Substance use treatment needs, characteristics, and outcomes among emerging adults experiencing homelessness: A mixed-methods study

项目摘要/摘要 在美国，据估计，每30名青少年中就有1人和每10名年轻人中有1人经历过 在过去的一年里无家可归的人。总体而言，经历无家可归的年轻人(是的)是一个非常脆弱的群体 面临多重负面健康和心理社会后果的高风险人群。在……里面 特别是，叶诗文中的物质使用和物质使用障碍的患病率非常高。 尽管如此，只有少数患有物质使用障碍的叶诗文接受了某种形式的物质使用 治疗。这可能是由于接受治疗的多重障碍，包括缺乏感知的需求， 运输和后勤困难，以及缺乏保险或支付能力。对于叶莉来说，谁收到了 物质使用治疗，研究表明，各种物质使用干预措施可能是有效的， 尽管到目前为止，研究主要是在临时收容中心和庇护所进行的。几乎没有什么 现有的研究使用全国性的治疗数据集或定性方法来描述独特的 叶氏病的特点或治疗结果。提出的论文研究使用了一种生态-- 在18-25岁的初出茅庐的成年人中调查这些问题的发展方法 无家可归。这一年龄段占美国发展理论如风险等的89% 放大模型认为，叶诗文在成为 无家可归，这些逆境与危险的健康行为和有害的发育有关 结果。此外，新兴成年期理论认为，年轻人(18-25岁)是 具有更大的独立性、不稳定性和为成人角色做准备的机会的时期。 新出现的成人因素，如更大的独立性和同龄人的影响，被用来解释 在这一阶段增加了物质的使用。然而，新兴的成人论很少被用来 向叶教授通报研究情况。这项拟议的研究有三个目标。目标1和目标2将使用量化 分析全国性的治疗数据集(全球个体需求评估)。目标1将描述 最近无家可归的流行情况，并确定新兴成年人经历的独特特征 物质使用治疗中的无家可归现象。目标2将研究住房与住房之间的纵向联系 药物使用期间和之后的稳定性、生态发展因素和药物使用结果 治疗。目标3将利用对满足物质使用的新兴成年叶的深入定性访谈 加州洛杉矶的障碍标准(n=10)和无家可归的青年服务提供者(n=10)。一起， 这项研究将扩大关于以下物质使用结果的需求、特征和结果的知识 新兴的成人叶氏治疗，允许制定量身定制的治疗和住房干预措施。 此外，PI将接受高级纵向数据分析、混合方法研究、 对无家可归的新兴成年人口的经验，以及职业发展。

PROJECT SUMMARY/ABSTRACT In the United States, it is estimated that 1 in 30 adolescents and 1 in 10 young (“emerging”) adults experienced homelessness in the past year. Collectively, youth experiencing homelessness (YEH) are a highly vulnerable population who are at high risk of experiencing multiple negative health and psychosocial outcomes. In particular, the prevalence of substance use and substance use disorders among YEH is exceedingly high. Despite this, only a minority of YEH with substance use disorders have received some form of substance use treatment. This may be due to multiple barriers to receiving treatment, including lack of perceived need, transportation and logistical difficulties, and lack of insurance or ability to pay. For YEH who do receive substance use treatment, research indicates that a variety of substance use interventions may be effective, although research to date has largely been conducted in drop-in center and shelter settings. There is little research available that uses nationwide treatment data sets or qualitative methods to describe the unique characteristics or treatment outcomes of YEH. The proposed dissertation research uses an ecological- developmental approach to investigate these issues among emerging adults (18-25) experiencing homelessness. This age group makes up 89% of YEH in the U.S. Developmental theory such as the Risk Amplification Model posits that YEH have experienced multiple adversities before and after becoming homeless, and that these adversities are associated with risky health behaviors and harmful developmental outcomes. Furthermore, the Theory of Emerging Adulthood posits that the young adult years (ages 18-25) are a period characterized by greater independence, instability, and opportunity to prepare for adult roles. Emerging adult factors such as greater independence and peer influences have been used to explain heightened substance use during this stage. However, emerging adulthood theory has rarely been used to inform research with YEH. The proposed research has three aims. Aims 1 and 2 will utilize quantitative analysis of a nationwide treatment data set (the Global Appraisal of Individual Needs). Aim 1 will describe the prevalence of recent homelessness and identify the unique characteristics of emerging adults experiencing homelessness in substance use treatment. Aim 2 will examine longitudinal associations between housing stability, ecological-developmental factors, and substance use outcomes during and after substance use treatment. Aim 3 will utilize in-depth qualitative interviews with emerging adult YEH who meet substance use disorder criteria (n = 10) and homeless youth service providers (n = 10) in Los Angeles, California. Together, this research will expand knowledge regarding the needs, characteristics and substance use outcomes of emerging adult YEH in treatment, allowing for the development of tailored treatment and housing interventions. In addition, the PI will receive training in advanced longitudinal data analysis, mixed-methods research, experience with homeless emerging adult populations, and professional development.