Testing longitudinal models of substance abuse recovery mechanisms among homeless

描述（由申请人提供）：物质使用障碍是无家可归者普遍存在的健康问题。在这一人群中，药物使用障碍不仅造成心理痛苦和严重的公共卫生负担，还对无家可归者的康复造成额外障碍。一些研究表明，发展更健康的社交网络可能是无家可归者从药物滥用中长期康复和更广泛的功能成果的基础。然而，评估社会网络变化的中介作用需要收集纵向数据，这是非常困难的人口。在新英格兰最大的无家可归者日间服务提供者圣弗朗西斯之家的私人资助下，成瘾问题司朝着克服无家可归问题纵向研究的常见障碍迈出了重要的一步。更具体地说，该司已开发和实施新的计算机软件，以便在SFH客人使用各种SFH计划和服务时收集有关SFH客人的纵向数据。然而，私人资金仅限于技术开发，不支持研究活动，SFH工作人员缺乏进行复杂研究项目的科学培训和经验。因此，我们寻求成瘾研究（SOAR）的支持机会，使用新的计算机软件进行系统的程序评估，并测试一个模型，该模型指定了该人群中潜在的社会网络变化机制。我们将通过对无家可归的成年人进行药物滥用康复机制的纵向研究来实现这些具体目标。我们将使用结构方程模型来测试社会网络质量和结构变化在产生功能改进中的中介作用。这项研究将利用大约144名旧金山酒店客人在六个月的数据收集期内的数据。研究结果不仅具有理论意义，而且具有超越SFH的实际意义。 公共卫生相关性：在美国无家可归的人中，滥用药物的人比例过高。除了造成心理痛苦和巨大的公共卫生负担外，药物使用障碍还对无家可归者的自我维持造成障碍。拟议的研究将寻求揭示无家可归者从药物滥用中长期康复的机制。

DESCRIPTION (provided by applicant): Substance use disorders are a pervasive health problem for homeless persons. Among this population, substance use disorders not only create psychological suffering and a serious public health burden; they also create additional barriers to recovery from homelessness. Some research indicates that the development of healthier social networks might underlie homeless persons' long-term recovery from substance abuse and broader functional outcomes. However, evaluating the mediational role of social network changes requires the collection of longitudinal data, which is extremely difficult with this population. With private funding from St. Francis House (SFH), the largest day-service provider for homeless individuals in New England, the Division on Addictions has taken an important step toward overcoming common obstacles to longitudinal research on homelessness. More specifically, the Division has created and implemented new computer software that enables the collection of longitudinal data on SFH guests as they access a wide range of SFH programs and services. However, private funding is limited to technology development and does not support research activities, and SFH staff lack the scientific training and experience to conduct sophisticated research projects. Therefore, we seek Support Opportunity for Addiction Research (SOAR) support to use the new computer software to conduct a systematic program evaluation and to test a model specifying potential social network mechanisms of change among this population. We will accomplish these Specific Aims by conducting a longitudinal study of substance abuse recovery mechanisms among homeless adults. We will use structural equation modeling to test the mediating role of changes in social network quality and structure in producing functional improvements. The study will draw upon data from approximately 144 SFH guests over a data- collection period of six months. Results will have theoretical implications as well as practical significance beyond SFH. PUBLIC HEALTH RELEVANCE: People with substance abuse are overrepresented among those who experience homelessness in the United States. Beyond creating psychological suffering and a substantial public health burden, substance use disorders create barriers to homeless persons' self-sustainability. The proposed research will seek to uncover mechanisms that underlie homeless persons' long-term recovery from substance abuse.