Homeless Persons' Use of Addiction Treatment Services

简介（由申请人提供）：Stefan G. Kertesz，医学博士，普通内科学术医师，有五年的临床经验，照顾吸毒和酗酒的无家可归者，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，他将设法确定与滥用药物和/或酒精的无家可归者的成瘾治疗利用和成瘾结果相关的因素（目标1）。鉴于无家可归人口的异质性，特别是无家可归的持续时间从几个晚上到多年不等，拟议的研究还试图确定与成瘾治疗利用相关的因素是否会根据无家可归的持续时间而有所不同（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。在第一部分中，来自1996年全国无家可归者援助提供者和客户调查的数据将允许在全国代表性的无家可归者横断面调查中评估与治疗利用相关的因素。在第2部分中，对470名吸毒和/或酗酒的无家可归者和收容者进行了为期2年的前瞻性随访研究，数据将允许评估与持续治疗利用相关的因素，以及评估治疗利用与成瘾结果之间的关系。治疗本身的价值已在临床试验的背景下被证明。这项拟议研究的重要性在于，它有可能帮助决策者和治疗计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。

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.