Community Impact on Adoption of Sober Living Houses

描述（由申请人提供）：缺乏负担得起的，物质使用障碍的个人无物质住房对公共卫生系统具有重大意义。研究表明，这些人中的许多人无家可归，成为医疗保健，社会福利和刑事司法系统的负担。有稳定住所的药物滥用者通常居住在支持药物使用而不是禁欲的环境中。清醒的生活之家（SLH）是酒精和药物免费的生活环境，是一个很好的，但未充分利用的选择，这些人。我们目前对SLH的研究表明，居民在一系列领域都有改善，包括药物和酒精使用，就业和逮捕（Polcin &亨德森，2008）。这项R21（探索性）研究将结合联合收割机定量、定性和架构方法，以了解社区对在一个成功建立的社区中采用这一有前途的创新的影响。我们的理由是，将有希望的干预措施转化为社区服务需要的不仅仅是展示积极的成果。还必须考虑到采取干预措施的社会背景，特别是各利益攸关方的知识水平、态度和认识到的障碍。本研究将通过三角研究方法和来源评估社区对SLH的看法。该研究的一个组成部分将包括对150名人类服务专业人员的调查，使用自我报告问卷评估对SLH的态度和信念。第二部分将包括与16位SLH经理的深入访谈，以探讨他们对社区利益相关者如何影响SLH、当前和过去的障碍以及如何克服障碍的看法。我们还将采访6个目标SLH的邻居（n=20），以调查问题的另一面：SLH如何影响社区。将与当地住房、卫生部门和城市管理人员（n=9）进行关键信息提供者访谈。这些访谈将针对影响SLH的政策和政治力量的信息。研究的第三个组成部分将包括对房屋进行建筑评估，以了解物理和空间特征如何直接和间接影响利益攸关方群体。假设解决利益相关者的SLH的看法以及感知的障碍。定量分析将包括OLS和逻辑回归模型。定性分析将使用修改的扎根理论方法。结果描绘共同的和不同的主题的支持和障碍，以SLH内和跨利益相关者群体将被描述。因此，这项研究将提供信息，以指导翻译工作的内容，并确定这些努力是最需要的。它还将确定支持SLH的来源，倡导者可以使用这些来源来支持其扩展。对于那些缺乏有关SLH信息的人，可能需要不同的策略，相信他们是无效的，对其他治疗方法有异议，有观点认为恢复中的社会因素最小化，以及生活在公共政策阻碍SLH扩展的社区。 公共卫生相关性：这项研究将增加对如何评估社区背景因素的理解，这些因素影响基于研究的干预措施是否成功地转化为社区。从我们的案例研究的结果在一个社区，他们已经蓬勃发展的SLH将提供数据，可用于在其他社区的SLH的发展和翻译有关SLH的知识向公众。研究结果还将说明不同利益相关者群体的不同观点可能需要不同类型的知识翻译。

DESCRIPTION (provided by applicant): Lack of affordable, substance-free housing for individuals with substance use disorders has major significance for public health systems. Research shows many of these individuals experience homelessness and become burdens to healthcare, social welfare, and criminal justice systems. Substance abusers who do have stable housing often reside in environments that support substance use rather than abstinence. Sober Living Houses (SLHs) are alcohol and drug free living environments that are an excellent, yet underutilized option for these individuals. Our current study of SLHs suggests that residents make improvement in a range of areas, including drug and alcohol use, employment, and arrests (Polcin & Henderson, 2008). This R21 (Exploratory) study will combine quantitative, qualitative, and architectural methods to understand community influences on adoption of this promising innovation in one community where it has been successfully established. Our rationale posits that translating promising interventions into community services requires more than demonstrating positive outcomes. The social context within which interventions are delivered must also be considered, particularly the level of knowledge, attitudes, and perceived barriers of various stakeholders. This study will assess community perceptions of SLHs by triangulating study methods and sources. One component of the study will include a survey of 150 human service professionals using self report questionnaires that assess attitudes and beliefs about SLHs. A second component will include in depth interviews with 16 SLH managers to explore their views on how community stakeholders influence SLHs, current and past barriers, and how barriers have been overcome. We will also interview neighbors (n=20) of 6 targeted SLHs to investigate the other side of the question: how SLHs have impacted the community. Key informant interviews will be conducted with local housing, health department, and city manager administrators (n=9). These interviews will target information about policy and political forces that have impacted SLHs. A third component of the study will include an architectural assessment of the houses to understand how physical and spatial characteristics directly and indirectly affect stakeholder groups. Hypotheses address stakeholder perceptions of SLHs as well as perceived barriers. Quantitative analysis will include OLS and logistic regression models. Qualitative analysis will use a modified grounded theory approach. Results depicting common and disparate themes of support for and barriers to SLHs within and across stakeholder groups will be described. Thus, the study will provide information to guide the content of translational efforts and identify where such efforts are needed most. It will also identify sources of support for SLHs that advocates can use to support their expansion. Different strategies may be needed for those who lack information about SLHs, have beliefs that they are not effective, have allegiances to other treatment approaches, have views that minimize social factors in recovery, and live in communities where public policy hinders expansion of SLHs. PUBLIC HEALTH RELEVANCE: This study will increase understanding about how to assess community context factors that impact whether research based interventions are successfully translated into the community. Results from our case study of SLHs in one community where they have flourished will provide data that can be used in the development of SLHs in other communities and translation of knowledge about SLHs to the public. Research findings will also illustrate how the different perspectives of different stakeholder groups may require different types of knowledge translation.