to understand how to improve actual treatment access and treatment utilization by homeless persons who are addicted to drugs and/or alcohol. Career development activities for this career development award include the research itself, mentoring by individuals with extensive research experience in addiction and homelessness, and coursework to develop methodological expertise pertinent to the use of large and complex datasets, content expertise in the areas of addiction, addiction treatment theory, housing policy and homeless sociology, and research ethics. Completion of the proposed work will prepare Dr. Kertesz to independently investigate the treatment of drug and alcohol abuse in the homeless.