A randomized trial of urban vacant lot stabilization and substance abuse outcomes

描述(由申请人提供)：环境决定因素与药物滥用行为、成瘾程度、过量用药风险、危险行为以及整体心理和身体健康有关。对邻里环境对健康和药物滥用行为的贡献的日益加深的理解，创造了一个独特的机会，可以开发基于地点的预防策略的创新随机试验。这项研究的重点是稳定废弃的空地，作为一种潜在的预防公共药物滥用的策略。研究小组的初步研究表明，空地稳定计划减少了犯罪，并提高了精选的健康结果。空地的稳定很重要，因为空地非常丰富，社区成员特别指出空地很重要，而且是高度可改变的社区一级因素，有可能以相对较低的成本获得持续、长期的健康和安全益处。1999年，宾夕法尼亚州园艺协会开始了一项计划，以稳定和维护费城主要社区的空地。这项计划包括清理和绿化废弃的空地，清除杂物，对土地进行评级，种植草和树，以创造一个公园般的环境，并在其周围安装低矮的栅栏，以表明该地块得到了照顾，并阻止非法倾倒。这项研究将测试这样的计划对公共物质使用和相关行为的影响。在费城四个地理区段分层的420个空地的随机分配将在三个试验阶段进行：空地稳定(完全处理)、仅清理垃圾(垃圾控制)和不进行空地稳定或清理(不处理)。药物滥用和相关的健康和安全结果将在治疗前和治疗后的几年内进行评估。通过这一点，我们打算实现以下拟议的具体目标：(1)确定与只接受垃圾清理的空地和随机选择不接受任何垃圾的空地相比，随机选择的空地的稳定是否改变了非法贩毒和消费的公开发生；(2)确定与随机选择只接受垃圾清理的空地和随机选择不接受任何垃圾的空地相比，随机选择的空地的稳定是否改变了非法醉酒和饮酒的公开发生；(3)根据每次非法贩毒和消费以及避免非法公开酗酒和饮酒的空地稳定成本，确定空地稳定的增量成本效益估计。

DESCRIPTION (provided by applicant): Environmental determinants have been implicated in substance abuse behaviors, levels of addiction, risk of overdose, risky behaviors, and overall mental and physical health. An emerging understanding of the contribution of neighborhood environment to health and substance abuse behaviors has created a unique opportunity to develop an innovative randomized trial of a place-based prevention strategy. This study focuses on the stabilization of abandoned, vacant lots as a potential prevention strategy for public substance abuse. A preliminary study by the research team showed that the vacant lot stabilization program reduced crime and enhanced select health outcomes. The stabilization of vacant lots is important because they are in great abundance, singled out by community members as important, and are highly modifiable, community-level factors with potential for sustained, long-term health and safety benefits at relatively little cost. In 1999, the Pennsylvania Horticultural Society began a program to stabilize and maintain vacant lots in key Philadelphia neighborhoods. This program involves "cleaning and greening" abandoned vacant lots by removing debris, grading the land, planting grass and trees to create a park-like setting, and installing low fences around its perimeter to show that the lot is cared for and to deter illegal dumping. This study will test the impact of such a program on public substance use and related behaviors. The random assignment of 420 vacant lots stratified in four geographic sections of Philadelphia will be done in three trial arms: vacant lot stabilization (full treatment), trash clean-up only (trash control), and no vacant lot stabilization or clean-up (no treatment). Substance abuse and related health and safety outcomes on or near the lots will be measured in the years before and after treatment. Through this we intend to accomplish the following proposed specific aims: (1) To determine if the stabilization of randomly chosen vacant lots changes the public occurrence of illegal drug trafficking and consumption compared with vacant lots that have been randomly chosen to receive only trash clean-up and lots that have been randomly chosen to receive nothing; (2) To determine if the stabilization of randomly chosen vacant lots changes the public occurrence of illegal drunkenness and drinking compared with vacant lots that have been randomly chosen to receive only trash clean-up and lots that have been randomly chosen to receive nothing; (3) To determine incremental cost-effectiveness estimates of vacant lot stabilization in terms of the cost of vacant lot stabilization per instances of illegal drug trafficking and consumption and illegal public drunkenness and drinking avoided.