Enhancing Housing First Programs With a Social Network Substance Use Intervention

NCT ID: NCT02140359

Last Updated: 2017-11-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-06-30
• Study Completion Date: 2017-07-31

Brief Summary

Housing First programs are promising approaches to transitioning substance using chronically homeless adults to affordable housing. However, Housing First programs need to provide support to residents to adjust to their changing social environments. The proposed project fulfills a critical gap by developing an electronic tool for a social network intervention using motivational interviewing techniques as well as results of a pilot test of the tool. The hypothesis to be tested is that Housing First residents who are given the intervention will be significantly more motivated to change their drinking, drug use, sexual risk behaviors, and social networks compared to controls receiving usual care.

Detailed Description

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.

Conditions

Alcohol Drinking; Drug Abuse; HIV

Keywords

homelessness; housing first; social networks; drug abuse; alcohol use; HIV

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Control Group: Usual Care

Residents of a housing first permanent supporting housing program will be randomly assigned to this arm after screening and baseline assessments. They will meet with case managers according to the usual procedures for new residents and will be given a standard case manager interaction.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Motivational Network Interview Recipients

Residents of a housing first permanent supporting housing program will be randomly assigned to this arm after screening and baseline assessments. They will meet roughly every two weeks with a case manager and answer questions about their social network, will be shown visual feedback about their networks, and will participate in a motivational interview conducted by the case managers. The questions and visualizations will be facilitated by an electronic tool for presenting screens with questions, capturing responses, processing and visualizing social network data.

Group Type: EXPERIMENTAL

Motivational Network Interview

Intervention Type: BEHAVIORAL

Residents of a housing first permanent supporting housing program will be randomly assigned to this arm after screening and baseline assessments. They will meet roughly every two weeks with a case manager and answer questions about their social network, will be shown visual feedback about their networks, and will participate in a motivational interview conducted by the case managers. The questions and visualizations will be facilitated by an electronic tool for presenting screens with questions, capturing responses, processing and visualizing social network data.

Interventions

Motivational Network Interview

Residents of a housing first permanent supporting housing program will be randomly assigned to this arm after screening and baseline assessments. They will meet roughly every two weeks with a case manager and answer questions about their social network, will be shown visual feedback about their networks, and will participate in a motivational interview conducted by the case managers. The questions and visualizations will be facilitated by an electronic tool for presenting screens with questions, capturing responses, processing and visualizing social network data.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• New residents of Skid Row Housing Trust receiving permanent supportive housing

Exclusion Criteria

• Age younger than 18
• Does not speak English
• Cognitively impaired either by identifying those having a diagnosis of dementia in the new resident intake interview or using the Short Blessed Scale Exam)
• Does not screen positive for past -year harmful AOD use using the AUDIT-C (a score > 4 for men and > 3 for women) and DAST (a score greater than 2).

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

RAND

OTHER

Sponsor Role: lead

Responsible Party

David Kennedy

Behavioral / Social Scientist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

David P Kennedy, PhD

Role: PRINCIPAL_INVESTIGATOR

RAND

Locations

Skid Row Housing Trust

Los Angeles, California, United States

RAND Corporation

Santa Monica, California, United States

Countries

United States

References

Kennedy DP, Osilla KC, Hunter SB, Golinelli D, Maksabedian Hernandez E, Tucker JS. Restructuring personal networks with a Motivational Interviewing social network intervention to assist the transition out of homelessness: A randomized control pilot study. PLoS One. 2022 Jan 21;17(1):e0262210. doi: 10.1371/journal.pone.0262210. eCollection 2022.

Reference Type: DERIVED

PMID: 35061795 (View on PubMed)

Osilla KC, Kennedy DP, Hunter SB, Maksabedian E. Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents. Addict Sci Clin Pract. 2016 Sep 7;11(1):14. doi: 10.1186/s13722-016-0061-x.

Reference Type: DERIVED

PMID: 27604543 (View on PubMed)

Kennedy DP, Hunter SB, Chan Osilla K, Maksabedian E, Golinelli D, Tucker JS. A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents. Addict Sci Clin Pract. 2016 Mar 15;11(1):4. doi: 10.1186/s13722-016-0052-y.

Reference Type: DERIVED

PMID: 26979982 (View on PubMed)

Other Identifiers

R34DA034855

Identifier Type: NIH

Identifier Source: org_study_id

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