Housing First Model Fidelity and Implications for Substance Abuse Treatment

描述(由申请人提供)：住房优先是一种为患有药物使用障碍和严重精神疾病双重诊断的无家可归者提供服务的模式。虽然该模式与客户获得更高的药物滥用治疗机会有关，但人们认识到，在进一步调查住房优先方案与药物滥用治疗之间的联系之前，需要对其基本要素作出更明确的定义。以下申请请求支持博士论文研究，其目的是：(1)定义住房优先模式的基本组成部分；(2)开发住房优先规划的保真度指数；(3)测试最终的保真度指数的可靠性和有效性；以及(4)评估保真度预测客户获得更好的药物滥用治疗机会的程度。该研究试图通过分三个阶段开展的活动来实现这些目标。在第一阶段，与住房优先组织的工作人员和客户的面谈将确定该模式的核心要素。在第二阶段，将与住房优先专家进行访谈，以创建最终的保真度指数。最后阶段将通过将机构保真度分数与住房保留和来自住房组织的客户治疗访问数据相关联来评估该模型。 公共卫生相关性：住房优先模式以人权和公共卫生原则为基础。关于药物滥用，“住房优先”寻求帮助个人按照自己的条件进行治疗，以此作为获得更好的治疗结果的手段。该项目力求通过制定一个保真度指数来推动对住房优先模式的研究，以便更有力地衡量住房优先方案的执行和评估目的。

DESCRIPTION (provided by applicant): Housing First is a model for serving homeless individuals with dual diagnoses of substance use disorder and serious mental illness. While model has been associated with higher substance abuse treatment access for clients, it has been recognized that stronger definitions of its essential elements are needed before further investigation into the association between Housing First programming and substance abuse treatment can be carried out. The following application requests support for doctoral dissertation research that aims to: (1) define the essential components of the Housing First model; (2) develop a fidelity index for Housing First programming; (3) test the finalized fidelity index for reliability and validity; and (4) assess the degree to which fidelity predicts improved substance abuse treatment access for clients. The study seeks to address these aims through activities carried out in three phases. In the first phase interviews with staff and clients from Housing First organizations will define the core essential elements of the model. In the second phase, interviews with Housing First experts will be conducted to create a finalized fidelity index. The final phase will assess the model by correlating agency fidelity scores with housing retention and client treatment access data from housing organizations. PUBLIC HEALTH RELEVANCE: The Housing First model is based on human rights and public health principles. In relation to substance abuse, Housing First seeks to assist individuals to engage in treatment on their own terms as a means to obtaining stronger treatment outcomes. This project seeks to advance research on the Housing First model by developing a fidelity index that will allow for stronger measurement of Housing First programming for implementation and evaluation purposes.