Author/Authors :
Slesnick, Natasha Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Chavez, Laura Center for Innovation in Pediatric Practice - The Abigail Wexner Research Institute At Nationwide Children’s Hospital - 700 Children’s Drive, Columbus, USA , Bunger, Alicia College of Social Work - The Ohio State University, Columbus, USA , Famelia, Ruri Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Ford, Jodi College of Nursing - The Ohio State University, Columbus, USA , Feng, Xin Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Higgins, Sarah Center for Innovation in Pediatric Practice - The Abigail Wexner Research Institute At Nationwide Children’s Hospital - 700 Children’s Drive, Columbus, USA , Holowacz, Eugene Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Jaderlund, Soren Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Luthy, Ellison Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Mallory, Allen Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Martin, Jared Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Walsh, Laura Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Yilmazer, Tansel Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA , Kelleher, Kelly Department of Human Sciences -College of Education and Human Ecology - The Ohio State University, Columbus, USA
Abstract :
Background
Homeless youth experience high rates of substance use disorders, exposures to violence, mental and physical health conditions, and mortality. They have been particularly affected by the opioid crisis. However, no study to date has used a randomized controlled design to test preventive interventions of opioid and other drug use among this vulnerable population. Resolution of youth homelessness through housing and supportive services including prevention services, often referred to as “Housing First,” has great potential to reduce the likelihood for the development of an opioid use disorder as well as other problem behaviors associated with living on the streets. Housing First has been tested through randomized trials among homeless adults with mental health and substance use disorders, but has not been empirically tested for opioid prevention among homeless youth.
Methods
Homeless youth will be recruited from a drop-in shelter site frequented by disconnected youth; they will be screened for eligibility, including current homelessness, age 18–24 years, and not currently meeting criteria for opioid use disorder (OUD). In a controlled trial, 240 youth will then be randomized to one of two conditions, (1) housing + opioid and related risk prevention services, or (2) opioid and related risk prevention services alone. This project utilizes existing efficacious models of prevention to address opioid-related risks, including motivational interviewing, strengths-based outreach and advocacy, and an HIV risk preventive intervention. Follow-up will be conducted at 3, 6, 9 and 12-months post-baseline. The economic cost of each intervention will be determined to support implementation decisions with other providers and their funders.
Discussion
This study will provide essential information for researchers and providers on the efficacy of housing + opioid and related risk prevention services in an RCT for effects on opioid use and mechanisms underlying change. Because youth experiencing homelessness are at increased risk for a variety of adverse outcomes, the proposed intervention may produce substantial health care benefits to the youths and society at large.
Trial registration ClinicalTrials.gov, NCT04135703, Registered October 13, 2019, https://clinicaltrials.gov/ct2/show/NCT04135703?term=NCT04135703&draw=2&rank=1#contacts
