Building Social and Structural Connections for the Prevention of Opioid Use Disorder Among Youth Experiencing Homelessness
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Motivational Interviewing/Community Reinforcement Approach (MI/CRA), Strengths-Based Outreach and Advocacy (SBOA ), Services as Usual (SAU).
- Who it may be relevant to
- Registry conditions: Opioid Use Disorder, Dual Diagnosis, Housing Problems, Mental Disorder in Adolescence. Basic parameters: 14 years — 24 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Building Social and Structural Connections for the Prevention of Opioid Use Disorder Among Youth Experiencing Homelessness: An RCT Examining Biopsychosocial Mechanisms
Overview
Homelessness severely affects health and well-being and is particularly negative for youth. Between 70-95% of youth experiencing homelessness (YEH) report problem substance use and 66-89% have a mental health disorder. Youth appear to be at greater risk for living on the streets or being homeless than adults and are more vulnerable to long term consequences of homelessness. Multiple social determinants of health (SDOH) are uniquely associated with homelessness, driving substance use and adverse mental health consequences. However, limited research has identified pragmatic interventions that have a long-term ameliorating impact on the complex, multi-symptomatic issues among these youth. This study overcomes prior gaps in research through testing a multi-component comprehensive prevention intervention targeting SDOH that may affect biopsychosocial health indicators and longer-term health outcomes. In partnership with a drop-in center for YEH, youth between the ages of 14 to 24 years, will be engaged and randomly assigned to conditions using a dismantling design so that essential intervention components can be efficiently identified. In particular, youth (N = 300) will be randomly assigned to a) Motivational Interviewing/Community Reinforcement Approach + Services as Usual (MI/CRA + SAU, n = 80), b) Strengths-Based Outreach and Advocacy + Services As Usual (SBOA + SAU, n = 80), c) MI/CRA + SBOA + SAU (n = 80) or d) SAU (n=60) through the drop-in center. In order to assess the longer-term prevention effects on substance use, mental health and other outcomes, all youth will be assessed at baseline and at 3, 6, 12, 18 and 24-months post-baseline. The primary goal of this study is to establish the impact of a comprehensive intervention embedded within a system that serves YEH, a community drop-in center, on youth's opioid misuse and disorder, other substance misuse and disorders, mental health diagnoses, and other targeted outcomes. This study will offer unique information on the physiological and psychological stress pathways underlying change for specific subgroups of youth along with cost estimates to inform future implementation efforts in drop-in centers around the country.
Detailed description
Specific Aim 1. Using a dismantling randomized design, compare intervention conditions to determine those components essential for optimizing substance use and mental health: a) Strengths-Based Outreach and Advocacy (SBOA), b) Motivational Interviewing (MI)/Community Reinforcement Approach (CRA), c) SBOA+MI/CRA, and d) Services As Usual (SAU). Hypothesis. Youth assigned to SBOA+MI/CRA will show better short and long-term outcomes on Opioid Use Disorder prevention and on other substance use and mental health outcomes than youth assigned to either intervention alone or Services As Usual.
Specific Aim 2. Test whether intended change processes (social stability, psychosocial resources, stress) produce the desired change on substance use and mental health. Hypothesis. Inasmuch as the interventions trigger successful increases in social stability and psychosocial resources and reductions in stress, targeted outcomes will improve.
Specific Aim 3. Explore how the moderators of age, sex, race/ethnicity, sexual/gender minority status, and experience of childhood abuse and neglect influence intervention response.
Specific Aim 4. Determine cost effectiveness of the intervention approaches.
Interventions
- Behavioral Motivational Interviewing/Community Reinforcement Approach (MI/CRA)
MI/CRA includes two Motivational Interviewing sessions and twelve 1-hour Community Reinforcement Approach sessions. - Behavioral Strengths-Based Outreach and Advocacy (SBOA )
The number of Strengths-Based Outreach and Advocacy sessions participants will receive are flexibly determined based upon youth needs. - Behavioral Services as Usual (SAU)
Participants assigned to this group will receive the standard services provided to all youth involved with the drop-in center.
Primary outcome measures
- Form 90 Substance Use interview [Time frame: Administered at baseline, and 3-, 6-, and 12-, 18-, and 24-months post intervention.]
- Shortened Inventory of Problems - Alcohol and Drugs (SIP-AD) [Time frame: Administered at baseline, and 3-, 6-, and 12-, 18-, and 24-months post intervention.]
- Presence of drugs of abuse [Time frame: Administered at baseline, and 3-, 6-, and 12-, 18-, and 24-months post intervention.]
- Beck Depression Inventory II (BDI-II) [Time frame: Administered at baseline, and 3-, 6-, and 12-, 18-, and 24-months post intervention.]
- Beck Anxiety Inventory (BAI) [Time frame: Administered at baseline, and 3-, 6-, and 12-, 18-, and 24-months post intervention.]
- Short Form-12 [Time frame: Administered at baseline, and 3-, 6-, and 12-, 18-, and 24-months post intervention.]
Eligibility criteria
Inclusion criteria
- Youth must meet the criteria for homelessness as defined by the McKinney-Vento Act: children and youth who lack a fixed, regular, and adequate nighttime residence; or live in a welfare hotel, or place without regular sleeping accommodations, or live in a shared residence with other persons due to the loss of one's housing or economic hardship
- Must speak english adequately to complete measures
Exclusion criteria
- Youth who have a stable housing situation.
- Non-English speaker
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
United States · 2 centers
- Star House — Columbus
- Ohio State University — Columbus
Publications
- Ford J, Slesnick N, Browning C, Feng X, Yilmazer T, Boettner B, Luthy J, Fitzpatrick M, Pinkus L, Holowacz E, Hang C. Building social and structural connections for the prevention of opioid use among youth experiencing homelessness: study protocol for a randomized controlled trial. BMC Public Health. 2026 Jul 15. doi: 10.1186/s12889-026-28177-4. Online ahead of print. PMID 42449276
Identifiers
NCT: NCT06311838 · 2023H0244