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尝试对即将离开无家可归状态的青年进行关键时间干预的可行性。

Trialing the feasibility of a critical time intervention for youth transitioning out of homelessness.

机构信息

Department of Psychiatry.

Centre for Addiction and Mental Health.

出版信息

Am J Orthopsychiatry. 2020;90(5):535-545. doi: 10.1037/ort0000454. Epub 2020 Apr 20.

Abstract

Little is known regarding the specific types of service models and collaborations that are necessary to support diverse populations of youth in transition out of homelessness. Transitional supports addressing the complex needs of this population are needed to stabilize the array of housing arrangements that youth access. This study was a pilot randomized controlled trial of one such critical time intervention, called the Housing Outreach Program-Collaboration (HOP-C). HOP-C is a multicomponent, multidisciplinary intervention that provides 6 months of mental health and peer support, along with transitional case management to youth who have transitioned into some form of stable housing out of homelessness. In this trial, 65 youth were randomized to receive HOP-C plus treatment as usual or transitional case management plus treatment as usual. Outcome assessments were completed by 30 treatment and 28 control participants. The findings suggest that this intervention is feasible with mental health, employment or education, and housing metrics favoring HOP-C with odds ratios ranging from 2.28 to 3.18 and better subjective housing stability. Other indicators showed less change. HOP-C appears feasible and should be tested in a fully powered trial, providing the intervention for a duration longer than 6 months. Overall, these data suggest the potential benefit in fostering city-level, multidisciplinary teams sourced from several organizations to support youth transitioning out of homelessness. Pragmatic trial method considerations for this population are also addressed as are the ethical considerations pertinent to engaging highly marginalized youth in clinical trials. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

关于支持处于无家可归状态过渡阶段的不同青年群体所需的特定服务模式和合作类型,人们知之甚少。需要解决这一人群复杂需求的过渡性支持,以稳定青年获得的各种住房安排。这项研究是对一种称为住房外联计划合作(HOP-C)的关键时间干预措施的试点随机对照试验。HOP-C 是一种多组分、多学科的干预措施,为已经过渡到某种形式的稳定住房的无家可归青年提供 6 个月的心理健康和同伴支持,以及过渡性个案管理。在这项试验中,65 名青年被随机分配接受 HOP-C 加常规治疗或过渡性个案管理加常规治疗。有 30 名治疗参与者和 28 名对照参与者完成了结果评估。研究结果表明,该干预措施具有可行性,在心理健康、就业或教育以及住房指标方面,HOP-C 的优势比范围在 2.28 至 3.18 之间,主观住房稳定性更好。其他指标显示变化较小。HOP-C 似乎可行,应该在一项全面的试验中进行测试,为青年提供超过 6 个月的干预。总的来说,这些数据表明,培养由多个组织组成的城市层面的多学科团队,以支持青年过渡到无家可归状态,具有潜在的好处。还讨论了针对这一人群的实用试验方法考虑因素,以及与参与高度边缘化青年临床试验相关的伦理考虑因素。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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