Evaluating Impact of a Resource Center for Drug Users

描述(由申请人提供)：这项研究将评估旧金山为无家可归者和边缘收容所吸毒者建立的创新综合资源中心的影响。无家可归和居住在边缘的吸毒者面临严重的身心健康问题的高风险，由于他们与世隔绝、没有保险和服务不足，这些问题会加剧。鉴于卫生保健利用面临无数障碍，新的和创新的干预措施试图减轻这些障碍及其对健康的影响，这对公共卫生议程至关重要。同样重要的是，这些创新的干预措施必须经过严格的科学评估。在过去的十年里，出现了为吸毒者服务的综合资源中心，它们在一个屋檐下提供各种服务。教会邻里资源中心(MNRC)将于2002年5月开业，将整合初级保健、精神保健、药物滥用咨询、牙科保健、职业培训、住房宣传、同伴咨询和基本个人服务(包括淋浴、储物柜、语音信箱和储物)。这项研究的目的是(1)评估MNRC参与者是否比对照组更有可能减少他们的艾滋病毒危险行为，(2)评估MNRC参与者是否比对照组更有可能获得药物治疗，(3)评估MNRC参与者是否比对照组更有可能报告身心健康质量提高，以及(4)评估MNRC参与者是否比对照组更有可能增加初级卫生保健的利用率和减少急诊室的使用。为了实现这些目标，将招募由80名注射吸毒者和强效可卡因吸烟者组成的6个系列队列，并对其进行为期6个月的跟踪调查(n=480)。每个队列将由40名MNRC干预参与者和40名来自附近社区的对照对象组成。我们将通过检查MNRC客户是否比对照组的客户更有可能报告艾滋病毒危险行为、身心健康和初级卫生保健利用的变化来调查具体目标1、3和4。我们将通过比较MNRC患者和对照组患者进入药物治疗的情况来调查特定目标2。还将与客户(N=30)和工作人员(N=6)进行定性访谈，以更深入地了解MNRC的影响。

DESCRIPTION (provided by applicant): This study will evaluate the impact of an innovative integrated resource center for homeless and marginally housed drug users in San Francisco. Homeless and marginally housed drug users are at high risk for severe physical and mental health problems that are exacerbated because they are isolated, uninsured, and underserved. In light of the myriad of barriers to health care utilization, it is critical to the public health agenda that new and innovative interventions attempt to alleviate these barriers and their health consequences. It is equally critical that these innovative interventions undergo rigorous scientific evaluation. The past decade has seen the emergence of integrated resource centers serving drug users, which provide a variety of services under one roof. The Mission Neighborhood Resource Center (MNRC) is opening in May, 2002, and will integrate primary care, mental health care, substance abuse counseling, dental care, vocational training, housing advocacy, peer counseling, and basic personal services (including showers, lockers, voicemail, and storage). The aims of this study are (1) to assess whether MNRC participants are more likely than those in a comparison group to reduce their HIV risk behaviors, (2) to assess whether MNRC participants are more likely than those in a comparison group to access drug treatment, (3) to assess whether MNRC participants are more likely than those in a comparison group to report an increase in quality of physical and mental health, and (4) to assess whether MNRC participants are more likely than those in a comparison group to increase utilization of primary health care and reduce emergency room utilization. To accomplish these aims, six serial cohorts of 80 injection drug users (IDUs) and crack cocaine smokers (CCSs) will be recruited and followed for six months (n=480). Each cohort will consist of 40 MNRC intervention participants and 40 comparison subjects from a nearby neighborhood. We will investigate Specific Aims 1, 3 and 4 by examining if MNRC clients are more likely than those in the comparison group to report changes in HIV risk behavior, physical and mental health, and primary health care utilization. We will investigate Specific Aim 2 by comparing entry to drug treatment among MNRC clients to the comparison group. Qualitative interviews will also be conducted with clients (N=30) and staff (N=6), to gain a richer contextual understanding of the impacts of the MNRC.