Enhancing Housing First Programs with a Social Network Substance Use intervention

描述（由申请人提供）：我们提议进行一项为期3年的研究，为洛杉矶Skid Row地区永久支持性住房计划的居民开发和试点测试社会网络物质使用和艾滋病毒风险干预。该干预措施将为贫民窟住房信托基金（SRHT）的居民开发，该信托基金是洛杉矶最大的住房优先供应商之一。作为居住条件的要求，住房优先计划的居民不需要戒酒和吸毒。有一些证据表明，迅速向长期无家可归者提供住房——以及支持——有助于在短期内减少药物使用和艾滋病毒风险行为，因为无家可归是高风险行为的主要原因。然而，迄今为止的证据是有限的。有一个方面没有得到太多的研究关注，那就是住房优先计划的居民在从无家可归者过渡到住房优先计划的住所时，需要支持他们的社会网络。新居民暴露在广泛的潜在负面社会影响中，同时也有更大的可能与失去的积极关系重新建立联系。本项目将对SRHT居民进行社会网络干预，以增加他们对社会网络的了解，并增强他们做出必要改变的动机，以提高他们减少或继续避免高风险行为的能力。干预会议将加强SRHT个案工作者在新住院医师前6个月与他们进行的每周支持会议。个案工作者将接受培训，使用动机性访谈风格进行30分钟的干预。将开发干预，以便病例管理人员可以在电子平板设备的帮助下提供干预。平板电脑将引导他们收集有关居民社交网络的信息，然后显示几个图表，突出了居民网络的各个方面。然后，他们将使用动机访谈技术来指导居民思考他们的网络目前是如何运作的，他们希望它如何运作，以及他们可以采取哪些步骤来做出必要的改变，以实现与减少药物使用和性风险行为相关的目标。干预措施将由病例管理人员分四次提供（基线和两周间隔）。我们预计，参与这项干预的居民将在他们与社会网络的互动中制定新的策略

DESCRIPTION (provided by applicant): We propose a 3-year study to develop and pilot test a social network substance use and HIV-risk intervention for permanent supportive housing program residents in the Skid Row area of Los Angeles. The intervention will be developed for residents at the Skid Row Housing Trust (SRHT), one of the largest Housing First providers in Los Angeles. Housing First residents are not required to abstain from alcohol and drugs as a requirement of their residency. There is some evidence that providing housing rapidly to chronically homeless persons--along with support--helps to reduce substance use and HIV risk behaviors in the short term because homelessness is the primary cause of high-risk behavior. However, the evidence thus far is limited. One aspect that has not received much research attention is the needs of Housing First residents for support to transition their social networks while transitioning out of homeless into residency in a Housing First program. New residents are exposed to a wide range of potentially negative social influences while also having greater potential to reconnect with lost positive ties. This project will develop a social network intervention to residents of SRHT in order to increase their knowledge about their social networks and enhance their motivation to make necessary changes to improve their ability to reduce or continue to abstain from high-risk behavior. The intervention sessions will enhance the weekly support meetings that SRHT case workers already conduct with new residents during their first 6 months of residency. Case workers will be trained to deliver the 30-minute intervention sessions using a motivational interviewing style. The intervention will be developed so that case managers can deliver it with the aid of an electronic tablet device. The tablet will guide them in collecting information about the residents' social networks and then display several diagrams highlighting various aspects of the residents' networks. They will then use motivational interviewing techniques to guide residents to think about how their network currently functions, how they would like it to function, and what steps they can take to make changes necessary to achieve goals related to reducing their substance use and sexual risk behaviors. The intervention will be delivered by case managers across four sessions (at baseline and at two-week intervals). We anticipate that residents who participate in this intervention will develop new strategies in their interactions with their social networks that will facilitate a reduction in their high-risk behavior.