Clinical trial NCT02140359: Enhancing Housing First Programs With a Social Network Substance Use Intervention
Official title: Enhancing Housing First Programs With a Social Network Substance Use Intervention
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Alcohol Drinking
Drug Abuse
HIV
Keywords: homelessness
housing first
social networks
drug abuse
alcohol use
HIV
Lead sponsor: RAND
Sponsor class: OTHER
First posted: 2014-05-16
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

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.

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).

Primary outcomes:
measure: Readiness to change alcohol and other drug use
timeFrame: Baseline and 13-14 weeks (post intervention)
measure: Readiness to change risky sexual behavior
timeFrame: Baseline and 13-14 weeks (post intervention)
measure: Self efficacy to change alcohol and other drug use
timeFrame: Baseline and 13-14 weeks (post intervention)
measure: Self efficacy to change risky sexual behavior
timeFrame: Baseline and 13-14 weeks (post intervention)
measure: Self-efficacy to change social networks
timeFrame: Baseline and 13-14 weeks (post intervention)
measure: Perceived Social Network support and approval/disapproval of alcohol, drug use, and risky sex.
timeFrame: Baseline and 13-14 weeks (after intervention)
Secondary outcomes:
measure: Drug and Alcohol use
timeFrame: Baseline and 13-14 weeks (after intervention is completed)
measure: HIV risk behavior
timeFrame: baseline and 13-14 weeks (after intervention completion)
measure: Change in social network composition and structure
timeFrame: baseline and 13-14 weeks (after intervention completion)
Other outcomes:
measure: Satisfaction with Intervention
timeFrame: 13-14 weeks (after intervention)
Locations:
city: Los Angeles
country: United States
facility: Skid Row Housing Trust
state: California
city: Santa Monica
country: United States
facility: RAND Corporation
state: California
Study officials:
affiliation: RAND
name: David P Kennedy, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.
citation: 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.
citation: 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.