COST EFFECTIVE TREATMENT FOR DUALLY DIAGNOSED HOMELESS

描述：（申请人摘要） 无家可归者滥用药物与多种健康风险有关 并对提供服务的机构提出了严峻的挑战。提出 对这一弱势群体的研究是基于两个以前的随机 对照研究显示，创新的行为日治疗（BDT+） 在社区环境中与不同的比较组的有效性。的 第二，显示了节制特遣队住房和工作的优越性 与单独的BDT相比，同时控制 治疗效果。本研究确定BDT+是否用于双重诊断， 无家可归的药物滥用者可以被成功地转移到一个新的地点。它 为新员工制定培训材料和方法，以在 德克萨斯大学休斯顿恢复校区。预期产品为：治疗 手册、35毫米幻灯片、录像带等，和简短的观察量表来评估 每个传输的BDT+组件的保真度。客观标准和方法 确保BDT+组件已按照规定的精确度实施。 通过2组随机对照比较研究了实施情况， 常规护理从符合先前研究标准的人群中，各100例 将被分配到BDT+或现有的滨江综合医院日 治疗（RGHDT）对照。基线、1、2、6和12个月使用时的评估 原始研究中使用的工具和措施。结果包括酒精 吸毒、无家可归、就业和艾滋病毒/艾滋病风险行为，以及 成本效益分析。成功的实施最终取决于 假设BDT+的上级结局。如果BDT+可以复制，产品 和方法将允许传送到其它设置。结果将提供 重要的知识和技术，以传输复杂的心理社会 治疗以及如何最有效地治疗这些功能失调的人群， 具有重要的临床、经济、公共卫生和公众 住房政策的影响。

DESCRIPTION: (Applicant's Abstract) Substance abuse in homeless persons is associated with multiple health risks and presents daunting challenges to agencies providing services. Proposed research with this vulnerable population is based on two previous randomized controlled studies showing an innovative behavioral day treatment's (BDT+) effectiveness in a community setting with different comparison groups. The second demonstrated superiority of abstinent contingent housing and work compared to BDT alone, while controlling for alternative explanations of treatment effectiveness. This study determines if BDT+ for dually diagnosed, homeless substance abusers can be successfully transported to a new site. It develops training materials and methods for new staff to implement BDT at the University of Texas, Houston Recovery Campus. Expected products are: treatment manual, 35mm slides, video tapes etc., and brief observation scales to assess fidelity of each transported BDT+ component. Objective criteria and methods assure BDT+ components have been implemented with measured specified fidelity. Implementation is studied via a 2 group randomized control comparison with usual care. From a population meeting criteria from previous studies, 100 each will be assigned to either BDT+ or an existing Riverside General Hospital Day Treatment (RGHDT) control. Assessments at baseline, 1, 2, 6 and 12 months use instruments and measures employed in original studies. Outcomes include alcohol and drug abuse, homelessness, employment and HIV/A1DS risk behaviors, and a cost effectiveness analysis. Successful implementation is ultimately defined by hypothesized, superior outcomes for BDT+. If BDT+ can be replicated, products and methods would permit transport to other settings. Results will provide important knowledge and technology for transporting complex psychosocial treatment and how to most effectively treat this dysfunctional population, knowledge which has important clinical, economic, public health and public housing policy implications.