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评估一项针对无家可归且患有精神健康问题的物质使用者的过渡性住房项目:安大略省萨德伯里的一项混合方法研究方案

Evaluating a transitional housing program for people who use substances (PWUS) who experience homelessness and live with a mental health issue: a mixed-methods study protocol in Sudbury Ontario.

作者信息

Morin Kristen A, Molke Daniel, Aubin Natalie, Knowlan Shannon, Leary Tara

机构信息

Health Sciences North, Sudbury, ON, Canada.

ICES North (Institute for Clinical and Evaluative Sciences), Sudbury, ON, Canada.

出版信息

BMC Health Serv Res. 2024 Dec 4;24(1):1546. doi: 10.1186/s12913-024-12027-3.

Abstract

BACKGROUND

A new transitional housing program was established in Sudbury, Ontario, Canada, in response to the escalating global prevalence of substance use and homelessness, and the specific challenges faced in Northern Ontario. This protocol outlines a comprehensive program evaluation to assess its impact on patient outcomes, healthcare utilization, and client perspectives.

METHODS

We will conduct a parallel mixed-method study that includes the analysis of single-center-level administrative health data and primary data collection. This includes a longitudinal observational study (target n = 1,200), pre- and post-admission quantitative interviews (target n = 40), and qualitative interviews (target n = 40). We will implement a participatory approach to this evaluation collaborating with people who use substances, frontline staff, and decision-makers. Data analysis methods include a range of statistical techniques, including logistic regression models, Cox proportional hazards models, Kaplan-Meier curves, Generalized Estimating Equations, and thematic qualitative analysis, ensuring a robust evaluation of patient outcomes and healthcare utilization.

DISCUSSION

This protocol underpins a comprehensive assessment aimed at providing insights into the program's effectiveness in addressing substance use-related challenges, reducing healthcare disparities, and improving patient outcomes, such as stable housing and increased social capital. All study procedures adhere to the ethical principles outlined in the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. Findings will be disseminated progressively through established committees and working groups and subsequently published in peer-reviewed journals. Anticipated outcomes include informing evidence-based healthcare decision-making and driving improvements in addiction treatment practices within healthcare settings.

摘要

背景

鉴于全球物质使用和无家可归现象日益普遍,以及安大略省北部面临的特定挑战,加拿大安大略省萨德伯里市设立了一项新的过渡性住房计划。本方案概述了一项全面的项目评估,以评估其对患者结局、医疗保健利用情况和客户观点的影响。

方法

我们将进行一项平行混合方法研究,包括对单中心层面的行政健康数据进行分析以及收集原始数据。这包括一项纵向观察性研究(目标样本量n = 1200)、入院前和入院后的定量访谈(目标样本量n = 40)以及定性访谈(目标样本量n = 40)。我们将采用参与式方法进行此次评估,与物质使用者、一线工作人员和决策者合作。数据分析方法包括一系列统计技术,如逻辑回归模型、Cox比例风险模型、Kaplan-Meier曲线、广义估计方程以及主题定性分析,以确保对患者结局和医疗保健利用情况进行有力评估。

讨论

本方案为一项全面评估提供了基础,旨在深入了解该计划在应对与物质使用相关的挑战、减少医疗保健差距以及改善患者结局(如稳定住房和增加社会资本)方面的有效性。所有研究程序均遵循三理事会政策声明《涉及人类的研究的伦理行为》中概述的伦理原则。研究结果将通过既定的委员会和工作组逐步传播,随后发表在同行评审期刊上。预期成果包括为基于证据的医疗保健决策提供信息,并推动医疗保健环境中成瘾治疗实践的改进。

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