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“在家/在自己家中”试验方案:一项针对加拿大五个城市患有精神疾病的无家可归者的“住房优先”干预措施的务实、多地点随机对照试验。

The At Home/Chez Soi trial protocol: a pragmatic, multi-site, randomised controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities.

作者信息

Goering Paula N, Streiner David L, Adair Carol, Aubry Tim, Barker Jayne, Distasio Jino, Hwang Stephen W, Komaroff Janina, Latimer Eric, Somers Julian, Zabkiewicz Denise M

机构信息

Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2011 Nov 14;1(2):e000323. doi: 10.1136/bmjopen-2011-000323. Print 2011.

Abstract

Introduction Housing First is a complex housing and support intervention for homeless individuals with mental health problems. It has a sufficient knowledge base and interest to warrant a test of wide-scale implementation in various settings. This protocol describes the quantitative design of a Canadian five city, $110 million demonstration project and provides the rationale for key scientific decisions. Methods A pragmatic, mixed methods, multi-site field trial of the effectiveness of Housing First in Vancouver, Winnipeg, Toronto, Montreal and Moncton, is randomising approximately 2500 participants, stratified by high and moderate need levels, into intervention and treatment as usual groups. Quantitative outcome measures are being collected over a 2-year period and a qualitative process evaluation is being completed. Primary outcomes are housing stability, social functioning and, for the economic analyses, quality of life. Hierarchical linear modelling is the primary data analytic strategy. Ethics and dissemination Research ethics board approval has been obtained from 11 institutions and a safety and adverse events committee is in place. The results of the multi-site analyses of outcomes at 12 months and 2 years will be reported in a series of core scientific journal papers. Extensive knowledge exchange activities with non-academic audiences will occur throughout the duration of the project. Trial registration number This study has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374.

摘要

引言 “住房优先” 是一项针对有心理健康问题的无家可归者的综合住房与支持干预措施。它有足够的知识基础和关注度,值得在各种环境中进行大规模实施测试。本方案描述了一个在加拿大五个城市开展的、耗资1.1亿加元的示范项目的定量设计,并为关键科学决策提供了理论依据。方法 在温哥华、温尼伯、多伦多、蒙特利尔和蒙克顿对 “住房优先” 的有效性进行一项务实的、混合方法、多地点现场试验,将约2500名参与者按高需求和中等需求水平分层,随机分为干预组和常规治疗组。在两年期间收集定量结果指标,并完成定性过程评估。主要结果指标是住房稳定性、社会功能,以及用于经济分析的生活质量。分层线性建模是主要的数据分析策略。伦理与传播 已获得11个机构的研究伦理委员会批准,并设立了一个安全与不良事件委员会。12个月和2年时多地点结果分析的结果将在一系列核心科学期刊论文中报告。在项目期间将与非学术受众开展广泛的知识交流活动。试验注册号 本研究已在国际标准随机对照试验编号注册库注册,注册号为ISRCTN42520374。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a1/3221290/1778a8b9714b/bmjopen-2011-000323fig1.jpg

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