Homeless Persons' Use of Addiction Treatment Services

描述(申请人提供)：Stefan G.Kertesz，医学博士，普通内科学术内科医生，有五年护理流浪者药物和酒精成瘾的临床经验，以及药物滥用研究培训经验。作为其K23职业发展奖的一部分，他将寻求确定与滥用药物和/或酒精的无家可归者的成瘾治疗利用和成瘾结果有关的因素(目标1)。鉴于无家可归人口的异质性，特别是无家可归的时间从几个晚上到许多年不等，拟议的研究还试图确定与利用成瘾治疗有关的因素是否因无家可归的持续时间不同而不同(目标2)。该研究计划将使用两个现有的数据集来解决这些目标。在第一部分中，1996年全国无家可归者援助提供者和服务对象调查的数据将使我们能够在一项具有全国代表性的无家可归者横断面调查中评估与治疗利用有关的因素。在第二部分，对470名吸毒和/或酗酒的无家可归者和住宿者进行的为期两年的前瞻性跟踪研究的数据将使我们能够评估与持续使用治疗有关的因素，以及评估治疗使用和成瘾结果之间的关系。治疗本身的价值已经在临床试验的背景下得到了证明。这项拟议研究的重要性在于它有可能帮助政策制定者和治疗规划者，他们希望了解如何改善吸毒和/或酗酒成瘾的无家可归者获得和利用治疗的实际情况。 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问题上具有丰富研究经验的个人进行指导，以及为发展与使用大型和复杂的数据集有关的方法专长、成瘾治疗理论、住房政策和无家可归者社会学以及研究伦理领域的内容专长而进行的课程工作。拟议中的工作完成后，克尔特兹将为独立调查无家可归者滥用药物和酗酒的治疗做好准备。

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.